What the FDA labels say about taking them together
Meperidine and milnacipran
Milnacipran's FDA label of September 10, 2025 names meperidine in its warnings and precautions section; meperidine's label does not name milnacipran itself but warns about its class (SNRIs (serotonin and norepinephrine reuptake inhibitors)). The milnacipran label: “The risk is increased with concomitant use of other serotonergic drugs and with drugs that impair metabolism of serotonin i.e., MAOIs.”
Check it at the source: the meperidine FDA label on DailyMed (effective November 29, 2025, EPIC PHARMA, LLC); the milnacipran FDA label on DailyMed (effective September 10, 2025, Allergan, Inc.).
What does the meperidine label say about milnacipran?
Meperidine's label does not name milnacipran itself; it warns about its class (SNRIs (serotonin and norepinephrine reuptake inhibitors)):
Meperidine label, warnings and precautionsIf a patient is suspected to be experiencing OIH, carefully consider appropriately decreasing the dose of the current opioid analgesic or opioid rotation (safely switching the patient to a different opioid moiety) [see Dosage and Administration (2), Warnings and Precautions (5.15) ] . 5.8 Serotonin Syndrome with Concomitant Use of Serotonergic Drugs Cases of serotonin syndrome, a potentially life-threatening condition, have been reported during concomitant use of meperidine with serotonergic drugs. …
Meperidine label, warnings and precautionsSyndrome with Concomitant Use of Serotonergic Drugs Cases of serotonin syndrome, a potentially life-threatening condition, have been reported during concomitant use of meperidine hydrochloride tablets with serotonergic drugs. Serotonergic drugs include selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), St John’s wort, tricyclic antidepressants (TCAs), triptans, 5-HT3 receptor antagonists, drugs that affect the serotonergic neurotransmitter system (e.g. …
Source: FDA drug label (Meperidine Hydrochloride), EPIC PHARMA, LLC, effective November 29, 2025 (SPL set fae5cc34-5917-4445-9516-25f97ffca8db), via openFDA; the full label on DailyMed
What does the milnacipran label say about meperidine?
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
| Meperidine | Milnacipran | |
|---|---|---|
| Labeled for | Pain | Nerve pain and fibromyalgia |
| Boxed warning | Yes | Yes |
| Pharmacy cost (NADAC) | $0.157 per mL 50 mg/5 mL solution | $2.82 per tablet 100 mg tablet |
| Shortage now | Listed; available | 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