Milnacipran (By mouth)

Introduction

Milnacipran (mil-NA-si-pran)

Treats a condition called fibromyalgia, which causes muscle pain and stiffness. This medicine is a selective serotonin and norepinephrine reuptake inhibitor (SNRI).

Brand Name(s)

There may be other brand names for this medicine.

Savella, Savella Titration Pack

When This Medicine Should Not Be Used

You should not use this medicine if you have had an allergic reaction to milnacipran or tartrazine (a dye), or if you have used an MAO inhibitor (MAOI) such as isocarboxazid, phenelzine, selegiline, tranylcypromine, Eldepryl®, Marplan®, Nardil®, or Parnate® within the past 14 days. Do not take an MAO inhibitor for at least 5 days after stopping this medicine. You should not use this medicine if you have uncontrolled narrow-angle glaucoma.

How to Use This Medicine

Tablet

  • Your doctor will tell you how much of this medicine to use and how often. Your dose may need to be changed several times in order to find out what works best for you. Do not use more medicine or use it more often than your doctor tells you to.
  • You may take this medicine with or without food.
  • This medicine should come with a Medication Guide. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions. Ask your pharmacist for the Medication Guide if you do not have one. Your doctor might ask you to sign some forms to show that you understand this information.

If a dose is missed:

  • If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.

How to Store and Dispose of This Medicine

  • Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
  • Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any leftover medicine after you have finished your treatment. You will also need to throw away old medicine after the expiration date has passed.
  • Keep all medicine away from children and never share your medicine with anyone.

Drugs and Foods to Avoid

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

  • Make sure your doctor knows if you are using clomipramine (Anafranil®), clonidine (Catapres®), digoxin (Lanoxin®), epinephrine (Adrenalin Chloride®), lithium (Lithane®, Lithobid®, Eskalith®), norepinephrine (Levophed®), or tryptophan supplements. Tell your doctor if you are also using medicine to treat migraine headaches (such as rizatriptan, sumatriptan, zolmitriptan, Imitrex®, Maxalt®, Zomig®), pain or arthritis medicine, also called "NSAIDs" (such as aspirin, ibuprofen, naproxen, tramadol, Advil®, Aleve®, Celebrex®, Motrin®, Ultram®), or a blood thinner (such as warfarin, Coumadin®).
  • Tell your doctor if you are using any medicines that make you sleepy. These include sleeping pills, cold and allergy medicine, narcotic pain relievers, and sedatives.
  • Do not drink alcohol while you are using this medicine.

Warnings While Using This Medicine

  • Make sure your doctor knows if you are pregnant or breastfeeding. Tell your doctor if you have kidney disease, liver disease, heart disease, heart rhythm problems, high blood pressure, bleeding problems, low sodium in the blood, narrow-angle glaucoma, an enlarged prostate, urinary tract blockage, or a history of painful or difficult urination. Also tell your doctor if you have a history of seizures, depression, or mania.
  • For some young adults, this medicine can increase thoughts of suicide. Tell your doctor right away if you start to feel more depressed and have thoughts about hurting yourself. Report any unusual thoughts or behaviors that trouble you, especially if they are new or getting worse quickly. Make sure the doctor knows if you have trouble sleeping, get upset easily, have a big increase in energy, or start to act reckless. Also tell the doctor if you have sudden or strong feelings, such as feeling nervous, angry, restless, violent, or scared. Let the doctor know if you or anyone in your family has bipolar disorder (manic-depressive) or has tried to commit suicide.
  • This medicine may cause a serious condition called serotonin syndrome when taken with certain medicines. Check with your doctor first before taking any other medicines.
  • Liver problems may occur while you are using this medicine. Stop using this medicine and check with your doctor right away if you are having more than one of these symptoms: stomach pain or tenderness; clay-colored stools; dark urine; decreased appetite; fever; headache; itching; loss of appetite; nausea and vomiting; skin rash; swelling of the feet or lower legs; unusual tiredness or weakness; or yellow eyes or skin.
  • This medicine may cause some people to become less alert than they are normally. Avoid driving, using machines, or doing anything else that could be dangerous if you are not alert.
  • Your doctor will need to check your progress at regular visits while you are using this medicine. Be sure to keep all appointments.
  • Do not stop using this medicine suddenly without asking your doctor. You may need to slowly decrease your dose before stopping it completely.

Possible Side Effects While Using This Medicine

Call your doctor right away if you notice any of these side effects:

  • Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing.
  • Chest pain or discomfort.
  • Fast, pounding, or uneven heartbeat or pulse.
  • Numbness, tingling, or burning pain in your hands, arms, legs, or feet.
  • Severe headache.
  • Tremors or seizures.
  • Unusual behavior or thoughts about hurting yourself or others.
  • Unusual tiredness or weakness.
  • Yellowing of your skin or the whites of your eyes.

If you notice these less serious side effects, talk with your doctor:

  • Anxiety or trouble sleeping.
  • Constipation, diarrhea, nausea, vomiting, or stomach pain.
  • Cough, chills, sore throat, or runny or stuffy nose.
  • Dry mouth.
  • Increased sweating.
  • Loss of appetite.
  • Mild headache or dizziness.
  • Problems with sex.
  • Problems with urination.
  • Skin rash or itching.
  • Warmth or redness in your face, neck, arms, or upper chest.
  • Weight loss.

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088

Review Date: 2011-02-04 Reviewed By: Keywords: ,
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