Milnacipran is used in the management of fibromyalgia (a condition characterised by pain all over the body accompanied by tiredness and problems in sleep, memory, or mood).
This medicine may also be used to treat depression.
Take Milnacipran exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.
You may take this medicine with or without food. If it causes stomach discomfort, you may take Milnacipran with food. Try to take it at the same time each day.
Milnacipran is available as a tablet or capsule.
The dose of this medicine will be decided by your doctor. Your doctor will advise you on the treatment timeframe depending on your condition and response to the medication.
Milnacipran must be taken regularly for it to be effective. Continue taking this medicine even when you feel better. Do not stop taking it suddenly as this may worsen your condition.
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.
DO NOT double a dose under any circumstances.
If you often forget to take your medicine, let your doctor and pharmacist know.
Do not take Milnacipran with medicines used to treat depression known as monoamine oxidase inhibitors (MAOI) and a certain antibiotic. Please see the section "Can I take it with other medicines?" below for more information.
Inform your doctor if you have the following conditions:
- history of epilepsy (fits or seizures) or conditions predisposing to epilepsy e.g. brain damage
- depression and other mood disorders
- bipolar disorder (mental condition that causes extreme mood changes between feeling very high [mania] and very low [depression])
- heart disease e.g. high blood pressure, arrythmia (irregular or abnormal heartbeat)
- history of conditions that cause difficulty urinating or painful urination e.g. prostate enlargement
- glaucoma (increased pressure in the eyes)
- severe liver disease
- moderate to severe kidney disease
Let your doctor know if you are pregnant or breastfeeding.
Be sure to check with your doctor or pharmacist before giving Milnacipran to the elderly. Elderly people may be more sensitive to the side effects.
Notify your doctor if you consume large amounts of alcohol or if you are a frequent drinker.
Why is it important to keep my appointments with the doctor?
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
- Routine tests (e.g. kidney function) may be done while you are being treated with this medicine. Your doctor will advise you about how often you need to have these tests.
- Your blood pressure and heart rate may rise to unsafe levels without you noticing it. Monitor your blood pressure and heart rate regularly during treatment.
- Regular monitoring for signs of depression or unusual changes in mood or behaviour may also be needed.
Milnacipran may cause any of the following side effects: vomiting, constipation, stomach pain, headache, dizziness, difficulty sleeping, hot flushes, and dry mouth.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- agitation, confusion, hallucinations (seeing, hearing or feeling things that are not existent), fever, fast heartbeat, excessive sweating, muscle stiffness or spasms
- unusual changes in mood or behaviour (being too depressed, agitated, or having compulsive and impulsive behaviour)
- having thoughts of self-harm
- trouble breathing, weakness, loss of balance, fainting or passing out, seizures
- yellowing of the skin or eyes, abdominal pain, dark coloured urine, tiredness, swelling in the legs and ankles
- unusual bleeding or bruising
- vomiting blood or ground coffee-like material, blood in the urine, bloody or black as tar stools, gum bleeding, abnormal vaginal bleeding
- eye pain, change in eyesight, or swelling or redness in or around the eye
- not able to pass urine or change in how much urine is passed
- changes in sex drive, delayed or inability to have orgasm, erection problems
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Do not take Milnacipran if you are currently taking or have taken a medicine that is used to treat depression known as a monoamine oxidase inhibitor (MAOI) such as isocarboxazid, phenelzine and tranylcypromine in the last 14 days.
Do not take this medicine with linezolid (an antibiotic).
Inform your doctor and pharmacist if you are taking any of these medicines:
- other medicines to treat depression
- medicines for mood disorders e.g. lithium, clomipramine
- NSAIDs (medicines for pain and inflammation)
- blood-thinning medicines e.g. warfarin, heparin
- strong painkillers e.g. fentanyl, tramadol
- medicines for migraine e.g. eletriptan, almotriptan
- clonidine (medicine for high blood pressure)
- buspirone (medicine for anxiety)
- St John's wort (herbal medicine)
This list does not include all medicines that may interact with Milnacipran.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements, and medicines that you buy without a prescription.
Avoid alcohol. Consuming large amount of alcohol is very damaging to the liver.
Store in a cool dry place away from the reach of children.
Medicines must not be used past the expiry date.
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