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  • Generic Name: (milnacipran hydrochloride)
    Other Brands: N/A
  • Last Revised: 09/2016
    • What is this medication and its most common uses?

      Savella is a medicine used to manage fibromyalgia (a condition characterized by weakness and pain in the muscles and tissues surrounding the joints).

    • What should I know when beginning and continuing on this medication?

      How does this medication work?

      Savella is thought to work by increasing the activity of chemicals in your brain called serotonin and norepinephrine. By increasing serotonin and norepinephrine, Savella may help improve your symptoms.

      What are the beneficial effects of this medication and when should I begin to have results?

      What: Savella has been shown to relieve pain associated with fibromyalgia.

      When: Everyone responds differently to treatment, so try to be patient and follow your healthcare provider's instructions. It is important that you take Savella exactly as your healthcare provider has prescribed, even if you do not feel better right away.

      How do I know it is working?

      Your healthcare provider may ask you a series of questions from time to time that will help assess how well your symptoms are controlled with treatment.

    • What are the possible side effects of this medication?

      The following is not a full list of side effects. Side effects cannot be anticipated. If any develop or change in intensity, tell your healthcare provider as soon as possible. Only your healthcare provider can determine if it is safe for you to continue taking this medication.

      Savella is not used to treat depression, but it acts like medicines that are used to treat depression and other psychiatric disorders. Savella and antidepressant medicines may increase the risk of suicidal thoughts or actions in some children, teenagers, and young adults within the first few months of treatment or when the dose is changed. Depression or other serious mental illnesses are the most important causes of suicidal thoughts or actions. Watch for these changes and call your healthcare provider right away if you notice new or sudden changes in mood, behavior, thoughts, or feelings, or you have thoughts about suicide or dying, or attempts to commit suicide; experience new or worse depression, anxiety, or panic attacks; have trouble sleeping; have an extreme increase in activity and talking; experience feelings of agitation, restlessness, anger, or irritability; act aggressive or violent; act on dangerous impulses; or have other unusual changes in behavior or mood.

      Savella is not for use in children.

      More common side effects may include: nausea, headache, constipation, dizziness, trouble sleeping, flushing (warm, hot, burning feeling to your face), increased sweating, vomiting, irregular heartbeat, increased heart rate, dry mouth, high blood pressure.

      Less common side effects may include:

      Serotonin syndrome (a potentially life-threatening drug reaction that causes the body to have too much serotonin, a chemical produced by the nerve cells) with symptoms such as agitation, hallucinations, or other changes in mental status, coordination problems, muscle twitching, sweating, fever, diarrhea, muscle rigidity, dizziness, or tremor.

      Liver problems with symptoms such as itching, right upper abdominal (stomach area) pain, dark urine, yellowing of your skin or the whites of your eyes, enlarged liver, or increased liver enzymes.

      Low sodium (salt) levels in the blood with symptoms such as headache, weakness or feeling unsteady, confusion, problems concentrating or thinking, or memory problems. Elderly people may be at greater risk for this.

      Abnormal bleeding or bruising, especially if you also take blood thinners (such as warfarin), nonsteroidal anti-inflammatory drugs (NSAIDs) (such as ibuprofen or naproxen), or aspirin.

      Manic episodes with symptoms such as greatly increased energy, severe trouble sleeping, racing thoughts, reckless behavior, unusually grand ideas, excessive happiness or irritability, or talking more or faster than usual.

      Problems with urination, such as decreased urine flow or an inability to pass any urine. Men may be more likely to have these symptoms, and may develop pain in their testicles or have problems with ejaculation.

      Visual problems with symptoms such as eye pain, changes in vision, or swelling or redness in or around the eye. Only some people are at risk for these problems. You may want to undergo an eye examination to see if you are at risk and receive preventative treatment if you are.

      Savella may also cause seizure.

    • Who should not take this medication?

      Do not take Savella if you are allergic to it or any of its ingredients.

      Do not take Savella if you take another medicine called a monoamine oxidase inhibitor (MAOI) (such as phenelzine, selegiline, or linezolid), a class of medications used to treat depression and other conditions. Do not start taking Savella if you stopped taking an MAOI in the last 2 weeks, unless directed to do so by your healthcare provider.

    • What should I tell my healthcare provider before I take the first dose of this medication?

      Tell your healthcare provider about all prescription, over-the-counter, and herbal medications you are taking before beginning treatment with Savella. Also, talk to your healthcare provider about your complete medical history, especially if you have high blood pressure; have heart, liver, or kidney problems; have bipolar disorder or mania; have low sodium levels in your blood; have or had seizures or bleeding problems; drink alcohol; are pregnant; plan to become pregnant; or are breastfeeding.

    • What is the usual dosage?

      The information below is based on the dosage guidelines your healthcare provider uses. Depending on your condition and medical history, your healthcare provider may prescribe a different regimen. Do not change the dosage or stop taking your medication without your healthcare provider's approval.

      Adults: On the first day of treatment, you will take 1 dose of Savella as prescribed. After your first dose, your healthcare provider will tell you how much Savella to take and when to take it, usually 2 times each day.

      If you have kidney problems, your healthcare provider may adjust your dose appropriately.

      It is important that you do not stop taking this medication abruptly. If you need to change or stop taking this medication, it is important that you only do this with the guidance of your healthcare provider.

    • How should I take this medication?

      Take Savella exactly as prescribed by your healthcare provider. Do not change your dose or stop taking Savella without first talking to your healthcare provider.

      Take Savella with or without food. Taking Savella with food may help you tolerate it better.

    • What should I avoid while taking this medication?

      Do not drive, operate heavy machinery, or engage in other dangerous activities until you know how Savella affects you.

    • What are the possible food and drug interactions associated with this medication?

      If Savella is taken with certain other drugs, the effects of either could be increased, decreased, or altered. Savella may interact with numerous medications. Therefore, it is very important that you tell your healthcare provider about any other medications you are taking.

    • May I receive this medication if I am pregnant or breastfeeding?

      Savella may harm your newborn baby if you take it during the last few months of your pregnancy. Savella can be found in your breast milk. Tell your healthcare provider immediately if you are pregnant, plan to become pregnant, or are breastfeeding.

      If you become pregnant while taking Savella, talk to your healthcare provider about registering with the Savella Pregnancy Registry. The purpose of this registry is to collect information about the safety of Savella during pregnancy.

    • What should I do if I miss a dose of this medication?

      If you miss a dose of Savella, skip the one you missed and return to your regular dosing schedule. Do not take two doses at once.

    • How should I store this medication?

      Store at room temperature.

    • Who should I contact in case of emergency or overdose?
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      In the event of a medical emergency call your doctor or 9-1-1 immediately. In the event of overdose, call your doctor or poison control for further instructions.
      National Poison Control#: Call 1-800-222-1222

      This PDR+ drug information has been developed by the Physicians’ Desk Reference Network (PDRN), a source of medication information trusted by doctors for over 65 years.

      This monograph summarizes the most important information about your medication and does not cover all the information you may need. If you have any questions or concerns or want to learn more about your medication, ask your healthcare provider; he/she will be able to provide answers to your questions. This medication should only be used by the patient for whom it was prescribed and should not be shared with other people.
    • Additional patient resources.
      back to top Use your PDR® Pharmacy Discount Card when you or a family member fills a prescription and ask for your PDR® Discount every
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