What the FDA labels say about taking them together
Lithium and milnacipran
Milnacipran's FDA label of September 10, 2025 names lithium in its drug interactions section; lithium's label does not name milnacipran itself but warns about its class (SNRIs (serotonin and norepinephrine reuptake inhibitors)). The milnacipran label: “Serotonin syndrome can occur with use of SAVELLA and other serotonergic drugs, or with drugs that impair metabolism of serotonin.”
Check it at the source: the lithium FDA label on DailyMed (effective December 23, 2025, Glenmark Pharmaceuticals Inc., USA); the milnacipran FDA label on DailyMed (effective September 10, 2025, Allergan, Inc.).
What does the lithium label say about milnacipran?
Lithium's label does not name milnacipran itself; it warns about its class (SNRIs (serotonin and norepinephrine reuptake inhibitors)):
Lithium label, warnings and precautionsThe risk is increased with concomitant use of other serotonergic drugs (including selective serotonin reuptake inhibitors, serotonin and norepinephrine reuptake inhibitors, triptans, tricyclic antidepressants, fentanyl, tramadol, tryptophan, buspirone, and St. John’s Wort) and with drugs that impair metabolism of serotonin, i.e., MAOIs [see Drug Interactions ( 7.1 )].
Source: FDA drug label (Lithium Carbonate), Glenmark Pharmaceuticals Inc., USA, effective December 23, 2025 (SPL set 63b3790f-a9b5-47f4-bae1-ddf8b43c13c1), via openFDA; the full label on DailyMed
What does the milnacipran label say about lithium?
Milnacipran label, drug interactionsSerotonin syndrome can occur with use of SAVELLA and other serotonergic drugs (other SNRIs, SSRIs, triptans, tricyclic antidepressants, opioids, lithium, tryptophan, buspirone, amphetamines, and St. John’s Wort), or with drugs that impair metabolism of serotonin (i.e., monoamine oxidase inhibitors).
Milnacipran label, warnings and precautionsThe risk is increased with concomitant use of other serotonergic drugs (including triptans, tricyclic antidepressants, fentanyl, tramadol, meperidine, methadone, lithium, 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 )].
Source: FDA drug label (Savella), NDA022256 (Abbvie), as published by Allergan, Inc., effective September 10, 2025 (SPL set 16a4a314-f97e-4e91-95e9-576a3773d284), 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
| Lithium | Milnacipran | |
|---|---|---|
| Labeled for | Bipolar disorder | Nerve pain and fibromyalgia |
| Boxed warning | Yes | Yes |
| Pharmacy cost (NADAC) | $0.104 per capsule 300 mg capsule | $2.82 per tablet 100 mg tablet |
| 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