DRUGS AND SUPPLEMENTS

Levomilnacipran

March 21, 2017

Levomilnacipran Oral capsule, extended-release

What is this medicine?

Levomilnacipran (le vo mil NA si pran) is used to treat depression.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:

  • bleeding disorders

  • glaucoma

  • heart disease

  • high blood pressure

  • history of irregular heartbeat

  • if you drink alcohol

  • kidney disease

  • low levels of sodium in the blood

  • mania or bipolar disorder

  • seizures

  • 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

  • breast-feeding

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.

Overdosage: If you think you've taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

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.

What may interact with this medicine?

Do not take this medicine with any of the following medications:

  • linezolid

  • MAOIs like Azilect, Carbex, Eldepryl, Marplan, Nardil, and Parnate

  • medicines related to levomilnacipran including desvenlafaxine, duloxetine, milnacipran, or venlafaxine

  • methylene blue (injected into a vein)

This medicine may also interact with the following medications:

  • alcohol

  • 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

  • clarithromycin

  • diuretics

  • fentanyl

  • furazolidone

  • isoniazid

  • ketoconazole

  • lithium

  • medicines for heart rhythm or blood pressure

  • NSAIDS, medicines for pain and inflammation, like ibuprofen or naproxen

  • procarbazine

  • ritonavir

  • sibutramine

  • St. John's wort, Hypericum perforatum

  • stimulant medicines for attention disorders, weight loss, or to stay awake

  • tramadol

  • tryptophan

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

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.

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 blood pressure

  • changes in emotions or moods

  • change in sex drive or performance

  • changes in vision

  • confusion

  • fast or irregular heartbeat

  • feeling faint or lightheaded, falls

  • hallucination, loss of contact with reality

  • seizures

  • suicidal thoughts or actions or worsening depression

  • trouble passing urine or change in the amount of urine

  • unusual bleeding or bruising

  • weakness

Side effects that usually do not require medical attention (Report these to your doctor or health care professional if they continue or are bothersome.):

  • constipation

  • difficulty sleeping

  • dry mouth

  • loss of appetite

  • nausea, vomiting

  • sweating

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

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.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.

Levomilnacipran Oral capsule, extended-release, Levomilnacipran Oral capsule, extended-release

What is this medicine?

Levomilnacipran (le vo mil NA si pran) is used to treat depression.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:

  • bleeding disorders

  • glaucoma

  • heart disease

  • high blood pressure

  • history of irregular heartbeat

  • if you drink alcohol

  • kidney disease

  • low levels of sodium in the blood

  • mania or bipolar disorder

  • seizures

  • 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

  • breast-feeding

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.

Overdosage: If you think you've taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

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.

What may interact with this medicine?

Do not take this medicine with any of the following medications:

  • linezolid

  • MAOIs like Azilect, Carbex, Eldepryl, Marplan, Nardil, and Parnate

  • medicines related to levomilnacipran including desvenlafaxine, duloxetine, milnacipran, or venlafaxine

  • methylene blue (injected into a vein)

This medicine may also interact with the following medications:

  • alcohol

  • 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

  • clarithromycin

  • diuretics

  • fentanyl

  • furazolidone

  • isoniazid

  • ketoconazole

  • lithium

  • medicines for heart rhythm or blood pressure

  • NSAIDS, medicines for pain and inflammation, like ibuprofen or naproxen

  • procarbazine

  • ritonavir

  • sibutramine

  • St. John's wort, Hypericum perforatum

  • stimulant medicines for attention disorders, weight loss, or to stay awake

  • tramadol

  • tryptophan

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

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.

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 blood pressure

  • changes in emotions or moods

  • change in sex drive or performance

  • changes in vision

  • confusion

  • fast or irregular heartbeat

  • feeling faint or lightheaded, falls

  • hallucination, loss of contact with reality

  • seizures

  • suicidal thoughts or actions or worsening depression

  • trouble passing urine or change in the amount of urine

  • unusual bleeding or bruising

  • weakness

Side effects that usually do not require medical attention (Report these to your doctor or health care professional if they continue or are bothersome.):

  • constipation

  • difficulty sleeping

  • dry mouth

  • loss of appetite

  • nausea, vomiting

  • sweating

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

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.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.

Updated:  

March 21, 2017

Sources:  

U.S. FDA-approved Package Insert