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Generic name: milnacipran [ mil-NA-si-pran ]
Brand names: Savella, Savella Titration Pack
Form of dosage: Oral tablet (100mg, 12.5mg, 25mg or 50mg; different strengths)
Drug class: serotonin-norepinephrine reuptake inhibitors

What is Milnacipran?

The Milnacipran drug is used for the treatment of chronic pain that results from fibromyalgia. This medical condition causes pain and chronic muscle and joint pain. Milnacipran can be used in other ways not mentioned in the medication guide.

Side effects of Milnacipran

If you experience any of the following symptoms of an allergy reaction, seek immediate medical attention: difficulty breathing, hives, swelling in your lips, face, throat, or tongue. You should tell your doctor if any symptoms worsen or change, including depression, anxiety, attacks of panic, or trouble sleeping. Also, you may feel restless, hyperactive, or hostile or aggressive.

Milnacipran may cause serious side effects. If you experience:

  • Little or no urine;
  • Blurred vision or tunnel vision; eye swelling or pain.
  • A seizure;
  • Feeling as if they might faint is common during times of emotional stress and can result in feelings of lightheadedness, or the threat of passing out.
  • Liver problems: abdominal pain, itching, dark urine, and jaundice.
  • Low sodium levels can cause headaches, weakness, nausea, and problems thinking or remembering.
  • Manic episodes: racing thoughts, excessive energy, risky behavior that is unusual, extreme happiness, or irritability.

If you experience symptoms such as hallucinations or agitation, a rapid heartbeat, muscle stiffness, or twitching,.

Some side effects are more common in elderly adults.

Milnacipran side effects may include:

  • Nausea, vomiting, and constipation;
  • Dry mouth
  • Increased blood pressure
  • Fast or pounding pulses.
  • Increased sweating or flushing (warmth redness or tingly sensation);
  • Headache, dizziness;
  • Trouble sleeping

There may be other side effects. For medical advice on side effects, call your doctor. Report adverse reactions by calling the Food and Drug Administration's hotline at 1-800-FDA-1088.


Milnacipran can cause suicidal thoughts in some young people. Be alert for any changes to your mood, symptoms, or feelings.You should not take milnacipran after using an MAOI in the last 14 days. This includes isocarboxazid or linezolid. Methylene Blue Injection, phenelzine, rasagiline, and selegiline You must wait 5 days after stopping milnacipran before starting an MAOI. Milnacipran should not be used by those under the age of 18.Milnacipran should not be stopped without consulting your doctor.

Before you take this drug

If you have an allergy to milnacipran, it is best not to use this drug. Milnacipran should not be used if an MAO inhibitor has been taken within the last 14 days. A harmful drug-drug interaction may occur. Included in MAO inhibitors are isocarboxazid (linezolid), phenelzine (phenelzine injection), rasagiline (selegiline), methylene blue injection, and tranylcypromine. You must wait for at least five days after stopping milnacipran before starting an MAOI.

Milnacipran is not recommended for children younger than 18.

If you've ever:

  • Liver disease
  • Kidney disease
  • Hypertension and coronary heart disease.
  • Seizures or epilepsy;
  • Bipolar disorder
  • Bleeding problems
  • Low levels of sodium;
  • Sexual problems
  • If you consume alcohol,
  • If you are taking a blood thinner such as warfarin (Jantoven or Coumadin),.

Make sure to tell your doctor if you are also taking stimulant medicines, opioids, herbs, or medications for mental illnesses like Parkinson’s disease or migraine headaches. Milnacipran can interact with these medicines and lead to a dangerous condition known as serotonin syndrome. Milnacipran can cause suicidal thoughts in some young people. At regular doctor's visits, your doctor should monitor your progress. You or your family members should be aware of any changes you may experience in mood or symptoms. This medicine can cause lung complications or serious problems in infants. If you find out that you are pregnant, tell your doctor immediately. You should not stop or start taking this medication during pregnancy without consulting your doctor. You may find your name on a registry for pregnant women to monitor the effects of milnacipran. Breastfeeding may be unsafe while taking this medication. You should consult your physician about the risks.

How to take Milnacipran?

Read all the instructions or guides that come with your medication and follow the directions. Sometimes, your doctor will change the dose. Follow the instructions on your medicine. If you are feeling the urge to increase your milnacipran intake, tell your doctor. Food can help improve your tolerance for medicine. You will have to check your blood pressure and pulse rate often. If you notice any changes to your sexual function (such as a loss of interest, difficulty having orgasms, problems with erections, or ejaculation in men), tell your doctor. Certain sexual issues can be addressed. You may experience unpleasant withdrawal symptoms if you suddenly stop taking milnacipran. You can ask your doctor about how you can safely discontinue milnacipran. Keep away from heat and moisture. Store at room temperature.

Details on dosage

Usual Adult Dose for Fibromyalgia:
Maintenance dose: Orally, 50 mg twice a day.
The maximum dose is 100 mg, taken orally twice a day. (200 mg per day).
The following schedule can be used to titrate the dosage:
Initial dose: Orally, 12.5mg on the first day
Day 2 and 3. Take 12.5mg orally twice a day.
Days 4–7: Take 25mg orally twice a day.
After day 7, take 50mg orally twice a day.
Fibromyalgia: Treatment with a Chiropody

What happens if I miss the dose?

If you are almost due for the next dose, skip the missed one. Never take more than one dose at a time.

What happens if I overdose?

Call 1-800-222-1222 for poison help or seek immediate medical attention.
The symptoms of an overdose may include extreme sleepiness, a slow heartbeat, a weak pulse, and fainting.

What should be avoided?

Milnacipran can affect your reactions. Avoid dangerous activities or driving until you are sure of how they will impact you. You may be unable to react. Don't drink alcohol. Before taking a nonsteroidal inflammatory drug, such as aspirin (Aspirin), ibuprofen, naproxen, celecoxib, Indomethacin, or meloxicam, ask your doctor. Milnacipran can cause you to bleed or bruise easily if taken with an NSAID.

Interaction with other drug

Milnacipran can make this worse if you take it with drugs that cause drowsiness. Before taking an opioid, sleeping pills, muscle relaxers, anxiety medications, or medicines for seizures or anxiety, consult your doctor. Milnacipran can be affected by other drugs, such as prescription, over-the-counter, herbal, or vitamin products. Inform your doctor of all the medicines you are currently taking and those that you will begin or stop.