Savella (Milnacipran)

It’s typically taken two times a day, with or without food. Try to take SAVELLA around the same time each day.

Your doctor will probably start you on a low dose of SAVELLA and gradually increase it.

Follow the instructions on your prescription label carefully. Don’t take more or less SAVELLA than your doctor prescribes.

SAVELLA Overdose

Symptoms of an overdose may include:

• Confusion
• Extreme sleepiness
• Coma
• Slowed or stopped breathing
• Slowed or stopped heartbeat

If you suspect an overdose, contact a poison control center or emergency room immediately.

Missed Dose of SAVELLA

If you miss a dose of SAVELLA, take it as soon as you remember.

However, if it’s almost time for your next dose, skip the missed dose and continue on your regular medication schedule.

Don’t double up on doses to make up for a missed one.

Common Side Effects of SAVELLA

Tell your doctor if any of the following side effects become severe or don’t go away:

• Nausea, vomiting, or stomach pain
• Constipation
• Weight loss
• Dry mouth
• Facial warmth or redness
• Headache
• Blurred vision
• Decreased sexual desire or ability
• Pain or swelling of the testicles
• Difficulty urinating
• Itching or rash

Serious Side Effects of SAVELLA

Tell your doctor right away if you experience any of the symptoms listed in the SAVELLA Warnings section above, or any of the following serious side effects:

• Confusion
• Hallucinations
• Difficulty concentrating or memory problems
• Fever
• Sweating
• Diarrhea
• Dizziness or fainting
• Severe muscle stiffness
• Uncontrollable shaking of a part of the body
• Weakness
• Unsteady walking that can cause a fall
• Seizures
• Coma
• Slowed, difficult, or stopped breathing
• Fast or pounding heartbeat
• Extreme fatigue or lack of energy
• Loss of appetite
• Pain in the upper right part of the stomach
• Yellowing of the skin or eyes (jaundice)
• Flu-like symptoms
• Black, tarry, or bloody stools
• Bloody vomit or vomit that looks like coffee grounds
• Unusual bruising or bleeding
• Nosebleeds
• Little red spots directly under the skin

SAVELLA isn’t used to treat depression, but it works like many antidepressants.

In some clinical studies, antidepressants increased the chances of suicidal behavior in a small number of children, teenagers, and young adults.

Young people who take antidepressants for mental health disorders may have a higher risk of suicidal behavior than those who take drugs like SAVELLA for fibromyalgia.

However, this drug may still cause changes in your mental health.

You or your caregiver should call your doctor right away if you experience any of the following symptoms while taking SAVELLA:

• New or worsening depression
• Thoughts about suicide
• Extreme worry
• Agitation
• Panic attacks
• Difficulty falling asleep or staying asleep
• Aggressive behavior
• Irritability
• Severe restlessness
• Acting without thinking
• Frenzied, abnormal excitement

Don’t give this medicine to anyone younger than 17 years old without talking to a doctor.

Older adults may be more sensitive to the side effects of SAVELLA. Talk to your doctor if you’re over the age of 65.

SAVELLA can help control symptoms of fibromyalgia, but it isn’t a cure. Don’t stop taking this drug without first talking to your doctor because you could experience unpleasant withdrawal symptoms.

Before taking SAVELLA, tell your doctor if you have or have had:

• Allergies to any medications
• A history of heavy alcohol use
• Bipolar disorder or another mental health condition
• Glaucoma (an eye condition)
• High blood pressure
• Seizures
• An irregular heartbeat
• An enlarged or irregular prostate
• Bleeding problems
• Difficulty urinating
• Kidney, heart, or liver disease

Tell your doctor you’re taking SAVELLA before any type of surgery, including dental procedures.

This medicine may cause an increase in blood pressure and heart rate.

Your healthcare provider will want to check your blood pressure and conduct other lab tests often while you’re taking SAVELLA. Keep all appointments with your doctor and laboratory.

Pregnancy and SAVELLA

It’s not known if SAVELLA will harm an unborn baby. Tell your doctor if you’re pregnant or plan to become pregnant while taking this medicine.

It’s also not known whether SAVELLA passes into breast milk and could hurt a breastfeeding baby. Talk to your doctor before using this drug while breastfeeding.

Tell your doctor about all prescription, non-prescription, illegal, recreational, herbal, nutritional, or dietary drugs you’re taking, especially:

• Anticoagulants (blood thinners) such as warfarin (Coumadin, Jantoven)
• Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn)
• Buspirone (BuSpar)
• Clonidine (Catapres)
• Digoxin (Lanoxicaps, Digitek, Lanoxin)
• Diuretics (water pills)
• Epinephrine (EpiPen, Primatene Mist)
• Fentanyl (Abstral, Actiq, Fentora, Onsolis, others)
• Lithium (Eskalith, Lithobid)
• Medications for anxiety, mental illness, pain, or seizures
• Medications for migraine headaches such as almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt), sumatriptan (Imitrex), and zolmitriptan (Zomig)
• Sedatives
• Selective serotonin reuptake inhibitors (SSRIs) such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil), and sertraline (Zoloft)
• Sleeping pills
• Tramadol
• Tranquilizers
• Serotonin–norepinephrine reuptake inhibitors (SNRIs) such as duloxetine (Cymbalta), desvenlafaxine (Pristiq), and venlafaxine (Effexor)
• Supplements such as St. John’s wort and tryptophan
• Tricyclic antidepressants such as amitriptyline (Elavil), amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Adapin, Sinequan), imipramine (Tofranil), nortriptyline (Aventyl, Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil)

Also, tell your doctor if you’re taking a monoamine oxidase inhibitor (MAOI) or have taken one in the last 14 days. These drugs include:

• Isocarboxazid (Marplan)
• Linezolid (Zyvox)
• Methylene blue
• Phenelzine (Nardil)
• Selegiline (Eldepryl, Emsam, Zelapar)
• Tranylcypromine (Parnate)

You should also wait at least five days after you stop taking SAVELLA to start taking an MAOI.

SAVELLA and Other Interactions

SAVELLA may make you drowsy.

Don’t drive a car or operate machinery until you know how this medicine affects you.

SAVELLA and Alcohol

Alcohol may worsen certain side effects of SAVELLA and increase your risk of liver damage.

Talk to your doctor about how much alcohol is safe to consume while taking this medicine.