What the FDA labels say about taking them together
Levomilnacipran and tranylcypromine
Levomilnacipran's FDA label of April 30, 2024 names tranylcypromine in its drug interactions section; tranylcypromine'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 tranylcypromine FDA label on DailyMed (effective July 2, 2025, Advanz Pharma (US) Corp.).
What does the levomilnacipran label say about tranylcypromine?
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. … 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 tranylcypromine label say about levomilnacipran?
Tranylcypromine's label does not name levomilnacipran itself; it warns about its class (SNRIs (serotonin and norepinephrine reuptake inhibitors)):
Tranylcypromine label, drug interactionsOther MAOIs (e.g., linezolid, intravenous methylene blue, selective MAOIs) Selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) Tricyclic antidepressants Amoxapine, bupropion, maprotiline, nefazodone, trazodone, vilazodone, vortioxetine Contraindicated a SS for all antidepressants For MAOIs, increased MAO inhibition and risk of adverse reactions, SS, and HR g Amphetamines and methylphenidates and derivatives Contraindicated a HR Sympathomimetic drugs** …
Tranylcypromine label, contraindicationsCONTRAINDICATIONS Concomitant use or use in rapid succession with other MAOIs; selective serotonin reuptake inhibitors; serotonin and norepinephrine reuptake inhibitors; tricyclic antidepressants; sympathomimetic drugs; and numerous other drugs.
Source: FDA drug label (PARNATE), Advanz Pharma (US) Corp., effective July 2, 2025 (SPL set b72d8187-dfcc-4ea0-b5e9-c0be95b69a27), 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 | Tranylcypromine | |
|---|---|---|
| Labeled for | Depression | Depression |
| Boxed warning | Yes | Yes |
| Pharmacy cost (NADAC) | $17.61 per unit 20-40 mg titration pak | $0.591 per tablet 10 mg tablet |
| Shortage now | No current entry | A presentation being discontinued |
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