Medication interaction hub

What Supplements Interact with Levomilnacipran?

Levomilnacipran brand name: Fetzima. Every interaction below applies to the brands too.

156 Interactions 4 Major 110 Moderate 42 Minor
Curated & coded by · Clinical Pharmacist · Updated September 24, 2026

Drug–supplement interaction data sourced from Natural Medicines Pro, the licensed clinical database from TRC Healthcare / Therapeutic Research, with additional analysis by the HelloPharmacist Pharmacist Team. Our sources · Editorial policy

What is this page for?

One answer, for one medication: what supplements and herbal products interact with Levomilnacipran? Every vitamin, herb, and supplement ingredient we’ve checked against it is on this page, ranked by severity, each linking to the full report for that exact pair.

This page covers supplement interactions only — to check Levomilnacipran against your other medications, use the drug–drug interaction checker. Educational information from our licensed clinical databases, not medical advice. Our editorial policy

HelloPharmacist Bottom Line
Our Pharmacist Explains
What is this? The interaction data in the HelloPharmacist supplement database is licensed from Natural Medicines Pro by TRC Healthcare (Therapeutic Research). HelloPharmacist pharmacists often add our own analysis and context on top of that licensed data — such as this Bottom Line summary and the notes on individual interaction pages — and any such commentary is noted as ours.

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. John's wort push the drug's blood level up or down through the CYP3A4 enzyme, and lithium raises the risk of serotonin syndrome, a dangerous serotonin excess. Most of the rest run along the same two threads, 121 ingredients that affect CYP3A4 and how much drug reaches your blood, and 20 that add serotonin on top of what Fetzima provides.

Another 17 entries, charcoal products and bulky fibers among them, can block the capsule from absorbing, so space those well apart from your dose. The 110 moderates and 42 minors mostly echo the same mechanisms at lower intensity, which is why I favor targeted vigilance over blanket avoidance. If you add any serotonin-boosting supplement, watch for agitation, sweating, or a racing heart.

— , Clinical Pharmacist · July 18, 2026

Major 4 Moderate 110 Minor 42 No known interaction 1,296

This box checks one ingredient at a time (like turmeric or magnesium). Taking a supplement product with a whole label of ingredients? Search the product instead — we check every ingredient on it ↓

Top Ingredient Interactions

Levomilnacipran: Top Interactions at a Glance

The most significant Levomilnacipran supplement & herbal interactions, colored by severity. Tap any ingredient to open the full report for that pair.

Showing the 12 highest-ranked of 156 interacting ingredients — plus 1,296 more checked with no known interaction. See the complete ranked list.

Start here

The Major Interactions to Know About

The most clinically significant Levomilnacipran + supplement combinations in our database, best-documented first. Open any card for the full report.

Major Likelihood Likely Grapefruit + Levomilnaciprani

Grapefruit juice can increase levels of drugs metabolized by CYP3A4.

Read the full interaction Major Likelihood Probable Activated Charcoal + Levomilnaciprani

Activated charcoal reduces systemic exposure to many drugs, including those that undergo enterohepatic recirculation, regardless of the route of administration.

Read the full interaction Major Likelihood Probable Lithium + Levomilnaciprani

Theoretically, taking lithium supplements with serotonergic drugs might both mask and increase the risk of serotonin syndrome.

Read the full interaction Major Likelihood Probable St. John's Wort + Levomilnaciprani

St.

Read the full interaction
The complete list

Every Supplement Checked Against Levomilnacipran

All 1,452 ingredients in our database, ranked by severity — 156 with a Levomilnacipran interaction on file and 1,296 with none found. Filter by severity or search any ingredient; hover the for what each ingredient is.

Looking for an interaction with a specific supplement product? Search products instead ↓

Straight answers

Can You Take It With Levomilnacipran?

One-line answers, one card per combination — scroll through today’s 20 and tap any card for the full report. A different set rotates in daily until every combination has had its turn.

Can you take Kava with Levomilnacipran?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. It is unclear if kava inhibits CYP3AA; research is conflicting.

Full Kava + Levomilnacipran answer

Can you take Schisandra with Levomilnacipran?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.

Full Schisandra + Levomilnacipran answer

Can you take African Wild Potato with Levomilnacipran?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. In vitro evidence shows that African wild potato extract can inhibit cytochrome P450 3A4 (CYP3A4) enzyme activity by up to 86%.

Full African Wild Potato + Levomilnacipran answer

Can you take American Elder with Levomilnacipran?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, taking American elder might increase levels of CYP3A4 substrates.

Full American Elder + Levomilnacipran answer

Can you take Astaxanthin with Levomilnacipran?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, astaxanthin may decrease levels of drugs metabolized by CYP3A4.

Full Astaxanthin + Levomilnacipran answer

Can you take Ayahuasca with Levomilnacipran?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, ayahuasca might increase levels of serotonin, which may have additive effects with serotonergic drugs.

Full Ayahuasca + Levomilnacipran answer

Can you take Bacopa with Levomilnacipran?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, bacopa might increase the levels and adverse effects of CYP3A4 substrates.

Full Bacopa + Levomilnacipran answer

Can you take Beer with Levomilnacipran?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, concomitant use may increase the absorption and elimination of levomilnacipran.

Full Beer + Levomilnacipran answer

Can you take Beet with Levomilnacipran?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, beet might increase the levels of CYP3A4 substrates.

Full Beet + Levomilnacipran answer

Can you take Berberine with Levomilnacipran?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, berberine might increase serum levels of drugs metabolized by CYP3A4.

Full Berberine + Levomilnacipran answer

Can you take Beta-methylphenethylamine (bmpea) with Levomilnacipran?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, BMPEA might increase the levels and clinical effects of CYP3A4 substrates.

Full Beta-methylphenethylamine (bmpea) + Levomilnacipran answer

Can you take Bishop's Weed with Levomilnacipran?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Bergapten, a constituent of bishop's weed, has been shown to inhibit cytochrome P450 3A4 (CYP3A4) in vitro.

Full Bishop's Weed + Levomilnacipran answer

Can you take Bitter Orange with Levomilnacipran?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Bitter orange might increase levels of drugs metabolized by CYP3A4.

Full Bitter Orange + Levomilnacipran answer

Can you take Black Cohosh with Levomilnacipran?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Combining serotonergic drugs with black cohosh might cause additive serotonergic effects.

Full Black Cohosh + Levomilnacipran answer

Can you take Black Pepper with Levomilnacipran?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.

Full Black Pepper + Levomilnacipran answer

Can you take Black Seed with Levomilnacipran?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, combining serotonergic drugs with black seed might increase the risk of serotonergic side effects, including serotonin syndro...

Full Black Seed + Levomilnacipran answer

Can you take Bog Labrador Tea with Levomilnacipran?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. In vitro research shows that aqueous and ethanolic extracts of Bog Labrador tea leaves can increase the concentration of cytochrome P450 3A4...

Full Bog Labrador Tea + Levomilnacipran answer

Can you take Boswellia Serrata with Levomilnacipran?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, Boswellia serrata might increase or decrease the levels and clinical effects of CYP3A4 substrates.

Full Boswellia Serrata + Levomilnacipran answer

Can you take Bulbine Natalensis with Levomilnacipran?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, Bulbine natalensis stem might reduce the levels and clinical effects of CYP3A4 substrates.

Full Bulbine Natalensis + Levomilnacipran answer

Can you take Calamus with Levomilnacipran?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, taking calamus with drugs metabolized by CYP3A4 might increase drug levels and potentially increase the risk of adverse effec...

Full Calamus + Levomilnacipran answer
Read the list like a pharmacist

What Severity, Likelihood & Evidence Mean

Severity — How Serious It Can Be

  • Major. Clinically significant; generally best avoided, or used only under direct professional supervision.
  • Moderate. May need monitoring, a dose adjustment, or separating the times you take each one.
  • Minor. Generally not clinically significant, but still worth noting and mentioning to your pharmacist.
  • No known interaction. Checked against our sources with nothing documented — not the same as proven safety.

Likelihood — How Well It’s Documented

  • Likely. Well-controlled human studies have demonstrated the likely existence of this interaction
  • Probable. Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • Possible. Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists
  • Unlikely. Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans.

Where This Data Comes From

  • Interaction records are evidence-graded and sourced from the Natural Medicines database (TRC Healthcare), the same reference used by pharmacists and hospitals.
  • Each entry links to a full report with the clinical detail, likelihood, evidence level, and citations for that exact combination.
  • Content is reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

How Does Our Interaction Checker Work?

Behind every verdict on this page is a category system. Our source database doesn’t document supplement interactions drug-by-drug — it documents them against groups of medications that behave the same way (for example, “drugs processed by the CYP3A4 liver enzyme” or “blood-thinning medications”).

So the check works in three steps: (1) Levomilnacipran is classified into the pharmacology categories it belongs to, (2) every supplement interaction documented against any of those categories is inherited by Levomilnacipran, and (3) each ingredient keeps its own severity, likelihood, and evidence grades from the underlying record. That’s why one supplement can carry several records for one drug — it may interact through more than one category.

Levomilnacipran sits in 5 interaction categories. Open any one to see what the group means:

Cytochrome P450 3A4 (Cyp3A4) Substrates 121 ingredients

A drug-metabolism group: these medications are processed by the named liver enzyme (a cytochrome P450). Supplements that speed this enzyme up or slow it down can lower or raise the medication's levels in your body.

121 of the supplement ingredients on this page reach Levomilnacipran through this category.

Serotonergic Drugs 20 ingredients

Medications that raise serotonin activity. Combining them with serotonin-active supplements can, in rare cases, push serotonin too high.

20 of the supplement ingredients on this page reach Levomilnacipran through this category.

Oral Drugs 17 ingredients

A pharmacology grouping from our source database: medications in this group share a property that certain supplements are known to interact with, so an interaction documented for the group applies to every drug in it.

17 of the supplement ingredients on this page reach Levomilnacipran through this category.

Levomilnacipran (Fetzima) 2 ingredients

A pharmacology grouping from our source database: medications in this group share a property that certain supplements are known to interact with, so an interaction documented for the group applies to every drug in it.

2 of the supplement ingredients on this page reach Levomilnacipran through this category.

Serotonergic Drugs 1 ingredient

Medications that raise serotonin activity. Combining them with serotonin-active supplements can, in rare cases, push serotonin too high.

1 of the supplement ingredient on this page reaches Levomilnacipran through this category.

About Levomilnacipran

Levomilnacipran is a serotonin-norepinephrine reuptake inhibitor (SNRI) antidepressant used to treat major depressive disorder (MDD) in adults.

Generic name: Levomilnacipran  ·  Brand name: Fetzima.

See the full Levomilnacipran drug information
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Take a Supplement Product? Check the Whole Bottle Against Levomilnacipran

Most supplements are combination products — and the interaction may come from an ingredient you didn’t buy it for. Search any product below (or scan its label) and we’ll check every ingredient on it against Levomilnacipran.

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Pharmacist Counseling Corner

Levomilnacipran & Supplements: Common Questions

What supplements interact with Levomilnacipran?
Our database currently documents 156 ingredients with a known Levomilnacipran interaction (4 major, 110 moderate, 42 minor). The practical move: scan the major group first, then look up the exact supplements you take rather than reading all 156. The highest-ranked right now: Grapefruit, Activated Charcoal, Lithium.
Which Levomilnacipran supplement interactions are the most serious?
Focus on the major group: Grapefruit, Activated Charcoal, Lithium and St. John's Wort. A major rating means the combination can be clinically significant, not that harm is guaranteed — but it's exactly the kind of thing to run past your pharmacist before your next dose, not after. Jump to the ranked list.
Can I take vitamins or supplements while on Levomilnacipran?
Plenty of supplements coexist fine with Levomilnacipran; a shorter list does not. Rather than memorizing it, check the specific ingredients on your labels — the ranked list above covers every one we've checked, and multi-ingredient products can be checked label-by-label with our scanner. Try the label scanner or the interaction checker.
Do brands like Fetzima have the same supplement interactions as Levomilnacipran?
Yes — Fetzima all contain Levomilnacipran, so everything on this page applies to them equally. Interactions belong to the active drug, never to the brand on the box; the same is true of generics.
Where do these interaction ratings come from?
Every rating comes from the Natural Medicines database — the same evidence-graded reference pharmacists and hospitals use — and each interaction carries three separate grades: severity (how bad it can be), likelihood (how well it's documented in studies and case reports), and an evidence level. Our pharmacists review the content; we never let an AI decide an interaction. See how to read the ratings and our editorial policy.
What about Levomilnacipran and my other medications?
This page covers Levomilnacipran against supplements and herbal ingredients. Checking Levomilnacipran against your other prescription or OTC medications is a different tool — our drug interaction checker covers that side. Head to the drug–drug interaction checker, or read the full Levomilnacipran drug information.

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

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Sourcing

Where This Data Comes From — and Why You Can Trust It

🧪 Licensed clinical database

Every interaction verdict on this page comes from Natural Medicines Pro (TRC Healthcare / Therapeutic Research) — the same evidence-graded reference used by pharmacists and hospitals. We license this data directly; we do not scrape it, and no AI invents an interaction.

🧑‍⚕️ Pharmacist review

This page is curated and coded by , Clinical Pharmacist, with additional analysis by the HelloPharmacist Pharmacist Team. Editorial commentary is ours; the licensed interaction records are shown as sourced.

🔄 Kept current

Our interaction database refreshes on a weekly cycle, and this page re-checks the live database every time it’s rebuilt — what you see reflects the database as of September 24, 2026.

🔍 Full transparency

How every dataset on this site is sourced, licensed, and updated is documented publicly: our data sources · editorial policy · how we use AI.

Educational information, not medical advice. An interaction being on file does not mean it will happen to you — and absence of one is not proof of safety. Never start or stop a medication or supplement without talking to your pharmacist or doctor.