Levomilnacipran
About Levomilnacipran
Levomilnacipran is a prescription medicine used to treat major depressive disorder (depression) in adults. Depression can cause persistent sadness, loss of interest in usual activities, low energy, difficulty concentrating, and changes in sleep or appetite. Levomilnacipran helps improve these symptoms by increasing the activity of certain chemical messengers in the brain.
Take Levomilnacipran once daily at about the same time each day. You can take it with or without food. It may take several weeks to feel the full benefit, so continue taking it as prescribed even if you do not notice an improvement straight away.
Common side effects include nausea, constipation, increased sweating, a fast or pounding heartbeat, and reduced appetite. Consult your doctor right away if your depression gets worse or you develop unusual changes in mood or behaviour, severe agitation, or thoughts of harming yourself.
Before starting Levomilnacipran, tell your doctor if you have high blood pressure, heart problems, bipolar disorder, seizures, bleeding problems, glaucoma (an eye condition caused by increased pressure), difficulty passing urine, or kidney problems. Do not take Levomilnacipran with monoamine oxidase inhibitors (MAOIs), a type of antidepressant, or within the required time interval before or after using an MAOI.
Tell your doctor about all medicines, supplements, and herbal products you use. If you are pregnant, planning a pregnancy, breastfeeding, or an older adult, your doctor will consider your individual health needs before prescribing Levomilnacipran.
Uses of Levomilnacipran
Medicinal Benefits
Levomilnacipran can help manage symptoms of depression and support your ability to carry out everyday activities.
- Improves mood: May gradually reduce persistent sadness and other emotional symptoms of depression.
- Restores interest: May help you regain interest and enjoyment in activities that depression has made difficult.
- Supports daily functioning: As your symptoms improve, you may find it easier to concentrate, stay motivated, and manage everyday tasks.
- Improves related symptoms: Treatment may also help with low energy, sleep changes, or appetite changes related to depression.
Directions for Use
- Take Levomilnacipran with or without food or as advised by a doctor.
- Recommended to take once daily or as advised by your doctor.
- Swallow the medicine as a whole with a glass of water.
- Do not crush, break, or chew it.
Storage
Side Effects of Levomilnacipran
Common Side Effects (Usually Mild)
- Nausea
- Constipation
- Increased sweating
- Fast or pounding heartbeat
- Reduced appetite
- Vomiting
- Difficulty getting or maintaining an erection
Serious Side Effects (Consult your doctor right away)
- Worsening depression, unusual changes in mood or behaviour, or thoughts of self-harm or suicide
- Severe agitation, confusion, high fever, heavy sweating, shaking, muscle stiffness, or a fast heartbeat
- Very high blood pressure, severe headache, severe dizziness, chest pain, or fainting
- Unusual or persistent bleeding or bruising
- Eye pain, sudden changes in vision, or redness or swelling around the eye
- Difficulty passing urine
- Seizures
- Hives, swelling of the face, lips, tongue, or throat, or difficulty breathing
Drug Warnings
- Suicidal thoughts and behaviour: Antidepressants, including Levomilnacipran, can increase the risk of suicidal thoughts and behaviours in children, adolescents, and young adults, particularly during the first few months of treatment and when the dose is changed. Levomilnacipran is not approved for use in children. People of any age taking an antidepressant should be monitored for worsening depression, suicidal thoughts, or unusual changes in behaviour. Family members or caregivers should also watch for these changes and contact the treating doctor promptly if they occur.
- Seek support for self-harm thoughts: If you develop thoughts of self-harm or suicide, tell a family member or someone you trust and contact your doctor immediately.
- Monitor your mood: Tell your doctor promptly if you notice worsening depression, new or worsening anxiety, agitation, panic attacks, unusual behaviour, or other significant mood changes.
- Do not stop suddenly: Stopping Levomilnacipran suddenly can cause withdrawal symptoms such as dizziness, headache, nausea, irritability, anxiety, trouble sleeping, or tingling sensations. Your doctor may reduce your dose gradually.
- Check blood pressure and heart rate: Levomilnacipran can increase blood pressure and heart rate. Your doctor may check these before and during treatment.
- Watch for serotonin syndrome: Consult your doctor right away if you develop agitation, confusion, high fever, heavy sweating, shaking, muscle stiffness, or a fast heartbeat. These may be signs of a serious reaction caused by too much serotonin activity.
- Tell your doctor about bipolar disorder: Antidepressants can sometimes trigger mania (an unusually elevated or highly active mood) in people with bipolar disorder.
- Take care when driving: Levomilnacipran may cause dizziness or affect alertness in some people. Avoid driving or operating machinery until you know how it affects you.
Drug Interactions
- Monoamine oxidase inhibitors (MAOIs, e.g. phenelzine, tranylcypromine): Do not take these medicines with Levomilnacipran because the combination can cause a serious reaction called serotonin syndrome. Levomilnacipran should not be started within 14 days of stopping an MAOI, and an MAOI should not be started until at least 7 days after stopping Levomilnacipran.
- Other medicines that increase serotonin (e.g. other antidepressants, tramadol, triptans, lithium): Taking these medicines with Levomilnacipran can increase the risk of serotonin syndrome.
- Medicines that increase bleeding risk (e.g. aspirin, ibuprofen, warfarin): Taking these medicines with Levomilnacipran may increase the risk of bleeding or bruising.
- Strong CYP3A4 inhibitors (e.g. ketoconazole, clarithromycin): These medicines can increase the amount of Levomilnacipran in your body, so your doctor may need to limit your dose.
- Medicines that raise blood pressure or heart rate: Taking these with Levomilnacipran may further increase blood pressure or heart rate and may require closer monitoring.
Drug-Drug Interactions Checker List:
Safety Advice
Alcohol
unsafeAvoid consumption of alcohol while on treatment with Levomilnacipran.
Pregnancy
cautionLevomilnacipran belongs to pregnancy category C. It should be used during pregnancy only if the benefits outweigh the risks.
Breast Feeding
cautionIt is not known if Levomilnacipran passes into breastmilk. Consult the doctor if you are breastfeeding.
Driving
cautionLevomilnacipran may cause drowsiness and affect your judgement, movements and thinking. Avoid driving or operating machinery unless you know how this medicine affects you.
Liver
consult your doctorPlease consult the doctor if you have liver problems before taking Levomilnacipran.
Kidney
cautionLevomilnacipran is not recommended for people with end-stage renal disease. Please consult the doctor if you have kidney impairment or any concerns regarding this.
Children
unsafeLevomilnacipran is not recommended for children as the safety and effectiveness have not been established.
Habit Forming
Diet & Lifestyle Advise
- Limit or avoid alcohol: Alcohol may increase dizziness, affect your judgement, and make depression symptoms harder to manage.
- Keep a regular sleep routine: Try to go to bed and wake up at similar times each day to support healthy sleep.
- Eat balanced meals: Regular, nutritious meals can support your overall health during treatment.
- Stay physically active: Regular activity, such as walking, may support your physical and mental wellbeing.
- Stay connected: Keep in contact with family, friends, or other people you trust who can support you during treatment.
Patients Concern
Disease/Condition Glossary
Major depressive disorder: Major depressive disorder, also known as clinical depression, is a mental health disorder characterised by a persistent and intense feeling of sadness for an extended duration of time. It mainly impacts mood, behaviour, and other physical functions, such as sleep and appetite. Symptoms include sadness, loss of interest, changes in appetite, sleep problems, restlessness, lack of energy, feeling worthless or guilty, thoughts of harming oneself, and difficulty concentrating, making decisions, and thinking. The exact cause of depression is unknown. However, factors such as stress, changes in hormone levels, alcohol or drug abuse, abuse during childhood, certain medical conditions and medications might increase the risk of developing depression.
FAQs
Levomilnacipran is used to treat Major depressive disorder.
Levomilnacipran works by increasing the levels of natural substances in the brain, such as serotonin and norepinephrine, that help maintain mental balance.
Levomilnacipran may cause angle-closure glaucoma. Consult the doctor if you have eye pain, nausea, changes in vision, swelling or redness in or around the eye.
Levomilnacipran may cause high blood pressure. Therefore, inform the doctor if you have hypertension. Blood pressure and pulse/heart rate should be monitored prior to the start of the treatment and regularly during treatment with Levomilnacipran.
Antidepressants can increase the risk of suicidal thoughts and behaviours in children, adolescents, and young adults, particularly during the first few months of treatment and after dose changes. Levomilnacipran is not approved for use in children. Tell your doctor promptly about worsening depression or unusual changes in mood or behaviour.
Tell a family member or someone you trust and contact your doctor immediately. Do not ignore new or worsening thoughts of self-harm or suicide.
Your doctor may prescribe them together, but Levomilnacipran can increase blood pressure and heart rate. Your doctor may monitor your blood pressure and adjust your treatment if needed.
Weight changes can occur during depression and its treatment. Tell your doctor if you notice a significant or unexpected change in your weight.
Tell your doctor if you are pregnant, planning a pregnancy, or breastfeeding. Your doctor will consider the benefits of treating depression and the possible risks of the medicine when deciding whether Levomilnacipran is suitable for you.
Take Levomilnacipran once daily at about the same time each day. Ask your doctor about the best time to take it if it causes sleepiness or makes it difficult for you to sleep.
Yes. Levomilnacipran can cause sexual side effects, such as reduced sexual desire or difficulty with sexual function. Talk to your doctor if these effects are troublesome, as they can discuss ways to manage them.
