Before Using

Drug information provided by: Merative, Micromedex®

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of milnacipran in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of milnacipran in the elderly. However, elderly patients are more likely to have hyponatremia (low sodium in the blood) and age-related kidney problems, which may require an adjustment in the dose for patients receiving milnacipran.

Breastfeeding

Studies in women breastfeeding have demonstrated harmful infant effects. An alternative to this medication should be prescribed or you should stop breastfeeding while using this medicine.

Drug Interactions

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Isocarboxazid
  • Linezolid
  • Methylene Blue
  • Metoclopramide
  • Ozanimod
  • Phenelzine
  • Procarbazine
  • Rasagiline
  • Safinamide
  • Selegiline
  • Tranylcypromine

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Abciximab
  • Aceclofenac
  • Acemetacin
  • Acenocoumarol
  • Alfentanil
  • Almotriptan
  • Amifampridine
  • Amineptine
  • Amitriptyline
  • Amitriptylinoxide
  • Amoxapine
  • Amphetamine
  • Amtolmetin Guacil
  • Anagrelide
  • Anileridine
  • Apixaban
  • Ardeparin
  • Argatroban
  • Aspirin
  • Avitriptan
  • Bemiparin
  • Benperidol
  • Benzhydrocodone
  • Benzphetamine
  • Betrixaban
  • Bivalirudin
  • Bromfenac
  • Brompheniramine
  • Bufexamac
  • Buprenorphine
  • Bupropion
  • Buspirone
  • Butorphanol
  • Cangrelor
  • Carbamazepine
  • Celecoxib
  • Certoparin
  • Chlorpheniramine
  • Choline Salicylate
  • Cilostazol
  • Citalopram
  • Clomipramine
  • Clonixin
  • Clopidogrel
  • Cocaine
  • Codeine
  • Cyclobenzaprine
  • Dabigatran Etexilate
  • Dalteparin
  • Danaparoid
  • Desipramine
  • Desirudin
  • Desvenlafaxine
  • Dexibuprofen
  • Dexketoprofen
  • Dextroamphetamine
  • Dextromethorphan
  • Dibenzepin
  • Diclofenac
  • Difenoxin
  • Diflunisal
  • Digoxin
  • Dihydrocodeine
  • Diphenoxylate
  • Dipyridamole
  • Dipyrone
  • Dolasetron
  • Donepezil
  • Doxepin
  • Droxicam
  • Duloxetine
  • Edoxaban
  • Eletriptan
  • Enoxaparin
  • Epinephrine
  • Epoprostenol
  • Eptifibatide
  • Escitalopram
  • Ethylmorphine
  • Etodolac
  • Etofenamate
  • Etoricoxib
  • Felbinac
  • Fenfluramine
  • Fenoprofen
  • Fentanyl
  • Fepradinol
  • Feprazone
  • Floctafenine
  • Fluconazole
  • Flufenamic Acid
  • Fluoxetine
  • Flurbiprofen
  • Fluvoxamine
  • Fondaparinux
  • Frovatriptan
  • Gepirone
  • Granisetron
  • Heparin
  • Hydrocodone
  • Hydromorphone
  • Hydroxyamphetamine
  • Hydroxytryptophan
  • Ibuprofen
  • Iloprost
  • Imipramine
  • Indomethacin
  • Iobenguane I 123
  • Iobenguane I 131
  • Ketobemidone
  • Ketoprofen
  • Ketorolac
  • Lasmiditan
  • Lepirudin
  • Levoketoconazole
  • Levomilnacipran
  • Levorphanol
  • Lisdexamfetamine
  • Lithium
  • Lofepramine
  • Lorcaserin
  • Lornoxicam
  • Loxoprofen
  • Lumiracoxib
  • Meclofenamate
  • Mefenamic Acid
  • Melitracen
  • Meloxicam
  • Meperidine
  • Metaxalone
  • Methadone
  • Methamphetamine
  • Methotrexate
  • Mirtazapine
  • Morniflumate
  • Morphine
  • Morphine Sulfate Liposome
  • Nabumetone
  • Nadroparin
  • Nalbuphine
  • Naproxen
  • Naratriptan
  • Nefazodone
  • Nepafenac
  • Nicomorphine
  • Niflumic Acid
  • Nimesulide
  • Nimesulide Beta Cyclodextrin
  • Norepinephrine
  • Nortriptyline
  • Ondansetron
  • Opipramol
  • Opium
  • Opium Alkaloids
  • Oxaprozin
  • Oxycodone
  • Oxymorphone
  • Oxyphenbutazone
  • Palonosetron
  • Papaveretum
  • Parecoxib
  • Paregoric
  • Parnaparin
  • Paroxetine
  • Pentazocine
  • Phenindione
  • Phenprocoumon
  • Phenylbutazone
  • Piketoprofen
  • Piritramide
  • Piroxicam
  • Pranoprofen
  • Prasugrel
  • Proglumetacin
  • Propyphenazone
  • Proquazone
  • Protein C
  • Protriptyline
  • Remifentanil
  • Reviparin
  • Rivaroxaban
  • Rizatriptan
  • Rofecoxib
  • Salicylic Acid
  • Salsalate
  • Selexipag
  • Sertraline
  • Sibutramine
  • Sodium Salicylate
  • St John's Wort
  • Sufentanil
  • Sulfinpyrazone
  • Sulindac
  • Sulodexide
  • Sumatriptan
  • Tapentadol
  • Tenoxicam
  • Tianeptine
  • Tiaprofenic Acid
  • Ticagrelor
  • Ticlopidine
  • Tilidine
  • Tinzaparin
  • Tirofiban
  • Tolfenamic Acid
  • Tolmetin
  • Tramadol
  • Trazodone
  • Treprostinil
  • Trimipramine
  • Tryptophan
  • Valdecoxib
  • Venlafaxine
  • Vilazodone
  • Vorapaxar
  • Vortioxetine
  • Warfarin
  • Ziprasidone
  • Zolmitriptan

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

  • Ethanol

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Alcohol abuse, or history of or
  • Bleeding problems or
  • Depression, history of or
  • Enlarged prostate or
  • Glaucoma, angle-closure or
  • Heart disease or
  • Heart rhythm problems (eg, tachyarrhythmia) or
  • Hypertension (high blood pressure) or
  • Hyponatremia (low sodium in the blood) or
  • Liver disease or
  • Mania, history of or
  • Painful or difficult urination, history of or
  • Seizures, history of or
  • Urinary tract blockage—Use with caution. May make these conditions worse.
  • Kidney disease, end-stage—Use is not recommended in patients with this condition.
  • Kidney disease, moderate or severe—Use with caution. The effects may be increased because of slower removal of the medicine from the body.