Levomilnacipran(lee voe mil na’ sih pran)
FetzimaDNC
PREGNANCY CATEGORY C
Drug Classes
Antidepressant
Serotonin/norephinephrine reuptake inhibitor
Therapeutic Actions
Acts in CNS to potentiate the effects of norephinephrine and serotonin through inhibition of reuptake into the presynaptic nerve; this is thought to have antidepressant effects, though exact mechanism of this effect is not understood.
Indications
Treatment of major depressive disorder
Contraindications and Cautions
Contraindicated with history of hypersensitivity reactions to components of drug or to milnacipran; concurrent use of MAOIs within 14 days; IV use of methylene blue or linezolid; uncontrolled narrow-angle glaucoma; pregnancy, lactation.
Use cautiously with controlled narrow-angle glaucoma, urinary retention, SIADH, seizure disorder, hypertension, renal impairment.
Available Forms
ER capsulesDNC—20, 40, 80, 120 mg
Dosages
Adults
Initially, 20 mg/day PO for 2 days; then increase to 40 mg/day PO. May increase in increments of 40 mg every 2 days if needed. Maximum dose, 120 mg/day.
Patients with renal impairment
Moderate impairment: Do not exceed 80 mg/day. Severe impairment: Do not exceed 40 mg/day.
Pharmacokinetics
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