Levomilnacipran

Generic name: Levomilnacipran
Brand names: Fetzima
Dosage form: oral capsule, extended release (120 mg; 20 mg; 20 mg-40 mg; 40 mg; 80 mg)
Drug class: Serotonin-norepinephrine reuptake inhibitors

Usage of Levomilnacipran

Levomilnacipran is a serotonin and norepinephrine reuptake inhibitor antidepressant (SNRI).

Levomilnacipran is used to treat major depressive disorder.

A similar medicine called milnacipran (Savella) is used to treat a chronic pain disorder called fibromyalgia. Levomilnacipran (Fetzima) should not be used to treat fibromyalgia.

Levomilnacipran may also be used for purposes not listed in this medication guide.

Levomilnacipran side effects

Get emergency medical help if you have signs of an allergic reaction: skin rash or hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Tell your doctor right away if you have new or sudden changes in mood or behavior, including new or worse depression or anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, more active or talkative, or have thoughts about suicide or hurting yourself.

Levomilnacipran may cause serious side effects. Call your doctor at once if you have:

blurred vision, tunnel vision, eye pain or swelling, eye redness;

painful or difficult urination;

easy bruising, unusual bleeding, purple or red spots under your skin;

pounding heartbeats or fluttering in your chest;

seizure (convulsions);

manic episodes--racing thoughts, increased energy, decreased need for sleep, risk-taking behavior, being agitated or talkative; or

low sodium level--headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady.

Serious side effects may be more likely in older adults.

Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.

Common side effects of levomilnacipran may include:

nausea, vomiting, constipation;

irregular heartbeats;

sweating; 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.

Before taking Levomilnacipran

You should not use levomilnacipran if you are allergic to levomilnacipran or milnacipran (Savella).

Do not use levomilnacipran within 7 days before or 14 days after you have taken an MAO inhibitor. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, and tranylcypromine.

Tell your doctor if you also use stimulant medicine, opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. An interaction with levomilnacipran could cause a serious condition called serotonin syndrome.

Tell your doctor if you have ever had:

glaucoma;

heart problems, high blood pressure;

a stroke;

bleeding problems;

urination problems;

sexual problems;

kidney disease;

a seizure;

low levels of sodium in your blood;

bipolar disorder (manic depression);

if there is a history of depression, manic behavior, or suicide in your family; or

if you drink alcohol.

People with depression or mental illness may have thoughts about suicide. Some young people may have increased suicidal thoughts when first starting a medicine to treat depression. Stay alert to changes in your mood or symptoms. Your family or caregivers should also watch for sudden changes in your behavior.

Taking this medicine during pregnancy could harm the baby, but stopping the medicine may not be safe for you. Do not start or stop levomilnacipran without asking your doctor.

If you are pregnant, your name may be listed on a pregnancy registry to track the effects of levomilnacipran on the baby.

If you are breastfeeding, tell your doctor if your baby is agitated or irritable and has feeding problems or trouble gaining weight.

Not approved for use by anyone younger than 18 years old.

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How to use Levomilnacipran

Usual Adult Dose for Depression:

Initial dose: 20 mg orally once a day for 2 days, then increase to 40 mg orally once a dayMaintenance dose: 40 to 120 mg orally once a dayMaximum dose: 120 mg/dayComments:-The dose may be increased in increments of 40 mg at intervals of 2 or more days based on tolerability and efficacy.-Efficacy was established in trials lasting 5 weeks.Use: Treatment of major depressive disorder (MDD)

Warnings

People with depression or mental illness may have thoughts about suicide. Some young people may have increased suicidal thoughts when first starting a medicine to treat depression. Tell your doctor right away if you have any sudden changes in mood or behavior, or thoughts about suicide.

Do not stop using levomilnacipran without first asking your doctor.

What other drugs will affect Levomilnacipran

Using levomilnacipran with other drugs that make you drowsy can worsen this effect. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety or seizures.

Tell your doctor about all your other medicines, especially:

any other antidepressant;

sibutramine;

St. John's wort;

tryptophan (sometimes called L-tryptophan);

a diuretic or "water pill";

a blood thinner (warfarin, Coumadin, Jantoven);

diet pills, stimulants, or medicine to treat attention deficit hyperactivity disorder (ADHD) such as Adderall or Ritalin;

pain medication--fentanyl, tramadol;

medicine to treat anxiety, mood disorders, thought disorders, or mental illness--Buspirone, lithium, and many others; or

migraine headache medicine--sumatriptan, rizatriptan, zolmitriptan, and others.

This list is not complete. Other drugs may affect levomilnacipran, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Disclaimer

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