Linezolid Injection and Milnacipran: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Milnacipran
Linezolid Injection
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
An increased risk of serotonin syndrome (hypertension, hyperthermia, myoclonus, mental status changes)
Interaction Deep Dive
Concurrent administration or overlapping therapy with milnacipran and an MAOI may result in serotonin syndrome, a hyper-serotonergic state characterized by symptoms such as mental status changes (e.g., agitation, hallucinations, delirium, and coma), autonomic instability (e.g., tachycardia, labile blood pressure, dizziness, diaphoresis, flushing, hyperthermia), neuromuscular symptoms (e.g., tremor, rigidity, myoclonus, hyperreflexia, incoordination), seizures, and/or gastrointestinal symptoms (e.g., nausea, vomiting, diarrhea). Concomitant administration of milnacipran and an MAOI is contraindicated. A minimum of 14 days should elapse after discontinuing an MAOI before initiating therapy with milnacipran, and a minimum of 5 days should elapse after discontinuing milnacipran before initiating therapy with an MAOI. If it is necessary to initiate treatment with a MAOI such as linezolid, discontinue milnacipran before initiating treatment with linezolid. Monitor all patients taking milnacipran for the emergence of serotonin syndrome. Discontinue treatment with milnacipran and any concomitant serotonergic agents immediately if the serotonin syndrome occurs and initiate supportive symptomatic treatment. If concomitant use of milnacipran with other serotonergic drugs is clinically warranted, inform patients of the increased risk for serotonin syndrome and monitor for symptoms1.
Why it happens (mechanism)
Additive serotonergic effects
Common questions
Can I take Linezolid Injection and Milnacipran together?
An increased risk of serotonin syndrome (hypertension, hyperthermia, myoclonus, mental status changes) Always confirm with your pharmacist or prescriber before making any change.
How serious is the Linezolid Injection and Milnacipran interaction?
It is rated contraindicated. These should generally not be used together.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
Questions for your pharmacist
- Does my dose of Linezolid Injection or Milnacipran need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (1)
- Product Information: SAVELLA(R) oral tablets, milnacipran HCl oral tablets. Allergan USA Inc. (per FDA), Madison, NJ, 2023. DailyMed
Keep reading about Milnacipran
Keep reading about Linezolid Injection
Check another combination
Our instant two-drug interaction checker is almost here.
Still have questions about this combination?
Every question gets a real answer from a licensed pharmacist — free, and usually within a day.
Ask the pharmacist