Milnacipran belongs to the class of selective serotonin and norepinephrine reuptake inhibitors (SNRIs) and is used to treat fibromyalgia. This chronic condition is characterized by symptoms such as muscle stiffness, tenderness, pain, fatigue, and difficulty falling asleep or staying asleep.
Milnacipran helps to increase the levels of natural substances in the brain, namely serotonin and norepinephrine, which aid in halting the transmission of pain signals.
Uses and Dosage
Take this medication orally, either with or without food, usually twice daily or as instructed by your healthcare provider.
In case of nausea, taking this medication with food may provide relief.
The dosage of this medication is determined based on your medical condition and response to treatment. Your doctor may initiate treatment with a low dose to minimize the risk of side effects and gradually increase the dosage.
Do not exceed the prescribed dose or take this medication more frequently than directed. Doing so may not improve your condition any faster and can increase your chances of experiencing severe side effects.
Abrupt discontinuation of this medication may result in withdrawal symptoms, such as mood swings, headaches, tiredness, changes in sleep patterns, and brief sensations similar to electric shock. To avoid withdrawal symptoms, your doctor may taper your dose gradually. The risk of experiencing withdrawal symptoms is higher if you have used milnacipran for an extended period or in high doses. Notify your doctor or pharmacist immediately if you encounter withdrawal symptoms.
Inform your healthcare provider if your condition does not improve or worsens.
Some side effects may occur that usually do not need medical attention:
- stomach pain
- weight loss
- dry mouth
- feeling of extreme facial warmth and/or redness
- blurred vision
- extreme tiredness
- lack of energy
- loss of appetite
- 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
- pain or swelling of the testicles
- difficulty urinating
Inform your healthcare provider immediately if you experience any serious side effects:
- hallucinations (seeing things or hearing voices that do not exist)
- difficulty concentrating
- memory problems
- sweating or fever
- uncontrollable shaking of a part of the body
- severe muscle stiffness
- unsteady walking that may cause falling
- coma (loss of consciousness for a period of time)
- fast or irregular heartbeat
- difficulty breathing
- pain in the upper right part of the stomach
- yellowing of the skin or eyes
- dark colored urine
- unusual bleeding or bruising
- tiny red spots directly under the skin
Before taking milnacipran, inform your doctor or pharmacist if you are allergic to it, levomilnacipran, or any other allergies. This medication may contain inactive ingredients that can cause allergic reactions or other complications.
Prior to using this medication, disclose your medical history to your doctor or pharmacist, particularly if you have kidney disease, liver disease, alcohol use disorder, glaucoma (angle-closure type), bipolar/manic-depressive disorder, a personal or family history of suicide attempts or psychiatric disorders, high blood pressure, heart problems, seizure disorder, dehydration, intestinal ulcers/bleeding, low levels of sodium in the blood, or painful/difficult urination (enlarged prostate).
This medication can cause dizziness. Alcohol or cannabis use can exacerbate this side effect. Do not drive, operate machinery, or engage in any activity that requires alertness until you can do so safely.
Older adults may be more susceptible to this medication’s side effects, particularly bleeding. When using this drug, older adults may also be more vulnerable to mineral imbalances, especially low sodium levels in the blood, particularly when taking diuretics (water pills) with this medication.
During pregnancy, only use this medication if it is clearly necessary. Discuss the benefits and risks with your doctor. Infants born to mothers who used this drug during the final three months of pregnancy may experience withdrawal symptoms such as breathing/feeding difficulties, muscle stiffness, seizures, or constant crying. Inform your doctor immediately if you observe any of these symptoms in your newborn.
This medication passes into breast milk. Consult your doctor before breastfeeding.
Form and Strength
Savella is available in the following forms and strengths:
How long does it take for Savella to work?
Some patients who experienced overall improvement with Savella also experienced pain reduction as early as week one of taking a stable dose. It may take several weeks for patients to feel the effect of Savella.
Does Savella help with fatigue?
In addition to relieving fibromyalgia pain, Savella may help reduce the fatigue common in people who have fibromyalgia.