Milpran Side Effects

Like all medicines, this medicine can cause side effects, although not everybody gets them. Side effects can occur especially in the first week or the first two weeks of treatment with milnacipran.
Be immediately advised if patient has any of the following side effects: If he/she develops a rash or an allergic reaction such as itching, swollen lips and/or tongue or wheezing and/or shortness of breath, stop taking the capsules.
If patient experiences sudden weakness or numbness in the face, arms or legs, particularly on one side only, or speech difficulties (symptoms of a cerebrovascular accident).
If patient has heart problems such as chest pain (feeling of tension, tightness, squeezing).
If patient has a set of symptoms related to excess serotonin in the brain (serotonin syndrome) due to significant effects from Milpran manifested by a high fever, nausea, excessive sweating, anxiety, hot flushes, twitching or muscle tremors, palpitations and restlessness. This syndrome is seen particularly in patients taking other drugs simultaneously.
Very common (may affect more than 1 in 10 people): Headache, nausea.
Common (may affect up to 1 in 10 people): Agitation, anxiety, depression, eating disorders, sleep disorders, suicidal behaviour; Migraines, tremors, dizziness, changes in sensitivity, somnolence; Feeling the heartbeat (palpitations), faster heartbeat (tachycardia), increased blood pressure, hot flush; Abdominal pain, diarrhoea, constipation, dry mouth, indigestion, vomiting; Itching, rash, excessive sweating; Muscle pains; Inability to urinate, abnormally frequent urination (pollakiuria); Erectile dysfunction, ejaculation disorders, testicular pain; Fatigue.
Uncommon (may affect up to 1 in 100 people): Hypersensitivity; Increased lipids in the blood, weight loss; Feelings of panic, confusion, delusion, strange visions or sounds (hallucinations), hyperactive behaviour or thoughts (mania), decreased libido, abnormal dreams, suicidal thoughts; Memory problems, feeling restless (akathisia), balance problems, taste changes, syncope; Blurred vision, dry eyes, painful eyes, decreased visual acuity, dilated pupils (mydriasis), accommodation disorders; Sensation of dizziness or spinning (vertigo), ringing or buzzing in the ears (tinnitus); Heart problems, such as low blood pressure, conduction abnormalities; Poor circulation, causing numbness and discoloration in fingers and toes (Raynaud's syndrome), orthostatic hypotension; Difficulty breathing, cough, dry nose, throat conditions; Gastrointestinal disorders such as gastritis, stomatitis, abdominal discomfort, abdominal distension, ulcers, haemorrhoids, colitis; Disturbed liver function tests; Skin disease (dermatosis), allergic skin reactions (hives), skin inflammation (dermatitis); Muscle pain or stiffness; Urinary problems such as urination disorders, urinary retention, incontinence, possibly red-coloured urine; Some women may have irregular heavy menstrual bleeding or no period; Prostate disorders; Feeling abnormal, pain, chills.
Rare (may affect up to 1 in 1,000 people): Anaphylactic shock; Inappropriate secretion of a hormone controlling urine volume (syndrome of inappropriate antidiuretic hormone secretion); Psychotic disorders, derealisation (thinking abnormal); Involuntary movements (dyskinesia), parkinsonism (medical term that can include many symptoms, such as increased secretion of saliva, musculoskeletal stiffness, limited or abnormal body movements, lack of facial expression, muscle tightness, shaking), convulsion; Heart-related pain behind the sternum, which can radiate into the environment (Angina pectoris); Hepatitis, hepatocellular damage Sensitivity to sunlight (photosensitivity reaction).
The following side effects have been reported, however precise frequency cannot be identified and therefore how often these occur is classed as not known: A reduction in the level of sodium in the blood (hyponatremia); bleeding of the skin and mucous membranes; convulsions especially in patients with a history of epilepsy; Serotonin Syndrome; Aggression; Cytolytic hepatitis; Stevens-Johnson syndrome (a serious generalised illness with blistering of the skin and the mucous membranes); Takotsubo cardiomyopathy (Stress cardiomyopathy); *Heavy vaginal bleeding shortly after birth (postpartum haemorrhage), see Use in Pregnancy & Lactation.
*This event has been reported for the therapeutic class of SSRIs/SNRIs.
Some symptoms can also be caused by depression.
Reporting of side effects: Be advised if patient gets any side effects. This includes any possible side effects not listed in this monograph.