Fetzima (Levomilnacipran)

Description

Indications

Levomilnacipran is prescribed for the treatment of depression. Belonging to the class of selective serotonin and norepinephrine reuptake inhibitors (SNRIs), levomilnacipran functions by augmenting the levels of serotonin and norepinephrine. These are essential neurotransmitters in the brain that play a crucial role in regulating mental equilibrium.

Uses and Dosage

Levomilnacipran is administered orally in the form of extended-release capsules, designed to provide a prolonged effect. It is typically taken once a day, either with or without food.

Consistency in timing is recommended, aiming to take levomilnacipran at approximately the same time each day. Strictly follow the prescribed dosage regimen and refrain from adjusting the dose or frequency without professional guidance.

The capsules should be swallowed whole and should not be opened, chewed, or crushed.

Initially, your doctor may initiate treatment with a low dose of levomilnacipran, gradually increasing it, but not more frequently than once every 2 days.

While levomilnacipran effectively manages depression, it does not provide a cure. It may take a few weeks or longer before the full benefits of levomilnacipran are realized.

Even if you start to feel better, continue taking levomilnacipran as prescribed. Abruptly discontinuing levomilnacipran without consulting your doctor is not advised. Your doctor will likely taper your dosage gradually. Abrupt cessation of levomilnacipran may lead to withdrawal symptoms such as changes in mood, restlessness, irritability, dizziness, tinnitus, electric shock-like sensations, anxiety, confusion, fatigue, insomnia, numbness or tingling in the extremities, headaches, increased sweating, seizures, or nausea. Should you experience any of these symptoms during the dose reduction process, promptly inform your doctor.

Side Effects

Some side effects may occur that usually do not need medical attention:

• nausea
• constipation
• excessive sweating
• vomiting
• sexual problems in males; decreased sex drive, inability to get or keep an erection, or delayed or absent ejaculation
• sexual problems in females; decreased sex drive, or delayed orgasm or unable to have an orgasm
• decreased appetite

Inform your healthcare provider immediately if you experience any serious side effects:

• rash
• hives
• swelling
• difficulty breathing or swallowing
• hallucinations
• confusion
• memory problems
• difficulty concentrating
• agitation, fever, sweating, confusion, fast or irregular heartbeat, severe muscle stiffness or twitching, loss of coordination, nausea, vomiting, or diarrhea
• unsteady walking that may cause falling
• seizures
• fainting
• coma
• abnormal bleeding or bruising
• difficulty urinating or unable to urinate
• rapid, pounding, or irregular heartbeat

Caution

Prior to initiating levomilnacipran, inform your doctor or pharmacist about any known allergies to levomilnacipran, milnacipran, or any other substances. This medication may contain inactive ingredients that can cause allergic reactions or other complications.

Before using this medication, disclose your medical history to your doctor or pharmacist, particularly if you have a history of bleeding disorders, kidney problems, glaucoma (specifically angle-closure type) in yourself or your family, bipolar disorder, a personal or family history of suicide attempts, high blood pressure, heart conditions, insufficient blood flow to the brain, urinary retention or difficulties in urination, seizures, or mineral imbalances.

This medication may cause dizziness or blurred vision. The consumption of alcohol or marijuana can intensify these effects. Refrain from driving, operating machinery, or engaging in activities that require alertness or clear vision until you can safely do so.

Elderly individuals may be more susceptible to the side effects of this medication, particularly bleeding. Additionally, older adults may have a higher risk of experiencing mineral imbalances, specifically low sodium levels in the blood, while using this medication, especially if they are taking diuretics (“water pills”).

During pregnancy, this medication should only be used when clearly necessary, as it may pose a risk to the unborn baby. Infants born to mothers who have used this medication during the last three months of pregnancy may rarely exhibit withdrawal symptoms, such as difficulties with feeding or breathing, seizures, muscle stiffness, or persistent crying. If you observe any of these symptoms in your newborn, promptly inform the doctor.

Since untreated mental/mood disorders can be serious conditions, do not discontinue this medication without the guidance of your doctor. If you are planning a pregnancy, become pregnant, or suspect you may be pregnant, promptly discuss the potential benefits and risks of using this medication during pregnancy with your doctor.

It is unknown whether this medication passes into breast milk. Similar drugs have been found to pass into breast milk. Consult your doctor before breastfeeding.

Form and Strength

Fetzima is available in the following forms and strengths:

• Fetzima capsule:
  • 20mg
  • 40mg
  • 80mg

FAQ

Is Fetzima good for anxiety?

Fetzima belongs to a class of drugs called serotonin-norepinephrine reuptake inhibitors. These drugs are recommended as a first-choice treatment option for generalized anxiety disorder.

Can Fetzima work immediately?

Fetzima may take a while to work. Many people report some effects within 1 to 2 weeks, but full effects may take up to 6 to 8 weeks of use.

Resources

1. https://www.medicalnewstoday.com/articles/326812#uses
2. https://www.goodrx.com/fetzima/what-is#faqs
3. https://www.mayoclinic.org/drugs-supplements/levomilnacipran-oral-route/side-effects/drg-20061242?p=1
4. https://www.webmd.com/drugs/2/drug-165446/fetzima-oral/details
5. https://medlineplus.gov/druginfo/meds/a613048.html
6. https://www.drugs.com/fetzima.html