Milnacipran

Description

Milnacipran is used to treat the symptoms of depression and other pain disorders. It should be used with caution due to the increased risk of suicidal thoughts. This medicine is not recommended for use in patients less than 18 years of age.

Side effects

Major & minor side effects for Milnacipran

  • Nausea and vomiting
  • Headache
  • Constipation
  • Blurred vision
  • Chills and fever
  • Difficulty in breathing
  • Dizziness
  • Increased sweating
  • Unusual tiredness or weakness
  • Difficult or painful urination
  • Chest pain or discomfort
  • Rapid weight gain

Uses of Milnacipran

What is it prescribed for?

  • Major depressive disorder
  • Fibromyalgia
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Concerns

Commonly asked questions

  • Onset of action
    The amount of time taken by this medicine to show its effect is subject to vary based on the constitution of the individual.
  • Duration of effect
    The amount of time for which this medicine remains effective in the body is subject to vary based on the constitution of the individual.
  • Safe with alcohol?
    Consumption of alcohol is not recommended during treatment with this medicine due to the increased risk of liver damage. Report any signs and symptoms of liver damage such as fever, chills, joint pain or swelling, excessive tiredness or weakness, unusual bleeding or bruising, skin rash, itching, loss of appetite, nausea, vomiting, dark colored urine, yellowing of the skin or the whites of your eyes, etc. to the doctor immediately.
  • Is it habit forming?
    No habit-forming tendencies were reported.
  • Usage in pregnancy?
    This medicine is not recommended for use in pregnant women unless absolutely necessary. All the risks and benefits should be discussed with the doctor before taking this medicine.
  • Usage while breast-feeding?
    This medicine is not recommended for use in breastfeeding women unless absolutely necessary. All the risks and benefits should be discussed with the doctor before taking this medicine.

Allergy

This medicine is not recommended for use in patients with a known allergy to Milnacipran or any other inactive ingredients present along with it.

Monoamine oxidase inhibitors (MAOI)

This medicine is not recommended for use while the patient is receiving treatment with monoamine oxidase inhibitors (MAOI) (Rasagiline/Selegiline/methylene blue etc.). Treatment with Milnacipran should be initiated at least 14 days after stopping the use of MAOI medicines.
Warnings for special population

Pregnancy

This medicine is not recommended for use in pregnant women unless absolutely necessary. All the risks and benefits should be discussed with the doctor before taking this medicine.

Breast-feeding

This medicine is not recommended for use in breastfeeding women unless absolutely necessary. All the risks and benefits should be discussed with the doctor before taking this medicine.
General warnings

Suicidal ideation and behaviour

Use of this medicine is reported to provoke suicidal thoughts and increased suicidal tendencies, especially in young patients. The patient's caretakers should be educated and any signs and symptoms of a change in the behavior should be reported to the doctor. Counseling and monitoring of progress should be performed at regular intervals for such patients. Replacement with a suitable alternative may be necessary in some cases based on the clinical condition.

Withdrawal symptoms

The use of this medicine should not be discontinued abruptly since abrupt discontinuation may result in withdrawal symptoms, especially if you have been using a high dose for a long duration. Do not stop the use of this medicine without consulting your doctor.

Increase in blood pressure

This medicine should be used with caution in patients suffering from hypertension (high blood pressure levels) due to the increased risk of elevated blood pressure levels. Close monitoring of blood pressure levels is recommended during treatment with this medicine. Appropriate dose adjustments or replacement with a suitable alternative may be necessary based on the clinical condition.

Abnormal bleeding

This medicine may increase the risk of bleeding events when it is used along with anti-coagulants, aspirin, warfarin, and nonsteroidal anti-inflammatory drugs (NSAIDs). Appropriate dose adjustments or replacement with a suitable alternative may be necessary in such cases based on the clinical condition.

Use in children

This medicine is not recommended for use in patients less than 18 years of age since the safety and efficacy of use are not clinically established.

Driving or operating machinery

This medicine may cause blurred vision or drowsiness or dizziness in some patients. It is advised that you do not perform any activities such as driving a vehicle or operating machinery if you experience any of these symptoms during treatment with this medicine.

Missed Dose

Take the missed dose as soon as you remember. However, if it is almost time for the next scheduled dose, then the missed dose should be skipped. Do not use extra medicine to make up for the missed dose.

Overdose

Seek emergency medical treatment or contact the doctor in case of an overdose.
All drugs interact differently for person to person. You should check all the possible interactions with your doctor before starting any medicine.
Interaction with Alcohol

Description

N/A

Instructions

Consumption of alcohol is not recommended during treatment with this medicine due to the increased risk of liver damage. Report any signs and symptoms of liver damage such as fever, chills, joint pain or swelling, excessive tiredness or weakness, unusual bleeding or bruising, skin rash, itching, loss of appetite, nausea, vomiting, dark colored urine, yellowing of the skin or the whites of your eyes, etc. to the doctor immediately.
Interaction with Medicine

Ondansetron

Fluoxetine

Linezolid

Aspirin

Disease interactions

Liver Disease

This medicine should be used with caution in patients suffering from liver function impairment due to the increased risk of severe adverse effects. Close monitoring of liver function tests may be required during treatment with this medicine. Appropriate dose adjustments or replacement with a suitable alternative may be necessary in some cases based on the clinical condition.

Renal Disease

This medicine should be used with caution in patients suffering from kidney function impairment due to the increased risk of severe adverse effects. This medicine is not recommended for use in patients suffering from end-stage renal disease. Close monitoring of kidney function tests may be required during treatment with this medicine. Appropriate dose adjustments or replacement with a suitable alternative may be necessary in some cases based on the clinical condition.

Glaucoma

This medicine should be used with caution in patients suffering from glaucoma due to the increased risk of worsening of the condition. Appropriate dose adjustments or replacement with a suitable alternative may be necessary based on the clinical condition.

Hypertension

This medicine should be used with caution in patients suffering from hypertension (high blood pressure levels) due to the increased risk of elevations in blood pressure levels. Close monitoring of blood pressure levels is recommended during treatment with this medicine. Appropriate dose adjustments or replacement with a suitable alternative may be necessary in some cases based on the clinical condition.

Hyponatremia

This medicine should be used with caution in patients suffering from hyponatremia (decreased sodium levels) due to the increased risk of worsening of the condition. Close monitoring of sodium levels, appropriate dose adjustments, or replacement with a suitable alternative may be necessary based on the clinical condition of the patient.

Mania

This medicine should be used with caution in patients suffering from mania due to the increased risk of worsening of the condition. Appropriate dose adjustments or replacement with a suitable alternative may be necessary based on the clinical condition of the patient.

Seizures

This medicine should be used with caution in patients suffering from seizures due to the increased risk of worsening of the condition. Appropriate dose adjustments or replacement with a suitable alternative may be necessary in some cases based on the clinical condition.

Urinary tract obstruction

This medicine should be used with caution in patients suffering from urinary tract obstruction due to the increased risk of worsening of the condition. Appropriate dose adjustments or replacement with a suitable alternative may be necessary in some cases based on the clinical condition.
Food interactions
Information not available.
Lab interactions
Information not available.
Take this medicine exactly as instructed by the doctor and at around the same time every day. Do not use in smaller or larger amounts than the recommended dose. The dose is likely to change over time based on your response and hence adherence to the changes is necessary. Consult the doctor if you experience any undesirable side effects. Do not stop the use of this medicine without consulting your doctor.
Miscelleneous

Can be taken with or without food, as advised by your doctor

To be taken as instructed by doctor

May cause sleepiness

How it works
It works by increasing the levels of certain chemical substances in the brain and thus helps in relieving symptoms of depression. It also stops the movement of pain signals in the brain, thus providing relief from the feeling of pain.
Legal Status

Approved

Approved

Approved

Unknown

Classification

Category

Serotonin-norepinephrine reuptake inhibitors

Schedule

Schedule H

[Internet]. Cdn.neiglobal.com. 2018 [cited 26 September 2018]. Available from:

http://cdn.neiglobal.com/content/pg/live/milnacipran.pdf

[Internet]. Accessdata.fda.gov. 2018 [cited 26 September 2018]. Available from:

https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/022256s013lbl.pdf

DailyMed - Milnacipran hcl tablet [Internet]. Dailymed.nlm.nih.gov. 2018 [cited 26 September 2018]. Available from:

https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=eaa14195-1b9c-423c-9412-d2fe0857e39d

Effect of high-dose milnacipran in patients with depression [Internet]. PubMed Central (PMC). 2018 [cited 26 September 2018]. Available from:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2656309/

Milnacipran - DrugBank [Internet]. Drugbank.ca. 2018 [cited 26 September 2018]. Available from:

https://www.drugbank.ca/drugs/DB04896

Milnacipran: MedlinePlus Drug Information [Internet]. Medlineplus.gov. 2018 [cited 26 September 2018]. Available from:

https://medlineplus.gov/druginfo/meds/a609016.html

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Information on this page was last updated on 4 Jun 2019

Disclaimer

We’ve made all possible efforts to ensure that the information provided here is accurate, up-to-date and complete, however, it should not be treated as a substitute for professional medical advice, diagnosis or treatment. Practo only provides reference source for common information on medicines and does not guarantee its accuracy or exhaustiveness. The absence of a warning for any drug or combination thereof, should not be assumed to indicate that the drug or combination is safe, effective, or appropriate for any given patient. Practo does not assume any responsibility for any aspect of healthcare administered with the aid of information provided above. If you have any doubts about your medication then we strongly recommend that you consult with your doctor, nurse or healthcare provider. See detailed T&C here.