Milnacipran Hydrochloride

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

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

Uses

Milnacipran is indicated for the management of fibromyalgia. Milnacipran is not approved for use in pediatric patients

Dosage

Milnacipran Hydrochloride dosage

The recommended dose of Milnacipranis 100 mg/day (50 mg twice daily). Based on efficacy and tolerability dosing may be titrated according to the following schedule:Day 1:12.5 mg onceDays 2-3:25 mg/day (12.5 mg twice daily)Days 4-7:50 mg/day (25 mg twice daily)After Day 7:100 mg/day (50 mg twice daily)Based on individual patient response, the dose may be increased to 200 mg/day (100 mg twice daily). Doses above 200 mg/day have not been studied. Should be taken with food. Preferably taken during meals.

Side Effects

Increased heart rate, HTN, increased liver enzymes, severe liver injury, hyponatraemia, abnormal bleeding, dysuria, mydriasis, nausea, vomiting, constipation, headache, insomnia, dizziness, hot flushes, hyperhidrosis, palpitations, dry mouth, migraine.

Precaution

Patient with major depressive disorder or other psychiatric disorders, history of dysuria, controlled narrow-angle glaucoma, pre-existing HTN, tachyarrhythmias or other CV disease, history of seizure disorder or condition predisposing to seizures (e.g. brain damage, alcoholism). Avoid abrupt withdrawal. Severe hepatic and moderate to severe renal impairment including ESRD. Pregnancy and lactation.

Interaction

Increased risk of bleeding with aspirin, NSAIDs, warfarin and other drugs that affect coagulation. Increased CNS effects with centrally-acting drugs (e.g. clomipramine). Increased risk of serotonin syndrome and NMS-like reactions with serotonergic drugs (e.g. tramadol), SSRIs, other selective serotonin-norepinephrine reuptake inhibitors, 5-HT1 receptor agonists (e.g. sumatriptan), antipsychotic agents and other dopamine antagonists. May inhibit antihypertensive effect of clonidine. May potentiate adverse haemodynamic effects with digoxin. Paroxysmal HTN and cardiac arrhythmia may occur when taken concurrently with epinephrine or norepinephrine.

Pregnancy & Breastfeeding use

Pregnancy: Patients should be advised to notify their physician if they become pregnant or intend to become pregnant during Milnacipran therapy. Patients should be encouraged to enroll in the Milnacipran Pregnancy Registry if they become pregnant, preferably before any prenatal testing is done. This registry is collecting information about the safety of milnacipran during pregnancy. Nursing: Advise patients to notify their physician if they are breast feeding

Contraindication

Uncontrolled narrow-angle glaucoma. Concomitant use with MAOI or within 2 wk after withdrawal of MAOI.

Special Warning

Renal Impairment: Severe (CrCl 5-29 mL/min): 25 mg bid, may increase to 50 mg bid according to response. End stage renal disease (ESRD): Not recommended.Pediatric use: Safety and effectiveness of Milnacipran in a fibromyalgia pediatric population below the age of 18 have not been established. The use of Milnacipran is not recommended in pediatric patients.

Acute Overdose

Symptoms: Increased BP, cardio-resp arrest, changes in the level of consciousness (ranging from somnolence to coma), confusional state, dizziness, and increased hepatic enzymes. Management: Symptomatic treatment with gastric lavage and activated charcoal. Maintain adequate airway, oxygenation and ventilation and monitor cardiac rhythm and vital signs. May give cyproheptadine with adequate temp control to treat serotonin syndrome.