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- What is milnacipran, and how does it work (mechanism of action)?
- What brand names are available for milnacipran?
- Is milnacipran available as a generic drug?
- Do I need a prescription for milnacipran?
- What are the side effects of milnacipran?
- What is the dosage for milnacipran?
- Which drugs or supplements interact with milnacipran?
- Is milnacipran safe to take if I'm pregnant or breastfeeding?
- What else should I know about milnacipran?
What is the dosage for milnacipran?
The recommended starting dose is 12.5 mg once a day, then 12.5 mg every 12 hours for days 2 and 3, then 25 mg every 12 hours for days 4 to 7, then 100 mg twice a day thereafter.
- The maximum dose is 200 mg per day.
- It may be administered with or without food, but food improves the ability to tolerate this medication.
- This drug has not been studied in the pediatric population (under age 18).
Which drugs or supplements interact with milnacipran?
Milnacipran should not be used in combination with a monoamine oxidase inhibitor (MAOI) such as phenelzine (Nardil), tranylcypromine (Parnate), isocarboxazid (Marplan), and selegiline (Eldepryl), or within 14 days of discontinuing the MAOI. At least 5 days should be allowed after stopping milnacipran before starting an MAOI. Combinations of SNRIs and MAOIs may lead to serious, sometimes fatal, reactions including very high body temperature, rigidity, rapid fluctuations of heart rate and blood pressure, extreme agitation progressing to delirium and coma. Similar reactions may occur if milnacipran is combined with antipsychotics, tricyclic antidepressants or other drugs that affect serotonin in the brain (for example, tryptophan and sumatriptan [Imitrex]).
Combining milnacipran with epinephrine or norepinephrine may lead to high blood pressure and abnormal heart beats because milnacipran increases epinephrine and norepinephrine.
Combining milnacipran with aspirin, nonsteroidal antiinflammatory drugs (NSAIDs), warfarin (Coumadin) or other drugs that are associated with bleeding may increase the risk of bleeding, because milnacipran is associated with bleeding.
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