What the FDA labels say about taking them together
Levomilnacipran and selegiline
Levomilnacipran's FDA label of April 30, 2024 names selegiline in its drug interactions section; selegiline's label does not name levomilnacipran itself but warns about its class (SNRIs (serotonin and norepinephrine reuptake inhibitors)). The levomilnacipran label: “Concomitant use of SSRIs and SNRIs including FETZIMA with MAOIs increases the risk of serotonin syndrome.”
Check it at the source: the levomilnacipran FDA label on DailyMed (effective April 30, 2024, Allergan, Inc.); the selegiline FDA label on DailyMed (effective August 7, 2024, Rising Pharma Holdings, Inc.).
What does the levomilnacipran label say about selegiline?
Levomilnacipran label, drug interactionsMonoamine Oxidase Inhibitors (MAOIs) Clinical Impact: Concomitant use of SSRIs and SNRIs including FETZIMA with MAOIs increases the risk of serotonin syndrome. … blue [see Dosage and Administration (,), Contraindications (), and Warnings and Precautions ()]. Examples: selegiline, tranylcypromine, isocarboxazid, phenelzine, linezolid, methylene blue
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
What does the selegiline label say about levomilnacipran?
Selegiline's label does not name levomilnacipran itself; it warns about its class (SNRIs (serotonin and norepinephrine reuptake inhibitors)):
Selegiline label, contraindicationsEMSAM (selegiline transdermal system) is contraindicated with selective serotonin reuptake inhibitors (SSRIs, e.g., fluoxetine, sertraline, and paroxetine); serotonin and norepinephrine reuptake inhibitors (SNRIs, e.g., venlafaxine and duloxetine); the tricyclic antidepressants clomipramine and imipramine, the opiate analgesics meperidine, tramadol, methadone, pentazocine, and propoxyphene; …
Selegiline label, contraindicationsSerotonergic drugs: selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), clomipramine and imipramine, meperidine, tramadol, methadone, pentazocine, and propoxyphene; and the antitussive agent dextromethorphan should not be used with EMSAM because of a risk of serotonin syndrome ( 4 , 5.2 ).
Source: FDA drug label (Selegiline Hydrochloride), Rising Pharma Holdings, Inc., effective August 7, 2024 (SPL set 23c4481f-d150-40c6-addb-b3e454ca914f), 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
| Levomilnacipran | Selegiline | |
|---|---|---|
| Labeled for | Depression | Parkinson's disease, Depression |
| Boxed warning | Yes | No |
| Pharmacy cost (NADAC) | $17.61 per unit 20-40 mg titration pak | $0.756 per capsule 5 mg capsule |
| 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