milnacipran, Savella

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

  • Medical and Pharmacy Editor: Charles Patrick Davis, MD, PhD
    Charles Patrick Davis, MD, PhD

    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

Fibromyalgia Overview Slideshow

PRESCRIBED FOR: Milnacipran is used for the treatment of pain associated with fibromyalgia. In studies of adults (18-74 years old), milnacipran provided better pain relief than placebo (sugar pill). Some patients may experience relief as early as 1 week after treatment begins.

DOSING: 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).

DRUG INTERACTIONS: 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]).

Medically Reviewed by a Doctor on 8/15/2014

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