Generic
Milnacipran Hydrochloride
3 brands available in the market
At a glance
Milnacipran Hydrochloride is an SNRI drug used for the treatment of fibromyalgia and depression.
Description
Milnacipran Hydrochloride is a serotonin and norepinephrine reuptake inhibitor (SNRI) that increases levels of serotonin and norepinephrine in the brain.
Indications
- Fibromyalgia
- Depression
Therapeutic class
Serotonin-Norepinephrine Reuptake Inhibitor (SNRI)
Pharmacological class
Antidepressant
Pharmacology
Milnacipran is a potent inhibitor of neuronal norepinephrine and serotonin reuptake in approximately 1:3 ratio.
Mechanism of action
Increases serotonin and norepinephrine levels to reduce pain and depression.
Dosage
Adult Dose (Oral):
- Day 1: 12.5 mg once
- Days 2-3: 25 mg/day (12.5 mg twice daily)
- Days 4-7: 50 mg/day (25 mg twice daily)
- After Day 7: 100 mg/day (50 mg twice daily)
- Maximum Dose: 200 mg/day (100 mg twice daily)
Child Dose: <17 years: Safety and efficacy not established.
Administration
- May be taken with or without food
- Take at a fixed time each day
- Do not chew or crush
Missed dose
If you miss a dose take it as soon as you remember; skip if its almost time for next dose; do not double the dose.
Side effects
Common Side Effects:
- Nausea and vomiting
- Dizziness
- Insomnia
- Constipation
- Anxiety
- Decreased appetite
- Increased sweating
- Sexual dysfunction
Precautions & warnings
- Caution while driving (may cause dizziness)
- Avoid alcohol
- Do not stop abruptly
- Inform doctor if suicidal thoughts occur
- Contraindicated in uncontrolled narrow-angle glaucoma
- Contraindicated with MAOIs
Contraindications
- Uncontrolled narrow-angle glaucoma
- Concomitant use with MAOI or within 2 weeks of MAOI withdrawal
Drug interactions
- Aspirin NSAIDs Warfarin: Increased bleeding risk
- Centrally-acting drugs: Increased CNS effects
- Serotonergic drugs: Risk of serotonin syndrome
- Clonidine: Inhibits antihypertensive effect
- MAOIs: Serotonin syndrome (potentially fatal)
Food interactions
Caution advised when consuming alcohol with Milnacipran Hydrochloride.
Use in pregnancy
Use in Pregnancy (Category C): Possibly unsafe. Your doctor will weigh benefits and risks.
Pregnancy Category: C — always consult a doctor before taking during pregnancy.
Use in lactation
Use in Lactation: Probably unsafe. May pass into breast milk and harm the baby.
Pediatric use
Safety and efficacy not established in children under 17 years.
Geriatric use
No specific dose adjustment for elderly but caution advised.
Renal / hepatic impairment
Renal Impairment: Mild: no dose adjustment; Moderate: caution; Severe: reduce dose by 50%.
Hepatic Impairment: Mild-moderate: no dose adjustment; Severe: caution.
Overdose effects
Overdose may cause sedation tremor convulsions dyspnea abdominal pain diarrhea fever palpitations hypotension. Supportive treatment.
Storage conditions
Store in a cool and dry place away from light. Keep out of reach of children.
Chemical structure
Milnacipran Hydrochloride