Savella

Generic Name: Milnacipran

  • What is this medication and its most common uses?

    Savella is a medicine called a serotonin and norepinephrine reuptake inhibitor (SNRI) used to treat 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 directions. 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 can increase the risk of suicidal thoughts and behavior in children, adolescents, and young adults. Your healthcare provider will monitor you closely for clinical worsening or suicidal/unusual behavior after you start taking Savella or start a new dose of Savella. Tell your healthcare provider right away if you experience anxiety, hostility, sleeplessness, restlessness, impulsive or dangerous behavior, thoughts about suicide or dying, or if you have new symptoms or seem to be feeling worse.

    More common side effects may include: nausea, headache, constipation, dizziness, sleeplessness, flushing (warm, hot, burning feeling to your face), sweating, vomiting, 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 mental status changes (such as agitation or hallucinations), an increase in your heart rate and temperature, lack of coordination, overactive reflexes, muscle rigidity, nausea, vomiting, or diarrhea.

    Liver problems with symptoms such as nausea, fatigue, weakness, itching, yellowing of your skin or the whites of your eyes, right upper abdominal pain, and flu-like symptoms.

    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.

    Low blood sodium (salt) levels with symptoms such as headache, weakness, an unsteady feeling, confusion, problems concentrating or thinking, or memory problems.

    Problems with urination, such as decreased urine flow or an inability to pass any urine.

    Savella may cause seizures, dilation of your pupils, or changes in your blood pressure or heart rate.

  • 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.

    Do not take Savella if you have uncontrolled glaucoma (high pressure in the eye).

  • 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; heart, liver, kidney, or prostate problems; low sodium levels in your blood; a history of glaucoma, bleeding problems, or seizures; or if you 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: The recommended dose is 50 milligrams twice a day. Your healthcare provider will prescribe the appropriate dose for you and may increase your dose as needed, until the desired effect is achieved.

    If you have kidney impairment, 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 improve tolerability.

  • 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.

    Do not drink alcohol while you are taking Savella.

  • 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. It is important to check with your healthcare provider before combining Savella with any of the following: alcohol, aspirin, clomipramine, clonidine, digoxin, epinephrine, lithium, medicines used to treat migraine headaches (such as sumatriptan or zolmitriptan), norepinephrine, NSAIDs (such as ibuprofen or naproxen), tryptophan, or warfarin.

  • 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 if taken while breastfeeding. 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, take it as soon as you remember. However, if it is almost time for your next dose, 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.