Drug & supplement interaction

Trigger Point Therapy + Levomilnacipran

Levomilnacipran brand name: Fetzima.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 20, 2026
The bottom line No known interaction

We found no known interaction between Trigger Point Therapy and Levomilnacipran in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Trigger Point Therapy and Levomilnacipran

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Levomilnacipran and Trigger Point Therapy in our sources. This does not guarantee that the combination is completely free of risk — research on Trigger Point Therapy alongside specific medications may be limited.

Worth understanding: our licensed dataset holds no drug-interaction record for Trigger Point Therapy at all — not against Levomilnacipran, and not against any other medication we track. This verdict therefore rests on the absence of any recorded data, not on research that looked at this combination and found nothing. We cannot rule an interaction out.

Trigger Point Therapy is a treatment rather than something you take. Tell whoever provides it which medicines you use, and ask your prescriber whether it is appropriate for your health and treatment. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Trigger Point Therapy safety at a glance

Trigger Point Ther... overall Use caution Generally low risk when done by a trained provider, but improper technique can cause bruising or soreness.
Pregnancy Use caution May be used with care, but tell your provider you are pregnant so they can adjust technique and avoid certain points.
Breastfeeding Generally safe No special concern, since it is a physical therapy and not something you take internally.

Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Levomilnacipran and Trigger Point Therapy? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
What to actually watch for

No Interaction Found — But Data Suggests Trigger Point Therapy and Levomilnacipran May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so having Trigger Point Therapy while taking the medicine can make those effects more likely to turn up, and harder to pin on one or the other if they do. 2 of them are worth acting on rather than waiting out — marked below.

  • Trouble passing urine Worth acting on Additional detail

    Trigger Point Therapy

    “In women with pelvic pain, trigger point therapy with botulinum toxin or saline was reported to cause urinary incontinence and, rarely, urinary retention and urinary tract infection. However, as urinary incontinence, urinary retention, and urinary tract infections are not unusual in women with pelvic pain, the relationship to trigger point therapy is unclear.”

    Trigger Point Therapy · Natural Medicines adverse-effect record, reported in pain.

    1 source cited
    1. 103556. Dessie SG, Von Bargen E, Hacker MR, Haviland MJ, Elkadry E. A randomized, double-blind, placebo-controlled trial of onabotulinumtoxin A trigger point injections for myofascial pelvic pain. Am J Obstet Gynecol. 2019;221(5):517.e1-517.e9. PubMed

    Levomilnacipran

    Listed in the ADVERSE REACTIONS section of the FDA label for Levomilnacipran. Read the label on DailyMed ›

  • Bleeding or bruising Worth acting on Additional detail

    Trigger Point Therapy

    “Incorrect placement of the needle during trigger point therapy has been reported to cause pneumothorax or hemopneumothorax. This serious complication can be avoided by refraining from insertion of the needle into an intercostal space. Accidental intrathecal injection has also been reported during an attempt to give a local injection in a superficial trapezius trigger point.”

    Trigger Point Therapy · Natural Medicines adverse-effect record, reported in depression.

    3 sources cited
    1. 28803. Shafer, N. Pneumothorax following "trigger point" injection. JAMA 1970;213(7):1193. DOI
    2. 103558. Genç S, Eneyli MG, Polat O, Oğuz AB, Enön S. Hemopneumothorax After Trigger Point Injection for Fibromyalgia. Altern Ther Health Med. 2020;26(2):62-64.
    3. 28804. Nelson, L. S. and Hoffman, R. S. Intrathecal injection: unusual complication of trigger-point injection therapy. Ann Emerg Med 1998;32(4):506-508. PubMed

    Levomilnacipran

    Listed in the ADVERSE REACTIONS section of the FDA label for Levomilnacipran. Read the label on DailyMed ›

  • Constipation Additional detail

    Trigger Point Therapy

    “In women with pelvic pain, trigger point therapy with botulinum toxin or saline was reported to cause constipation and, rarely, fecal incontinence. However, as constipation and fecal incontinence are not unusual in women with pelvic pain, the relationship to trigger point therapy is unclear.”

    Trigger Point Therapy · Natural Medicines adverse-effect record, reported in constipation.

    1 source cited
    1. 103556. Dessie SG, Von Bargen E, Hacker MR, Haviland MJ, Elkadry E. A randomized, double-blind, placebo-controlled trial of onabotulinumtoxin A trigger point injections for myofascial pelvic pain. Am J Obstet Gynecol. 2019;221(5):517.e1-517.e9. PubMed

    Levomilnacipran

    Listed in the ADVERSE REACTIONS section of the FDA label for Levomilnacipran. Read the label on DailyMed ›

Reported for Trigger Point Therapy but not commonly for Levomilnacipran: loss of bladder control, a stroke or mini-stroke, blurred vision and low potassium.

Effects for Levomilnacipran come from the ADVERSE REACTIONS section of its FDA label; effects for Trigger Point Therapy come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 1,905 voluntary FDA FAERS reports for Levomilnacipran that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Overlapping uses

What Levomilnacipran Is Prescribed For, and What Trigger Point Therapy Has Been Studied For

These two come up together because they touch the same health topic — not because they do the same job. Levomilnacipran is a prescription medicine with approved uses on its FDA label. Trigger Point Therapy is a treatment: what follows is what researchers have looked at it for, and how strong that evidence is.

Levomilnacipran is prescribed for: Fetzima (levomilnacipran) is approved to treat major depressive disorder (MDD) in adults. It is taken as a once-daily extended-release capsule. It is important to know that Fetzima is not approved for fibromyalgia — its safety and effectiveness for that condition have not been established. It is also not approved for use in children or teens.

Trigger Point Therapy has been studied for:

  • Fibromyalgia studied, not established Trigger Point Therapy has been studied for this. Natural Medicines rates the evidence: Insufficient Reliable Evidence To Rate Read what the research shows

    Trigger Point Therapy for fibromyalgia

    Preliminary clinical research in adults with fibromyalgia shows that four weekly sessions of trigger point dry needling improves myofascial pain when compared with cross-tape therapy. However, dry needling and cross-tape therapy resulted in similar improvements in spinal mobility.

    1 source cited
    1. 97829. Castro-Sanchez AM, Garcia-Lopez H, Mataran-Penarrocha GA, et al. Effects of dry needling on spinal mobility and trigger points in patients with fibromyalgia syndrome. Pain Physician. 2017;20(2):37-52. DOI

Effectiveness ratings and the research summaries above are the verbatim record from the Natural Medicines database, which grades evidence from “Effective” down to “Insufficient Reliable Evidence To Rate”. A rating below the top of that scale means researchers have looked at it — not that it works, and never that it can stand in for a prescribed medicine. Do not stop or replace Levomilnacipran on your own; if you are taking Trigger Point Therapy for the same health topic, tell your prescriber, especially if the medicine is being adjusted to a target.

Everything else you take

See Every Supplement That Interacts With Levomilnacipran

This page covers Trigger Point Therapy only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Levomilnacipran page lists 156 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), Lithium (major), St. John's Wort (major) and 5-htp (moderate).

By severity: 4 major · 110 moderate · 42 minor.

From our pharmacist’s overview on the Levomilnacipran page

“For levomilnacipran (Fetzima), an antidepressant, this list deserves real attention. Four of its 156 interacting ingredients rate major, and those are the ones to learn first: grapefruit and St.”

Reviewed by 2 · Jul 18, 2026

Open the Levomilnacipran interaction page

How much people look this up

Where Trigger Point Therapy and Levomilnacipran Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Trigger Point Therapy
Steady interest

#748 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Levomilnacipran
Steady interest

#2,733 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Trigger Point Therapy reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Trigger Point Therapy and Levomilnacipran records this page draws on were last updated July 10, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Treatment approach

About Trigger Point Therapy

What is Trigger Point Therapy?

  • Muscle knots and tightness
  • Neck and back pain
  • Tension headaches
  • Myofascial pain
  • Limited range of motion
  • Sports recovery

Trigger Point Therapy is a hands-on (manual) treatment, not a supplement or herb. It targets tight, tender spots in muscles ('trigger points') with pressure or needling to ease pain and stiffness. Some people find real relief, but the research is mixed, so it is best used alongside other care and guided by a qualified provider.

Not applicable (manual therapy technique) · Manual pressure, massage, dry needling, self-massage with tools (foam rollers, massage balls)

An interaction check asks whether these two react with each other — it does not ask whether Trigger Point Therapy is a good idea for someone in your situation. Here is what our Trigger Point Therapy record says about it on its own.

Trigger Point Therapy: dosing

Because Trigger Point Therapy is a hands-on treatment and not a supplement, there is no standardized 'dose.' The number and length of sessions vary based on your condition, your provider's approach, and how you respond.Many providers start with one or two sessions per week and adjust from there.

From our Trigger Point Therapy monograph — the full record covers uses, side effects and every documented interaction.

Read the full Trigger Point Therapy monograph & all interactions
Medication

About Levomilnacipran

What Is Levomilnacipran Used For?

Brand name: Fetzima

Fetzima (levomilnacipran) is approved to treat major depressive disorder (MDD) in adults. It is taken as a once-daily extended-release capsule.

It is important to know that Fetzima is not approved for fibromyalgia — its safety and effectiveness for that condition have not been established. It is also not approved for use in children or teens.

Most-Reported Side Effects for Levomilnacipran

From FAERS, the FDA’s public side-effect reporting system (1,905 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Vomiting 219 reports
Memory impairment 200 reports
Hypoaesthesia 191 reports
Abdominal pain upper 189 reports
Paraesthesia 189 reports
See full Levomilnacipran drug information
Keep checking

Other Drugs & Trigger Point Therapy

Browse every other medication we’ve checked against Trigger Point Therapy — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
0Moderate
0Minor
2,829No known interaction
2,829 No interaction
No interaction 2,829 drugs checked — show the list

We also checked Trigger Point Therapy against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,829 medications checked with no known interaction — see the full Trigger Point Therapy list.

See the full Trigger Point Therapy interactions page
See every supplement checked against Levomilnacipran, ranked by severity
Evidence & sources

Trigger Point Therapy References

The 44 references that drive our Trigger Point Therapy monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Hesse, J., Mogelvang, B., and Simonsen, H. Acupuncture versus metoprolol in migraine prophylaxis: a randomized trial of trigger point inactivation. J Intern Med 1994;235(5):451-456. PubMed
  2. Kovacs, F. M., Abraira, V., Pozo, F., Kleinbaum, D. G., Beltran, J., Mateo, I., Perez, de Ayala, Pena, A., Zea, A., Gonzalez-Lanza, M., and Morillas, L. Local and remote sustained trigger point therapy for exacerbations of chronic low back pain. A randomi DOI
  3. Garvey, T. A., Marks, M. R., and Wiesel, S. W. A prospective, randomized, double-blind evaluation of trigger-point injection therapy for low-back pain. Spine (Phila Pa 1976) 1989;14(9):962-964. PubMed
  4. Itoh, K., Katsumi, Y., and Kitakoji, H. Trigger point acupuncture treatment of chronic low back pain in elderly patients--a blinded RCT. Acupunct Med 2004;22(4):170-177. PubMed
  5. Iguchi, M., Katoh, Y., Koike, H., Hayashi, T., and Nakamura, M. Randomized trial of trigger point injection for renal colic. Int J Urol 2002;9(9):475-479. PubMed
  6. Nazareno, J., Ponich, T., and Gregor, J. Long-term follow-up of trigger point injections for abdominal wall pain. Can J Gastroenterol 2005;19(9):561-565. PubMed
  7. Ferrante, F. M., Bearn, L., Rothrock, R., and King, L. Evidence against trigger point injection technique for the treatment of cervicothoracic myofascial pain with botulinum toxin type A. Anesthesiology 2005;103(2):377-383. PubMed
  8. Iwama, H., Ohmori, S., Kaneko, T., and Watanabe, K. Water-diluted local anesthetic for trigger-point injection in chronic myofascial pain syndrome: evaluation of types of local anesthetic and concentrations in water. Reg Anesth Pain Med 2001;26(4):333-336 DOI
  9. Hameroff, S. R., Crago, B. R., Blitt, C. D., Womble, J., and Kanel, J. Comparison of bupivacaine, etidocaine, and saline for trigger-point therapy. Anesth Analg 1981;60(10):752-755. DOI
  10. Kamanli, A., Kaya, A., Ardicoglu, O., Ozgocmen, S., Zengin, F. O., and Bayik, Y. Comparison of lidocaine injection, botulinum toxin injection, and dry needling to trigger points in myofascial pain syndrome. Rheumatol Int 2005;25(8):604-611. PubMed
  11. Shafer, N. Pneumothorax following "trigger point" injection. JAMA 1970;213(7):1193. DOI
  12. Nelson, L. S. and Hoffman, R. S. Intrathecal injection: unusual complication of trigger-point injection therapy. Ann Emerg Med 1998;32(4):506-508. PubMed
  13. Edwards, J. and Knowles, N. Superficial dry needling and active stretching in the treatment of myofascial pain--a randomised controlled trial. Acupunct Med 2003;21(3):80-86. PubMed
  14. Sánchez-Romero EA, Pecos-Martín D, Calvo-Lobo C, Ochoa-Sáez V, Burgos-Caballero V, Fernández-Carnero J. Effects of dry needling in an exercise program for older adults with knee osteoarthritis: A pilot clinical trial. Medicine
  15. Brennan KL, Allen BC, Maldonado YM. Dry needling versus cortisone injection in the treatment of greater trochanteric pain syndrome: A noninferiority randomized clinical trial. J Orthop Sports Phys Ther. 2017;47(4):232-239. PubMed

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Having Trigger Point Therapy While Taking Levomilnacipran: Common Questions

Is it safe to have Trigger Point Therapy while taking Levomilnacipran?
We do not list a known interaction between Trigger Point Therapy and Levomilnacipran. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Trigger Point Therapy and Levomilnacipran have any of the same side effects?
Yes — our sources link each of them separately to 3 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
Are Trigger Point Therapy and Levomilnacipran used for the same thing?
They overlap in purpose, which usually means the real question is whether you need both rather than whether they are safe together. This page lists the shared uses and how strong the evidence is for Trigger Point Therapy in each. That is a conversation for your prescriber, especially if Levomilnacipran is being adjusted to a target.
Does Levomilnacipran interact with any supplements?
Yes. Levomilnacipran has documented interactions with 156 supplements in our database — Trigger Point Therapy is not one of them. The Levomilnacipran interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Where next

Keep Exploring

Trigger Point Therapy monograph Uses, safety profile, and every drug interaction in one place Levomilnacipran drug information The full plain-English guide to this medication Levomilnacipran supplement interactions Every supplement checked against Levomilnacipran, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 44 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.