milnacipran, Savella (cont.)

Pharmacy Author:
Medical and Pharmacy Editor:
Medical and Pharmacy Editor:

PRESCRIPTION: Yes

GENERIC AVAILABLE: No

PREPARATIONS: Tablets: 12.5, 25, 50, and 100 mg

STORAGE: Milnacipran should be stored at room temperature, 15 C to 30 C (59 F to 86 F).

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]).

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.

Medically Reviewed by a Doctor on 8/15/2014


Report Problems to the Food and Drug Administration

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.

Pill Finder Tool

Need help identifying pills and medications?
Use the pill identifier tool on RxList.


Back to Medications Index