Levomilnacipran Hydrochloride

Levomilnacipran Hydrochloride Uses, Dosage, Side Effects, Food Interaction and all others data.

Levomilnacipran Hydrochloride
Uses
Dosage
Side Effect
Precautions
Interactions
Uses during Pregnancy
Uses during Breastfeeding
Accute Overdose
Food Interaction
Half Life
Volume of Distribution
Clearance
Interaction With other Medicine
Contradiction
Storage

Trade Name	Levomilnacipran Hydrochloride
Generic	Levomilnacipran Hydrochloride
Type
Therapeutic Class	Serotonin-norepinephrine reuptake inhibitor (SNRI)
Manufacturer
Available Country	Bangladesh
Last Updated:	September 24, 2024 at 5:38 am

Uses

Levomilnacipran is a serotonin and norepinephrine reuptake inhibitor (SNRI) indicated for the treatment of Major Depressive Disorder (MDD) in adults.Limitation of Use: Levomilnacipran is not approved for the management of fibromyalgia. The efficacy and safety of Levomilnacipran for the management of fibromyalgia have not been established.

Dosage

Levomilnacipran Hydrochloride dosage

Recommended dose: 40 mg to 120 mg once daily with or without food. Initiate dose at 20 mg once daily for 2 days and then increase to 40 mg once daily. Based on efficacy and tolerability, increase dose in increments of 40 mg at intervals of 2 or more days. The maximum recommended dose is 120 mg once daily. Take capsules whole; do not open, chew or crush.Renal Impairment: Do not exceed 80 mg once daily for moderate impairment. Do not exceed 40 mg once daily for severe renal impairment.Discontinuation: Reduce dose gradually whenever possible.

Side Effects

Hypersensitivity Suicidal Thoughts and Behaviors in Adolescents and Young Adults Serotonin Syndrome Elevated Blood Pressure Elevated Heart Rate Increased Risk of Bleeding Angle Closure Glaucoma Urinary Hesitation or Retention Activation of Mania/Hypomania Seizure Discontinuation Syndrome Hyponatremia

Interaction

Strong CYP3A4 inhibitors such as ketoconazole: Do not exceed 80 mg once daily.

Pregnancy & Breastfeeding use

Pregnancy: Third trimester use may increase risk for symptoms of poor adaptation (respiratory distress, temperature instability, feeding difficulty, hypotonia, tremor, irritability) in the neonate.

Contraindication

Hypersensitivity to levomilnacipran, milnacipran HCl or to any excipient in the formulation.The use of MAOIs intended to treat psychiatric disorders with Levomilnacipran or within 7 days of stopping treatment with Levomilnacipran is contraindicated because of an increased risk of serotonin syndrome. The use of Levomilnacipran within 14 days of stopping an MAOI intended to treat psychiatric disorders is also contraindicated.Starting Levomilnacipran in a patient who is being treated with MAOIs such as linezolid or intravenous methylene blue is also contraindicated because of an increased risk of serotonin syndrome.

Special Warning

Pediatric Use: Clinical studies on the use of Levomilnacipran in pediatric patients have not been conducted; therefore, the safety and effectiveness of Levomilnacipran in the pediatric population have not been established. Levomilnacipran is not approved for use in pediatric patients.Geriatric Use: No dose adjustment is recommended on the basis of age. In a multiple-dose clinical pharmacokinetic study, elderly subjects (> 65 years) had a slightly higher exposure (C max by 24% and AUC by 26%) of levomilnacipran than younger subjects (18-45 years). Of the total number of subjects in the 8-week clinical studies of Levomilnacipran, 2.8% of patients were age 65 or older. Because levomilnacipran is predominately excreted by the kidney, renal clearance of levomilnacipran should be considered when determining the dose. SSRIs and SNRIs, including Levomilnacipran, have been associated with cases of clinically significant hyponatremia in elderly patients, who may be at greater risk for this adverse event.Hepatic Impairment: Hepatic elimination of levomilnacipran is low. Dose adjustment is not recommended in subjects with mild (Child-Pugh score of 1-6), moderate (Child-Pugh score of 7-9), or severe (Child-Pugh score of 10-13) hepatic impairment.Renal Impairment: Renal excretion plays a predominant role in the elimination of levomilnacipran. Dose adjustment is not recommended for patients with mild (creatinine clearance of 60-89 ml/min) renal impairment. Dosing adjustment is recommended for patients with moderate (creatinine clearance of 30-59 ml/min) or severe (creatinine clearance of 15-29 ml/min) renal impairment. Levomilnacipran is not recommended for patients with end stage renal disease.