Milnacipran
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DRUG STATUS
Government Approvals
None
WHO Essential Medicine
NO
Known Teratogen
No
Pharmaceutical Class
Serotonin and Norepinephrine Reuptake Inhibitor
Controlled Drug Substance
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Milnacipran
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Click HereSummary
Milnacipran is primarily used to manage fibromyalgia, a chronic condition that causes widespread pain, fatigue, and sleep disturbances. It is not used for treating depression or other psychiatric disorders.
Milnacipran is a type of medication known as a selective serotonin and norepinephrine reuptake inhibitor (SNRI). It works by increasing the levels of serotonin and norepinephrine in the brain. These neurotransmitters help regulate mood and pain perception, thereby reducing the symptoms of fibromyalgia.
The usual daily dose for adults is 100 mg, taken as 50 mg twice daily. The dose may be increased to 200 mg per day based on individual response. Milnacipran is taken orally and can be taken with or without food.
Common side effects of Milnacipran include nausea, headache, constipation, dizziness, and increased sweating. More serious side effects can include suicidal thoughts, serotonin syndrome, liver problems, and elevated blood pressure.
Milnacipran carries a risk of suicidal thoughts, especially in young adults. It can also cause a potentially life-threatening condition known as serotonin syndrome. It's contraindicated with MAOIs due to the risk of serotonin syndrome. Regular monitoring for mood changes and blood pressure is advised.
Indications and Purpose
What is Milnacipran used for?
Milnacipran is indicated for the management of fibromyalgia, a chronic condition characterized by widespread pain, muscle stiffness, and fatigue. It is not approved for the treatment of depression or other psychiatric disorders.
How does Milnacipran work?
Milnacipran works by inhibiting the reuptake of norepinephrine and serotonin, two neurotransmitters involved in pain regulation. This action increases their levels in the brain, helping to modulate pain signals and improve symptoms of fibromyalgia.
Is Milnacipran effective?
Milnacipran has been shown to be effective in managing fibromyalgia in clinical trials. Patients experienced significant reductions in pain and improvements in physical function compared to placebo. The exact mechanism involves inhibiting norepinephrine and serotonin reuptake.
How does one know if Milnacipran is working?
The benefit of Milnacipran is evaluated through regular follow-up appointments with your healthcare provider. They will assess symptom improvement, side effects, and overall health to determine the effectiveness of the treatment.
Directions for Use
What is the usual dose of Milnacipran?
The usual daily dose for adults is 100 mg, taken as 50 mg twice daily. The dose can be increased to 200 mg per day based on individual response. Milnacipran is not recommended for children under 18 years of age.
How do I take Milnacipran?
Milnacipran can be taken with or without food, but taking it with food may reduce stomach upset. There are no specific food restrictions, but it's important to follow your healthcare provider's instructions regarding diet and medication use.
For how long do I take Milnacipran?
Milnacipran is typically used for long-term management of fibromyalgia. The duration of use depends on individual response and the advice of a healthcare provider. It is important not to stop taking it abruptly without consulting a doctor.
How long does it take for Milnacipran to start working?
Milnacipran may start to improve symptoms within one week, but it can take several weeks to experience the full benefits. It's important to continue taking the medication as prescribed and consult your healthcare provider if you have concerns about its effectiveness.
How should I store Milnacipran?
Store Milnacipran at room temperature, away from excess heat and moisture. Keep it in its original container, tightly closed, and out of reach of children. Do not store it in the bathroom.
Warnings and Precautions
Who should avoid taking Milnacipran?
Milnacipran carries a risk of suicidal thoughts, especially in young adults. It should not be used with MAOIs due to the risk of serotonin syndrome. Monitor for changes in mood, blood pressure, and heart rate. Avoid abrupt discontinuation to prevent withdrawal symptoms.
Can I take Milnacipran with other prescription drugs?
Milnacipran should not be used with MAOIs due to the risk of serotonin syndrome. Caution is advised when used with other serotonergic drugs, blood thinners, and medications that affect blood pressure. Always inform your healthcare provider of all medications you are taking.
Can I take Milnacipran with vitamins or supplements?
Milnacipran may interact with supplements like St. John's Wort and tryptophan, increasing the risk of serotonin syndrome. Always inform your healthcare provider about any supplements you are taking to avoid potential interactions.
Can Milnacipran be taken safely while pregnant?
There is limited data on the use of Milnacipran during pregnancy. It should be used only if the potential benefit justifies the potential risk to the fetus. Pregnant women should consult their healthcare provider to discuss the risks and benefits.
Can Milnacipran be taken safely while breastfeeding?
Milnacipran is present in breast milk, and its effects on the breastfed infant are unknown. Breastfeeding mothers should consult their healthcare provider to weigh the benefits and risks before using Milnacipran.
Is Milnacipran safe for the elderly?
Elderly patients may be at higher risk for side effects like hyponatremia and should have their renal function assessed before starting Milnacipran. Regular monitoring is recommended, and dose adjustments may be necessary based on individual health conditions.
Is it safe to exercise while taking Milnacipran?
Milnacipran may cause side effects like dizziness and fatigue, which could affect your ability to exercise. If you experience these symptoms, consult your healthcare provider for advice on managing them while maintaining an exercise routine.
Is it safe to drink alcohol while taking Milnacipran?
Drinking alcohol while taking Milnacipran can increase the risk of liver damage and may exacerbate side effects like drowsiness and dizziness. It is advisable to avoid alcohol or discuss with your healthcare provider if you plan to drink occasionally.