Milnacipran is used in the management of fibromyalgia (condition in which there is severe fatigue and muscle aches).
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.
Take it together with food or immediately after a meal. Try to take it at the same time each day.
Milnacipran is available as a tablet or as a capsule.
Swallow the tablet or capsule whole with a glass of water. Do not divide, chew or crush the 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 response to the medication.
Milnacipran must be taken regularly for it to be effective. Continue taking it even when you feel better. Do not stop taking it suddenly as it 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.
Alert your doctor if you have the following conditions:
- severe or unstable heart disease
- at high risk of serious arrhythmia (irregular or abnormal heartbeat)
- uncontrolled high blood pressure
- uncontrolled narrow-angle glaucoma (increased pressure in the eye)
as this medicine may not be suitable for you.
Do not take Milnacipran with medicines used to treat depression known as monoamine oxidase inhibitors (MAOIs), certain antibiotic or medicine used for blood disorder. Please see section “Can I take it with other medicines?” below for more information.
Inform your doctor if you have the following conditions:
- depression and other mood disorders
- bipolar disorder (mood changes between feeling very high and very low)
- with or a history of epilepsy (fits or seizures)
- conditions predisposing to fits or seizures e.g. brain damage, alcoholism
- controlled narrow-angle glaucoma (increased pressure in the eye)
- previous bleeding problems
- high blood pressure or other heart diseases
- low blood volume circulating in the body
- history of conditions that causes difficulty urinating e.g. prostate enlargement or inflammation
- long-term and 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 this medicine to an elderly.
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
- Your blood pressure and heart rate may rise to unsafe levels without you noticing it. Monitor your blood pressure and pulse before and during treatment with Milnacipran.
- You may need to have routine tests such as kidney function test and eye examination. Your doctor will advise you about how often you will need to have these tests.
- It is important for you to monitor your condition especially at the start of treatment and if your dosage is still being adjusted. Monitoring for unusual changes of behaviour or mood may be needed while you are being treated with this medicine.
Milnacipran may reduce your mental or physical ability to perform certain tasks. If affected, do not drive or take part in any activity in which you need to be alert.
Other side effects include any of the following: headache, dizziness, migraine, nausea, dry mouth, constipation, stomach pain, loss of appetite, hot flushes, excessive sweating, difficulty sleeping, difficulty passing urine.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- having thoughts of self-harm
- unusual changes in mood or behaviour (being too depressed, being irritable, aggressive, or having compulsive and impulsive behaviour)
- confusion or hallucination (seeing, hearing or feeling things that are not existent)
- palpitations, fast or irregular heartbeat, chest pain
- fits or seizures
- yellowing of the skin and whites of the eyes
- unusual bleeding or bruising
- rashes, breathlessness, swollen mouth or eyes
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 to treat depression known as monoamine oxidase inhibitor (MAOI) such as isocarboxazid, phenelzine and tranylcypromine within 14 days of stopping MAOI or within 5 days of stopping Milnacipran.
Do not take this medicine if you are taking or using any of the following medicines:
- linezolid (antibiotic)
- methylene blue (medicine for blood disorder)
Inform your doctor and pharmacist if you are taking any of these medicines:
- medicines to treat mood disorder e.g. lithium, clomipramine
- medicines for migraine e.g. sumatriptan
- medicines for pain and inflammation e.g. NSAIDs, aspirin
- water pills or medicines for water retention
- strong painkillers e.g. fentanyl, tramadol
- buspirone (medicine for anxiety)
- warfarin (blood-thinning medicine)
- digoxin (medicine for heart disease)
- clonidine (medicine for high blood pressure)
- St. John’s wort (herbal supplement)
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.
Store in a cool dry place away from the reach of children.
Medicines must not be used past the expiry date.