What the FDA labels say about taking them together
Buspirone and levomilnacipran
Levomilnacipran's FDA label of April 30, 2024 names buspirone in its drug interactions section; buspirone's label does not name levomilnacipran itself but warns about its class (SNRIs (serotonin and norepinephrine reuptake inhibitors)). The levomilnacipran label: “Concomitant use of FETZIMA with other serotonergic drugs increases the risk of serotonin syndrome.”
Check it at the source: the buspirone FDA label on DailyMed (effective December 22, 2023, Unichem Pharmaceuticals (USA), Inc.); the levomilnacipran FDA label on DailyMed (effective April 30, 2024, Allergan, Inc.).
What does the buspirone label say about levomilnacipran?
Buspirone's label does not name levomilnacipran itself; it warns about its class (SNRIs (serotonin and norepinephrine reuptake inhibitors)):
Buspirone label, warningsSerotonin Syndrome The development of a potentially life-threatening serotonin syndrome has been reported with SNRIs, SSRIs, and other serotonergic drugs, including buspirone, alone but particularly with concomitant use of other serotonergic drugs (including triptans), with drugs that impair metabolism of serotonin (in particular, MAOIs, including reversible MAOIs such as linezolid and intravenous methylene blue), or with antipsychotics or other dopamine antagonists.
Source: FDA drug label (Buspirone Hydrochloride), Unichem Pharmaceuticals (USA), Inc., effective December 22, 2023 (SPL set a6bdf140-075e-445e-a62d-633a4b97f3a8), via openFDA; the full label on DailyMed
What does the levomilnacipran label say about buspirone?
Levomilnacipran label, drug interactionsClinical Impact: Concomitant use of FETZIMA with other serotonergic drugs increases the risk of serotonin syndrome. … Precautions ( 5.2 ) ]. Examples: other SNRIs, SSRIs, triptans, tricyclic antidepressants, opioids, lithium, buspirone, amphetamines, tryptophan, and St. John's Wort Drugs that Interfere with Hemostasis
Levomilnacipran label, warnings and precautionsThe risk is increased with concomitant use of other serotonergic drugs (including triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, meperidine, methadone, tryptophan, buspirone, amphetamines, and St. John’s Wort) and with drugs that impair metabolism of serotonin, i.e., MAOIs [see Contraindications ( 4 ), Drug Interactions ( 7.1 )].
Source: FDA drug label (Fetzima), NDA204168 (Abbvie), as published by Allergan, Inc., effective April 30, 2024 (SPL set f371258d-91b3-4b6a-ac99-434a1964c3af), via openFDA; the full label on DailyMed
These are the labels' own sentences. PlainMeds does not grade interactions; a pharmacist or prescriber can say what they mean for one person's medicines.
Both medicines on the record
| Buspirone | Levomilnacipran | |
|---|---|---|
| Labeled for | Anxiety | Depression |
| Boxed warning | No | Yes |
| Pharmacy cost (NADAC) | $0.043 per tablet 15 mg tablet | $17.61 per unit 20-40 mg titration pak |
| Shortage now | No current entry | No current entry |
Source: FDA NDC Directory, CMS NADAC of October 7, 2026 and the FDA Drug Shortage Database (FDA files October 8, 2026)
What next?
- Check more medicines together
- up to five at once