Generic Name: milnacipran (mil NA si pran)Brand Names: Savella
Milnacipran affects certain chemicals in the brain called neurotransmitters. An abnormality in these chemicals is thought to be related to fibromyalgia. Milnacipran is not used to treat depression but how it works in the body is similar to how some antidepressants work.
Milnacipran is used to treat a chronic pain disorder called fibromyalgia.
Milnacipran may also be used for other purposes not listed in this medication guide.
You may have thoughts about suicide when you first start taking this medication, especially if you are younger than 24 years old. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself. Avoid drinking alcohol while taking milnacipran. Alcohol may increase the risk of damage to your liver.
Cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression, or anxiety can add to sleepiness caused by milnacipran. Tell your doctor if you regularly use any of these other medicines.Milnacipran can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.
If you have any of these other conditions, you may need a dose adjustment or special tests to safely take milnacipran:
heart disease, high blood pressure, heart rhythm disorder;
seizures or epilepsy;
a bleeding or blood clotting disorder such as hemophilia;
enlarged prostate, urination problems;
bipolar disorder (manic depression);
a history of heavy alcohol use;
a history of suicidal thoughts or actions; or
if you are allergic to aspirin or yellow food dye.
You may have thoughts about suicide while taking this medication, especially if you are younger than 24 years old. Tell your doctor if you have new or worsening depression or suicidal thoughts during the first several weeks of treatment, or whenever your dose is changed.
Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.FDA pregnancy category C. It is not known whether milnacipran is harmful to an unborn baby. Before taking this medication, tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether milnacipran passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.
Older adults may be more sensitive to the side effects of this medication.Do not give milnacipran to anyone younger than 17 years old without the advice of a doctor.
Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results from the medication.
You may take medication with or without food. Take the medicine with food if it upsets your stomach.Do not stop using milnacipran suddenly, or you could have unpleasant withdrawal symptoms such as dizziness, anxiety, feeling irritable, confusion, headache, ringing in your ears, and sleep problems. Talk to your doctor about how to avoid withdrawal symptoms when you stop using milnacipran. Store milnacipran at room temperature away from moisture and heat.
See also: Savella dosage in more detail
Take the missed dose as soon as you remember. However, if it is almost time for the next regularly scheduled dose, skip the missed dose and take the next one as directed. Do not take extra medicine to make up the missed dose.
Call your doctor at once if you have any of these serious side effects:
fast or pounding heartbeats;
painful or difficult urination;
easy bruising or bleeding, nosebleeds, bloody or tarry stools, coughing up blood;
confusion, hallucinations, severe weakness, seizure (convulsions);
high fever, sweating, chills or goose bumps, memory problems, trouble concentrating, loss of coordination, overactive reflexes, vomiting, diarrhea;
high blood pressure (severe headache, blurred vision, buzzing in your ears, chest pain, shortness of breath, uneven heartbeats); or
stomach pain, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).
Less serious side effects may include:
dry mouth, nausea, stomach pain, heartburn, bloating;
dizziness, drowsiness, headache, tired feeling;
stuffy nose, sneezing, or other cold symptoms;
sleep problems (insomnia);
swelling in your hands or feet;
hot flashes, sweating, itching, mild skin rash;
numbness or tingling;
blurred vision; or
decreased sex drive, impotence, or difficulty having an orgasm.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Talk to your doctor before taking any medicine for pain, arthritis, fever, or swelling. This includes aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), diclofenac (Voltaren), indomethacin, piroxicam (Feldene), nabumetone (Relafen), etodolac (Lodine), and others. Taking any of these drugs with milnacipran may cause you to bruise or bleed easily.
Tell your doctor about all other medications you use, especially:
a blood thinner such as warfarin (Coumadin);
clonidine (Catapres, Clorpres);
a diuretic (water pill);
digoxin (digitalis, Lanoxin);
lithium (Lithobid, Eskalith);
tryptophan (sometimes called L-tryptophan);
migraine headache medicine such as almotriptan (Axert), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt), sumatriptan (Imitrex, Treximet), or zolmitriptan (Zomig); or
an antidepressant such as citalopram (Celexa), duloxetine (Cymbalta), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), paroxetine (Paxil), or sertraline (Zoloft).
This list is not complete and there may be other drugs that can interact with milnacipran. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.