Will Abilify (aripiprazole) or Effexor XR (venlafaxine) cause interactions with Mounjaro (tirzepatide) or Depo Provera (medroxyprogesterone acetate)?

Drug Interactions Between Abilify/Effexor XR and Mounjaro/Depo Provera

No clinically significant drug interactions are expected between Abilify (aripiprazole) or Effexor XR (venlafaxine) and Mounjaro (tirzepatide) or Depo Provera (medroxyprogesterone acetate). These medications can be safely used together with appropriate monitoring.

Metabolism Pathways and Interaction Potential

Abilify (Aripiprazole)

• Primarily metabolized through CYP3A4 and CYP2D6 pathways
• Does not have documented interactions with tirzepatide or medroxyprogesterone acetate
• No evidence of interference with the efficacy of Mounjaro or Depo Provera

Effexor XR (Venlafaxine)

• Metabolized primarily by CYP2D6 to its active metabolite O-desmethylvenlafaxine 1
• Has low protein binding and does not significantly inhibit CYP enzymes
• Considered a potential option when drug-drug interactions are a concern 1
• No documented interactions with tirzepatide or medroxyprogesterone acetate

Mounjaro (Tirzepatide)

• FDA labeling for Mounjaro does not list specific interactions with aripiprazole or venlafaxine 2
• Main interaction concern is with oral medications due to delayed gastric emptying
• FDA label states: "Caution should be exercised when oral medications are concomitantly administered with MOUNJARO" 2
• However, this concern applies primarily to:
  • Medications with narrow therapeutic indices (e.g., warfarin)
  • Oral hormonal contraceptives (which require additional contraceptive methods)

Depo Provera (Medroxyprogesterone Acetate)

• Studies have shown no significant pharmacokinetic interactions between Depo Provera and various medications 3
• Specifically, research demonstrates that medroxyprogesterone acetate levels (MPA) remain unchanged when combined with other medications 3
• Table 2 in the CDC medical eligibility criteria shows no significant interactions affecting the contraceptive efficacy of DMPA with various drugs 3

Monitoring Recommendations

While no significant interactions are expected, consider the following monitoring:

1. Psychiatric symptoms: Monitor for changes in mood, anxiety, or psychotic symptoms, as both psychiatric medications and hormonal treatments can affect mental health status

2. Blood glucose levels: If the patient is using Mounjaro for diabetes, regular monitoring of glucose levels is important, as psychiatric medications may occasionally affect metabolic parameters

3. Weight changes: Both psychiatric medications and Mounjaro can affect weight, so monitoring for significant changes is advisable

4. Blood pressure: Venlafaxine at higher doses can cause mild increases in blood pressure 1, so routine monitoring is recommended

Special Considerations

• Oral medication timing: If concerned about potential absorption issues with Mounjaro, consider separating administration times of oral medications by a few hours

• Serotonin syndrome: While not directly related to these specific combinations, be aware that venlafaxine has serotonergic properties that could theoretically interact with other serotonergic medications if added to the regimen 4

• Elderly patients: Consider starting with lower doses of all medications in elderly populations due to potential increased sensitivity to medication effects 5

In conclusion, the available evidence does not suggest clinically significant interactions between Abilify or Effexor XR and Mounjaro or Depo Provera that would affect morbidity, mortality, or quality of life outcomes.