snri
8 interactions related to snri
duloxetine + st. john's wort
Duloxetine is a serotonin-norepinephrine reuptake inhibitor (SNRI), and St. John's wort independently raises central serotonin through reuptake inhibition. Combined use can precipitate serotonin syndrome, and St. John's wort induction of CYP3A4 and P-glycoprotein may also alter duloxetine exposure.
tramadol + st. john's wort
Tramadol inhibits serotonin and norepinephrine reuptake, and St. John's Wort increases central serotonergic activity, so combining them raises the risk of serotonin syndrome. St. John's Wort also induces CYP3A4 and CYP2B6, which can reduce tramadol's active M1 metabolite and weaken analgesia.
venlafaxine + st. john's wort
Venlafaxine is a serotonin-norepinephrine reuptake inhibitor (SNRI). St. John's wort independently inhibits serotonin (and to a lesser extent norepinephrine and dopamine) reuptake. Combining them can drive a sharp rise in synaptic serotonin and trigger serotonin syndrome, and St. John's wort can also alter venlafaxine pharmacokinetics through CYP3A4 induction.
saffron + antidepressants
Saffron and its constituents crocin and safranal show antidepressant activity by inhibiting serotonin, norepinephrine, and dopamine reuptake and modulating monoamine oxidase, which is additive to SSRIs, SNRIs, and MAOIs and raises the theoretical risk of serotonin syndrome.
alcohol + venlafaxine
Venlafaxine (Effexor) is an SNRI that, like other antidepressants, has additive CNS-depressant effects with alcohol. The FDA-approved label warns patients to avoid alcohol because of worsening drowsiness, dizziness, impaired judgment, and the potential to aggravate the underlying mood or anxiety disorder.
alcohol + duloxetine
Duloxetine (Cymbalta) and heavy alcohol use both can damage the liver. The FDA-approved label explicitly states that Cymbalta should not be prescribed to patients with substantial alcohol use because the combination has been linked to severe, sometimes fatal, hepatotoxicity in clinical trial data.
tramadol + 5-htp
Tramadol inhibits serotonin reuptake, and 5-HTP is a direct precursor to serotonin that increases central serotonin synthesis. Combining them can cause serotonin syndrome, a potentially life-threatening reaction.
coffee + antidepressants
Many antidepressants (especially fluvoxamine, fluoxetine, sertraline, duloxetine) inhibit CYP1A2 to varying degrees and slow caffeine clearance, while caffeine itself can worsen the anxiety, insomnia, tremor, and tachycardia that antidepressants are often prescribed to treat. MAOIs add a risk of caffeine-induced hypertensive episodes.