Fetzima (Levomilnacipran)

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• Indications

• Dosage

• Side Effects

• Warnings

• Additional Information

Fetzima, also known as levomilnacipran, is indicated for the treatment of major depressive disorder (MDD) in adults. It is a serotonin-norepinephrine reuptake inhibitor (SNRI) antidepressant that works by increasing the levels of serotonin and norepinephrine in the brain, which helps regulate mood. Fetzima is not approved for use in children and its safety and efficacy have not been established for the management of fibromyalgia.

Do's

• Take Fetzima by mouth with or without food as directed by your healthcare provider, usually once daily. 
• Swallow the capsules whole. 
• Use Fetzima regularly to get the most benefit from it. Take it at the same time each day to help you remember. 
• Follow your healthcare provider's instructions carefully, especially regarding dosage adjustments and starting at a low dose. 
• Keep taking Fetzima even if you feel well, as it may take several months to experience the full benefit. 
• Start this medication at a low dose and gradually increase it as directed by your healthcare provider to reduce the risk of side effects. 
• Take Fetzima within the recommended dosage range of 40 mg to 120 mg once daily, with or without food. 
• Initiate Fetzima at 20 mg once daily for 2 days, then increase to 40 mg once daily. 
• Adjust Fetzima dosage based on clinical response and tolerability, increasing in increments of 40 mg at intervals of 2 or more days. 
• Follow the maximum recommended dosage of 120 mg once daily as prescribed by your healthcare provider. 

Don'ts

• Do not open, crush, or chew the capsules, as this can release all the drug at once, increasing the risk of side effects. 
• Do not increase your dose or use this drug more often or for longer than prescribed. Your condition will not improve any faster, and your risk of side effects will increase 
• Do not stop taking Fetzima without consulting your healthcare provider. Some conditions may become worse when this drug is suddenly stopped. Your healthcare provider may reduce your dose gradually to prevent withdrawal symptoms. 

The dosage of Fetzima is based on your medical condition, response to treatment, and other medications you may be taking.     

Common side effects:

• Nausea
• Vomiting
• Constipation
• Excessive sweating (hyperhidrosis)
• Increased or irregular heart rate (tachycardia)
• Erectile dysfunction
• Heart palpitations

Serious side effects: Although rare, certain side effects require more serious consideration if they occur. Seek prompt medical assistance if you experience any of the following:

• High blood pressure (hypertension)
• Increased heart rate
• Abnormal bleeding or bruising
• Visual problems

This is not an exhaustive list, and other side effects may occur. If you experience any unusual or severe side effects while taking  Fetzima,  contact your healthcare provider for medical advice.

Before taking  Fetzima, it is important to be aware of certain warnings and precautions:

1. Increased risk of suicidal thoughts and actions: Fetzima and other antidepressant medications may increase the risk of suicidal thoughts and actions, particularly in individuals under the age of 24, especially during the initial months of treatment or when the dosage is changed
2. Serotonin syndrome: Fetzima can potentially cause serotonin syndrome, a serious and potentially life-threatening condition, especially when taken with certain other medications. Inform your healthcare provider about all the medications you are taking to avoid potential interactions.
3. Activation of mania/hypomania: Fetzima may trigger the activation of mania or hypomania in individuals with a history of bipolar disorder. Patients and caregivers should be vigilant for signs of mood changes and report them to a healthcare provider.
4. Seizures: Caution should be exercised when using Fetzima in individuals with a history of seizure disorder.
5. Discontinuation syndrome: Abruptly stopping Fetzima without consulting a healthcare provider can lead to discontinuation symptoms. Follow the guidance of your healthcare provider when discontinuing the medication
6. Hyponatremia: Fetzima has been associated with cases of hyponatremia (low sodium levels). Patients should be aware of the signs and symptoms of hyponatremia and report them to their healthcare provider
7. Increased risk of bleeding: Caution should be exercised when using Fetzima in combination with nonsteroidal anti-inflammatory drugs (NSAIDs), aspirin, warfarin, or other drugs that affect coagulation, as it may increase the risk of bleeding.

 

Generic name:	Levomilnacipran
Formulation:	Capsule
Strength(s):	20mg, 40mg, 80mg, 120mg
Quantities Available:	30, 60, 90

Fetzima product monograph