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
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.
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.
Contraindications
- Uncontrolled narrow-angle glaucoma
- Concomitant use with MAOI or within 2 weeks of MAOI withdrawal
Side effects
Common Side Effects:
- Nausea and vomiting
- Dizziness
- Insomnia
- Constipation
- Anxiety
- Decreased appetite
- Increased sweating
- Sexual dysfunction
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.
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
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.
Therapeutic class
Serotonin-Norepinephrine Reuptake Inhibitor (SNRI)
Storage conditions
Store in a cool and dry place away from light. Keep out of reach of children.
Chemical structure
Milnacipran Hydrochloride