Precautions

Drug information provided by: Micromedex

It is important that your doctor check your progress at regular visits to allow for changes in your dose and to help reduce any side effects.

Milnacipran may cause some people to be agitated, irritable, or display other abnormal behaviors. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed. If you or your caregiver notice any of these side effects, tell your doctor right away.

Do not take this medicine during the 2 weeks (14 days) after stopping a monoamine oxidase inhibitor (MAOI) (eg, isocarboxazid [Marplan®], linezolid [Zyvox®], methylene blue injection, phenelzine [Nardil®], selegiline [Eldepryl®], or tranylcypromine [Parnate®]). Do not take an MAO inhibitor for at least 5 days after stopping milnacipran. Talk to your doctor about this if you have questions.

Make sure your doctor knows if you are also using aspirin, NSAIDs (eg, ibuprofen, naproxen, Advil®, Aleve®, Celebrex®, Motrin®), or a blood thinner (eg, warfarin, Coumadin®). Milnacipran may increase your risk of bleeding problems when taken together with these medicines.

Make sure your doctor knows about all the other medicines you are using. This medicine may cause a serious condition called serotonin syndrome when taken with certain medicines such as St. John's wort, buspirone, fentanyl, lithium, tryptophan, other medicines to treat depression, or some pain or migraine medicines (eg, rizatriptan [Maxalt®], sumatriptan [Imitrex®], tramadol [Ultram®], or zolmitriptan [Zomig®]. Check with your doctor first before taking any other medicines.

You will also need to have your blood pressure and pulse measured before starting and while you are using this medicine. If you notice any change to your recommended blood pressure or pulse rate, call your doctor right away. If you have questions about this, talk to your doctor.

Liver problems may occur while you are using this medicine. Check with your doctor right away if you are having more than one of these symptoms: abdominal or stomach pain or tenderness, clay-colored stools, dark urine, decreased appetite, fever, headache, itching, loss of appetite, nausea and vomiting, skin rash, swelling of the feet or lower legs, unusual tiredness or weakness, or yellow eyes or skin.

Avoid taking alcohol while you are using this medicine.

This medicine may cause some people to become less alert than they are normally. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are not alert.

Do not suddenly stop taking this medicine without first checking with your doctor. Your doctor may want you to gradually reduce the amount you are using before stopping it completely to decrease the chance of side effects.