Anthropometric Measurements as Predictors of Low Birth Weight Among Tanzanian Neonates: A Hospital-Based Study
November 7, 2025
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Brand Name :
Savella
Synonyms :
milnacipran
Class :
Analgesics, Antidepressants, Serotonin-norepinephrine reuptake inhibitors
Brand Name :
Savella
Synonyms :
milnacipran
Class :
Analgesics, Antidepressants, Serotonin-norepinephrine reuptake inhibitors
Dosage Forms & Strengths
Tablet
100mg
50mg
25mg
12.5mg
Dosing Modifications
Renal impairment
Mild: dosage adjustment is not required
Moderate: should be used with caution
Severe: decrease maintenance dose to 50% (i.e., to 50 mg/day every 12hr)
End-stage renal disease (ESRD): not recommended to use
Hepatic impairment
Mild or moderate: dosage adjustment is not required
Severe: should be use:
12.5 mg orally once on day 1, following 25 mg/day every 12hr from days 2-3, following 50 mg/day every 12hr from days 4-7, following 100 mg/day every 12hr after that should not exceed more than 200 mg/day
Therapy discontinuation
While discontinuing the therapy after more than 3 weeks, gradually taper the dose from 2-4 weeks
Switching to or from MAO inhibitors
Allow 5 or more days to discontinue milnacipran and initiation of MAO inhibitor
Allow 14 days to discontinue MAO inhibitor and initiation of milnacipran
Increase to 50 mg twice a day for severe renal impairment
Children under less than 17 years: safety and efficacy not established
Refer to adult dosing regimen
may have an increased tachycardic effect when combined with Alpha-/Beta-Agonists
may have an increased tachycardic effect when combined with alpha-/beta-agonists
may increase the tachycardic effect of Alpha-/Beta-Agonists
may have an increased hepatotoxic effect when combined with serotonin/norepinephrine reuptake inhibitors
may have an increased tachycardic effect when combined with alpha-/beta-agonists
may decrease the therapeutic effect when combined with Iobenguane Radiopharmaceutical Products
may decrease the therapeutic effect when combined with Iobenguane Radiopharmaceutical Products
may decrease the therapeutic effect when combined with Iobenguane Radiopharmaceutical Products
may decrease the therapeutic effect when combined with Iobenguane Radiopharmaceutical Products
may decrease the therapeutic effect when combined with Iobenguane Radiopharmaceutical Products
may decrease the therapeutic effect when combined with Iobenguane Radiopharmaceutical Products
may decrease the therapeutic effect when combined with Iobenguane Radiopharmaceutical Products
it increases the effect of serotonergic agents
may have an increased antiplatelet effect when combined with Abrocitinib
May have an increased serotonergic effect when combined with Serotonin/Norepinephrine Reuptake Inhibitors
may have an increased serotonergic effect when combined with Methylene Blue
May have an increased serotonergic effect when combined with Serotonin/Norepinephrine Reuptake Inhibitors
May have an increased serotonergic effect when combined with Serotonin/Norepinephrine Reuptake Inhibitors
May have an increased serotonergic effect when combined with Serotonin/Norepinephrine Reuptake Inhibitors
may have an increased serotonergic effect when combined with serotonin/norepinephrine reuptake inhibitors
may have an increased serotonergic effect when combined with serotonin/norepinephrine reuptake inhibitors
may have an increased serotonergic effect when combined with serotonin/norepinephrine reuptake inhibitors
may have an increased serotonergic effect when combined with serotonin/norepinephrine reuptake inhibitors
may have an increased serotonergic effect when combined with serotonin/norepinephrine reuptake inhibitors
May have an increased serotonergic effect when combined with Serotonin/Norepinephrine Reuptake Inhibitors
may decrease the therapeutic effect when combined with iobenguane radiopharmaceutical products
may decrease the therapeutic effect when combined with iobenguane radiopharmaceutical products
may decrease the therapeutic effect when combined with iobenguane radiopharmaceutical products
may decrease the therapeutic effect when combined with iobenguane radiopharmaceutical products
may decrease the therapeutic effect when combined with iobenguane radiopharmaceutical products
may decrease the therapeutic effect when combined with Alpha2-Agonists
may decrease the therapeutic effect when combined with Alpha2-Agonists
may decrease the therapeutic effect when combined with Alpha2-Agonists
may decrease the therapeutic effect when combined with Alpha2-Agonists
may decrease the therapeutic effect when combined with Alpha2-Agonists
it may diminish the metabolism when combined with aripiprazole lauroxil
may decrease the therapeutic effect when combined with Iobenguane Radiopharmaceutical Products
may decrease the therapeutic effect when combined with Iobenguane Radiopharmaceutical Products
may decrease the therapeutic effect when combined with Iobenguane Radiopharmaceutical Products
may decrease the therapeutic effect when combined with Iobenguane Radiopharmaceutical Products
may decrease the therapeutic effect when combined with Alpha2-Agonists
may have an increased serotonergic effect when combined with serotonin/norepinephrine reuptake inhibitors
may have an increased serotonergic effect when combined with serotonin/norepinephrine reuptake inhibitors
may have an increased serotonergic effect when combined with serotonin/norepinephrine reuptake inhibitors
may have an increased serotonergic effect when combined with serotonin/norepinephrine reuptake inhibitors
may have an increased serotonergic effect when combined with serotonin/norepinephrine reuptake inhibitors
may have an increased antiplatelet effect when combined with Aspirin
may have an increased CNS depressant effect when combined with Brexanolone
May have an increased serotonergic effect when combined with Serotonin/Norepinephrine Reuptake Inhibitors
May have an increased serotonergic effect when combined with Serotonin/Norepinephrine Reuptake Inhibitors
May have an increased serotonergic effect when combined with Serotonin/Norepinephrine Reuptake Inhibitors
May have an increased serotonergic effect when combined with Serotonin/Norepinephrine Reuptake Inhibitors
May have an increased serotonergic effect when combined with Serotonin/Norepinephrine Reuptake Inhibitors
May have an increased serotonergic effect when combined with Serotonin/Norepinephrine Reuptake Inhibitors
Actions and spectrum:
milnacipran is a selective serotonin/norepinephrine reuptake inhibitor (SNRI) used to treat depression and fibromyalgia. It acts by inhibiting the reuptake of the neurotransmitters serotonin and norepinephrine in the brain, thereby increasing their availability and enhancing their effects. milnacipran has been shown to improve mood, reduce anxiety, and relieve pain in patients with fibromyalgia.
Frequency defined:
Insomnia (12%)
Constipation (16%)
Hot flush (12%)
Headache (18%)
Nausea (37%)
Dizziness
Hypertension
Palpitations
Vomiting
Hyperhidrosis
Migraine
Tachycardia
Xerostomia
Frequency undefined:
Abnormal bleeding
Serotonin syndrome
Withdrawal signs or symptoms
Depression
Suicidal thoughts
Postmarketing Reports
Hematologic disorders
Eye disorders
Gastrointestinal disorder
Metabolic and nutritional disorders
Neurologic disorders
Renal and urinary disorder
Skin disorders
Cardiac disorders
Endocrine disorders
Hepatobiliary disorders
Psychiatric disorders
Vascular disorders
Black Box Warning
milnacipran has a black box warning as there is an increased risk of suicidal thoughts in children and young adults (up to 24 yrs) with major depressive disorder (MDD) and other psychiatric disorders.
The warning also notes that depression and other psychiatric disorders are associated with an increased risk of suicide. Therefore, patients should be closely monitored for suicidal thoughts and unusual behavior.
Contraindication/Caution
Contraindication
Caution
Pregnancy consideration: pregnancy category C
Lactation: should be caution before taking the medication because drug gets excreted in human milk.Â
Pregnancy category:
Pharmacology
milnacipran is a selective serotonin/norepinephrine reuptake inhibitor (SNRI) that affects the levels of two neurotransmitters, serotonin, and norepinephrine, in the brain. It works by inhibiting the reuptake of these neurotransmitters, which increases the availability of serotonin and norepinephrine in the synaptic cleft and enhances their effects on the postsynaptic receptors.
milnacipran has a higher affinity for the serotonin transporter than for the norepinephrine transporter, and it is thought to produce its therapeutic effects primarily acts by increasing the levels of serotonin in the brain. Serotonin and norepinephrine are involved in the regulation of mood, anxiety, pain perception, and other physiological processes. By increasing the availability of these neurotransmitters, milnacipran can help to alleviate the symptoms of depression, anxiety, and fibromyalgia.
Pharmacodynamics
milnacipran is a selective serotonin/norepinephrine reuptake inhibitor (SNRI), which acts by inhibiting the reuptake of the neurotransmitters serotonin and norepinephrine, leading to increased levels of these neurotransmitters in the central nervous system. This increased neurotransmitter activity is thought to be responsible for the antidepressant effects of milnacipran.
In addition to its effects on serotonin and norepinephrine reuptake, milnacipran has also been shown to have a weak inhibitory effect on dopamine reuptake. However, its primary therapeutic effects are due to its actions on serotonin and norepinephrine.
Pharmacokinetics
Milnacipran is rapidly absorbed with peak plasma concentration occurring within 2-4 hours after oral administration. The absolute bioavailability is unknown, but it is estimated to be approximately 85%. The drug is metabolized in the liver, primarily via CYP3A4, CYP2D6, and CYP1A2, with some contribution from CYP2C19 and CYP2C9. milnacipran is eliminated via both renal and non-renal pathways, with approximately 22% of an administered dose excreted in the urine and 73% excreted in the feces.
The terminal elimination half-life is approximately 8 hours. There are no clinically significant differences in the pharmacokinetics of milnacipran based on age, sex, or ethnicity. However, hepatic impairment and mild-to-moderate renal impairment can lead to an increase in exposure to milnacipran, and the drug is contraindicated in patients with severe renal impairment.
Administration
milnacipran is a prescription medication that is usually taken orally, with or without food, as directed by a healthcare professional. The dose and frequency of milnacipran may vary depending on the patient’s condition and response to treatment. milnacipran tablets should be swallowed whole with a glass of water and should not be crushed, chewed, or broken.
Patient information leaflet
Generic Name: milnacipran
Pronounced: [ mil-NA-si-pran ]
Why do we use milnacipran?
milnacipran is a medication used primarily to treat depression. It is classified as a serotonin-norepinephrine reuptake inhibitor (SNRI), which means it works by increasing the levels of neurotransmitters like serotonin and norepinephrine in the brain.
milnacipran has been approved by the USFDA for the treatment of major depressive disorders in adults. It may also be used off-label to treat fibromyalgia, a chronic pain condition characterized by musculoskeletal pain, fatigue, and tenderness in localized areas.
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