Levomilnacipran extended-release capsule
What is this medicine?
Levomilnacipran (le vo mil NA si pran) is used to treat depression.
How should I use this medicine?
Take this medicine by mouth with a drink of water. This medicine may be taken with or without food. Swallow whole; do not crush, cut, or chew the capsule. Follow the directions on the prescription label. Take your doses at regular intervals. Do not take your medicine more often than directed. Do not stop taking this medicine suddenly except upon the advice of your doctor. Stopping this medicine too quickly may cause serious side effects or your condition may worsen.
Contact your pediatrician or health care professional regarding the use of this medicine in children. Special care may be needed.
A special MedGuide will be given to you by the pharmacist with each prescription and refill. Be sure to read this information carefully each time.
What side effects may I notice from receiving this medicine?
Side effects that you should report to your doctor or health care professional as soon as possible:
allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
changes in vision
elevated mood, decreased need for sleep, racing thoughts, impulsive behavior
fast, irregular heartbeat
feeling faint or lightheaded, falls
feeling agitated, angry, or irritable
hallucination, loss of contact with reality
high blood pressure
loss of balance or coordination
redness, blistering, peeling or loosening of the skin, including inside the mouth
restlessness, pacing, inability to keep still
suicidal thoughts or other mood changes
trouble passing urine or change in the amount of urine
unusual bleeding or bruising
unusually weak or tired
yellowing of the eyes or skin
Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):
change in sex drive or performance
change in appetite or weight
What may interact with this medicine?
Do not take this medicine with any of the following medications:
MAOIs like Carbex, Eldepryl, Marplan, Nardil, and Parnate
methylene blue (injected into a vein)
This medicine may also interact with the following medications:
aspirin and aspirin-like medicines
certain medicines for depression, anxiety, or psychotic disturbances
certain medicines for sleep
certain medicines that treat or prevent blood clots like warfarin, enoxaparin, and dalteparin
certain medicines for migraine headache like almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, zolmitriptan
medicines for heart rhythm or blood pressure
NSAIDS, medicines for pain and inflammation, like ibuprofen or naproxen
St. John's wort, Hypericum perforatum
stimulant medicines for attention disorders, weight loss, or to stay awake
What if I miss a dose?
If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.
Where should I keep my medicine?
Keep out of the reach of children.
Store at room temperature between 20 and 25 degrees C (68 and 77 degrees F). Throw away any unused medicine after the expiration date.
What should I tell my health care provider before I take this medicine?
They need to know if you have any of these conditions:
high blood pressure
history of irregular heartbeat
if you drink alcohol
low levels of sodium in the blood
mania or bipolar disorder
suicidal thoughts, plans, or attempt; a previous suicide attempt by you or a family member
take MAOIs like Azilect, Carbex, Eldepryl, Marplan, Nardil, and Parnate
take medicines that treat or prevent blood clots
trouble passing urine
an unusual or allergic reaction to levomilnacipran, milnacipran, other medicines, foods, or preservatives
pregnant or trying to get pregnant
What should I watch for while using this medicine?
Tell your doctor if your symptoms do not get better or if they get worse. Visit your doctor or health care professional for regular checks on your progress. Because it may take several weeks to see the full effects of this medicine, it is important to continue your treatment as prescribed by your doctor. Do not stop taking except on your doctor's advice. You may develop a severe reaction. Your doctor will tell you how much medicine to take.
Patients and their families should watch out for new or worsening thoughts of suicide or depression. Also watch out for sudden changes in feelings such as feeling anxious, agitated, panicky, irritable, hostile, aggressive, impulsive, severely restless, overly excited and hyperactive, or not being able to sleep. If this happens, especially at the beginning of treatment or after a change in dose, call your health care professional.
This medicine can cause an increase in blood pressure. Check with your doctor for instructions on monitoring your blood pressure while taking this medicine.
You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medicine affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Alcohol may interfere with the effect of this medicine. Avoid alcoholic drinks.
Your mouth may get dry. Chewing sugarless gum, sucking hard candy and drinking plenty of water will help. Contact your doctor if the problem does not go away or is severe.
July 17, 2018