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Savella (milnacipran) affects certain chemicals in the brain called neurotransmitters. An abnormality in these chemicals is thought to be related to fibromyalgia (a medical condition that causes chronic pain in the muscles and joints).
Savella is not used to treat depression but it works similarly to how some antidepressants work.
Savella is used to treat the chronic pain caused by fibromyalgia (a medical condition that causes chronic pain in the muscles and joints).
Do not use Savella if you have used an MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine. After you stop taking milnacipran, you must wait at least 5 days before you start taking an MAOI.
You may have thoughts about suicide when you first start taking Savella, 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.
Report 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 while taking Savella. It may increase your risk of liver damage.
Tell your doctor if you regularly use other medicines that make you sleepy (such as cold or allergy medicine, sedatives, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression, or anxiety). They can add to sleepiness caused by Savella. Milnacipran may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. RELATED PRODUCTS
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May take with food. Titrate dose. Day 1: 12.5mg once. Days 2–3: 12.5mg twice daily. Days 4–7: 25mg twice daily. After Day 7: 50mg twice daily (recommended dose); max 100mg twice daily. Severe renal impairment (CrCl 5–29mL/min): maintenance 25mg twice daily; max 50mg twice daily. Withdraw gradually.
<18yrs: not recommended.
Concomitant MAOIs during or within 5 days of discontinuing milnacipran. During or within 14 days of discontinuing an MAOI. Concomitant linezolid or IV methylene blue. Uncontrolled narrow-angle glaucoma
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See Contraindications. Avoid IV digoxin (postural hypotension, tachycardia). Increased risk of serotonin syndrome with other serotonergic drugs (eg, triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, tryptophan, buspirone, amphetamines, St. John’s Wort) or with drugs that impair serotonin metabolism (eg, MAOIs, linezolid, IV methylene blue). Increased risk of bleeding with concomitant aspirin, NSAIDs, or others that affect coagulation. May antagonize certain antihypertensives (eg, clonidine). Caution with other CNS-active drugs. Arrhythmias, hypertension with epinephrine, norepinephrine.
Nausea, vomiting, headache, constipation, dizziness, insomnia, hot flush, hyperhidrosis, palpitations, increased heart rate, dry mouth, hypertension; rare: GU effects in men.
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