MILNACIPRAN

(mil NA si pran) Brand: Savella

What is the most significant information I must know about milnacipran?

• Do not take milnacipran together with thioridazine (Mellaril), or a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate). You should wait at least 14 days after stopping an MAOI till you can take milnacipran. After you stop taking milnacipran, you should wait at least 5 days till you start taking an MAOI.

• You may have thoughts about suicide when you first start taking this medicine, especially if you are younger than 24 years old. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

• Message any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

• Avoid drinking alcohol. It may magnify your risk of liver damage.

• Speak your doctor if you regularly use another medicines that create you sleepy (such as cool or allergy medication, sedatives, narcotic pain medication, sleeping pills, muscle relaxers, and medication for seizures, depression, or anxiety). They can add to sleepiness caused by milnacipran.

• Milnacipran may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

What is milnacipran?

• Milnacipran affects determined chemicals in the brain called neurotransmitters. An abnormality in these chemicals is thought to be related to fibromyalgia. Milnacipran is not used to treat depression but how it works in the body is similar to how some antidepressants work.

• Milnacipran is used to treat a chronic pain mess called fibromyalgia.

• Milnacipran may also be used for another purposes not listed in this medicine guide.

What must I discuss with my healthcare provider till taking milnacipran?

• Do not use milnacipran together with thioridazine (Mellaril), or an MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), rasagiline (Azilect), or selegiline (Eldepryl, Emsam). Serious and sometimes fatal reactions can occur when these medicines are taken with milnacipran. You should wait at least 14 days after stopping an MAO inhibitor till you can take milnacipran. After you stop taking milnacipran, you should wait at least 5 days till you start taking an MAOI.

• You must not use this medicine if you are allergic to milnacipran, or if you have untreated or uncontrolled narrow-angle glaucoma.

• If you have any of these another conditions, you may need a doze adjustment or particular tests:

· liver or kidney disease;

· heart malady, tall blood pressure, heart rhythm disorder;

· seizures or epilepsy;

· glaucoma;

· a bleeding or blood clotting mess such as hemophilia;

· enlarged prostate, urination problems;

· bipolar mess (manic depression);

· a history of hard alcohol use;

· a history of suicidal thoughts or actions; or

· if you are allergic to aspirin or yellow food dye.

• You may have thoughts about suicide while taking this medicine, especially if you are younger than 24 years old. Speak your doctor if you have new or worsening depression or suicidal thoughts during the first different weeks of treatment, or whenever your doze is changed.

• Your family or another caregivers must also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

• FDA pregnancy category C. It is not known whether milnacipran will harm an unborn child. Speak your doctor if you are pregnant or plan to become pregnant while using this medication.

• It is not known whether milnacipran passes into breast milk or if it could harm a nursing child. Do not use this medicine without telling your doctor if you are breast-feeding a baby.

• Older adults may be more sensitive to the side effects of this medication.

• Do not give milnacipran to anyone younger than 17 years old without the advice of a doctor.

How must I take milnacipran?

• Take exactly as predesigned by your doctor. Do not take in larger or less amounts or for longer than recommended. Follow the directions on your prescription label. Your doctor may occasionally change your doze to create certain you get the excellent results.

• Take the medication with food if it upsets your stomach.

• Your blood pressure will need to be checked often. Visit your doctor regularly.

• Do not stop using milnacipran suddenly, or you could have unpleasant withdrawal symptoms such as dizziness, anxiety, feeling irritable, confusion, headache, ringing in your ears, and sleep problems. Conversation to your doctor about how to avoid withdrawal symptoms when you stop using milnacipran.

• Store at room temperature away from moisture and heat.

What happens if I miss a dose?

• Take the missed doze as soon as you remember. Skip the missed doze if it is nearly time for your following scheduled doze. Do not take extra medication to create up the missed dose.

What happens if I overdose?

• Search abnormal medical attention or call the Poison Help line at 1-800-222-1222. Overdose symptoms may include extreme drowsiness, slow heart course, weak pulse, fainting, and slow breathing (breathing may stop).

What must I avoid while taking milnacipran?

• Avoid drinking alcohol. It may magnify your risk of liver damage.

• Milnacipran may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

What are the possible side effects of milnacipran?

• Get abnormal medical help if you have any of these signs of an allergic reaction: skin rash or hives; difficulty breathing; swelling of your person, lips, tongue, or throat.

• Call your doctor at once if you have any of these serious side effects:

· pounding heartbeats or fluttering in your chest;

· painful or difficult urination;

· light bruising or bleeding, nosebleeds, bloody or tarry stools, coughing up blood;

· severe weakness, seizure (convulsions);

· chills or goose bumps, memory problems, trouble concentrating,

· agitation, hallucinations, quick heart course, overactive reflexes, nausea, vomiting, diarrhea, loss of coordination, fainting;

· very stiff (rigid) muscles, tall fever, confusion, quick or uneven heartbeats, tremors, feeling like you might pass out;

· tall blood pressure (severe headache, blurred vision, buzzing in your ears, chest pain, shortness of breath, uneven heartbeats); or

· stomach pain, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

• Smaller serious side effects may include:

· headache;

· dizziness, drowsiness, weary feeling;

· swelling in your hands or feet;

· constipation, upset stomach, bloating;

· dry mouth;

· sleep problems (insomnia);

· hot flashes, sweating;

· weight changes; 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 message side effects to FDA at 1-800-FDA-1088.

What another drugs will affect milnacipran?

• Till using milnacipran, speak your doctor if you regularly use another medicines that create you sleepy (such as cool or allergy medication, sedatives, narcotic pain medication, sleeping pills, muscle relaxers, and medication for seizures, depression, or anxiety). They can add to sleepiness caused by milnacipran.

• Ask your doctor till taking any medication for pain, arthritis, fever, or swelling. This includes aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), diclofenac (Voltaren), indomethacin, piroxicam (Feldene), nabumetone (Relafen), etodolac (Lodine), and others. Taking any of these drugs with milnacipran may reason you to bruise or bleed easily.

• Speak your doctor about all another medications you use, especially:

· a blood thinner such as warfarin (Coumadin);

· clonidine (Catapres, Clorpres);

· a diuretic (water pill);

· digoxin (digitalis, Lanoxin);

· epinephrine (Epi-Pen);

· lithium (Lithobid, Eskalith);

· tramadol (Ultram);

· tryptophan (sometimes called L-tryptophan);

· medication to treat a psychiatric disorder;

· medicines to treat Parkinson's malady, restless leg syndrome, or pituitary gland tumor (prolactinoma);

· migraine headache medication such as almotriptan (Axert), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt), sumatriptan (Imitrex, Treximet), or zolmitriptan (Zomig); or

· an antidepressant such as citalopram (Celexa), duloxetine (Cymbalta), desvenlafaxine (Pristiq), fluoxetine (Prozac, Sarafem, Symbyax), paroxetine (Paxil), sertraline (Zoloft), or venlafaxine (Effexor).

• This list is not complete and another drugs may interact with milnacipran. Speak your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal commodity. Do not start a new medicine without telling your doctor.

Where can I get more information?

• Your pharmacist can provide more information about milnacipran.

Remember, hold this and all another medicines out of the reach of children, never share your medicines with others, and use this medicine only for the indication prescribed.

Disclaim: Each effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses external of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way must be construed to indicate that the drug or drug combination is safety, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the help of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

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