Skip to main content

Levomilnacipran (By mouth)

Levomilnacipran (lee-voe-mil-NA-si-pran)

This medicine is an SNRI that treats depression.

Brand Name(s):

Fetzima, Fetzima Titration Pack

There may be other brand names for this medicine.

When This Medicine Should Not Be Used:

This medicine is not right for everyone. Do not use this medicine if you have had an allergic reaction to levomilnacipran or milnacipran.

How to Use This Medicine:

Long Acting Capsule

  • Take your medicine as directed. Your dose may need to be changed several times to find what works best for you.
  • Extended-release capsule: Swallow whole. Do not open, crush, or chew the capsule. Take it at the same time each day. Do not take with alcohol because this may cause the contents of the capsule to be released too soon.
  • This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.
  • Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.
  • Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

  • Do not use this medicine together with an MAO inhibitor (MAOI) or if you have used an MAO inhibitor within the past 14 days. Do not take an MAO inhibitor for at least 7 days after you stop this medicine.
  • Some medicines and foods can affect how levomilnacipran works. Tell your doctor if you are also using medicine to treat migraine headaches, an NSAID pain or arthritis medicine (such as aspirin, diclofenac, ibuprofen, naproxen), or a blood thinner (such as warfarin).
  • Tell your doctor if you are also using buspirone, fentanyl, lithium, ritonavir, St John's wort, tramadol, a tryptophan supplement, medicine to treat an infection (such as clarithromycin, ketoconazole), or a diuretic (water pill).
  • Tell your doctor if you drink alcohol or if you are using any medicine that makes you sleepy, such as allergy medicine or narcotic pain medicine.

Warnings While Using This Medicine:

  • Tell your doctor if you are pregnant or breastfeeding, or if you have kidney disease, glaucoma, heart disease, heart rhythm problems, high blood pressure, or trouble urinating. Tell your doctor if you have a history of seizures, bipolar disorder, or mania.
  • This medicine may cause the following problems:
    • Serotonin syndrome
    • Low sodium levels in the blood
    • Increased blood pressure
  • For some children, teenagers, and young adults, this medicine may increase mental or emotional problems. This may lead to thoughts of suicide and violence. Talk with your doctor right away if you have any thoughts or behavior changes that concern you. Tell your doctor if you or your family has a history of bipolar disorder or suicide attempts.
  • This medicine may make you dizzy or drowsy. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.
  • Do not stop using this medicine suddenly. Your doctor will need to slowly decrease your dose before you stop it completely.
  • Call your doctor if your symptoms do not improve or if they get worse.
  • Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

  • Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
  • Anxiety, restlessness, fever, sweating, muscle spasms, nausea, vomiting, diarrhea, seeing or hearing things that are not there
  • Blurred vision, eye pain
  • Confusion, weakness, and muscle twitching
  • Difficult or painful urination
  • Fast or pounding heartbeat
  • Feeling more excited or energetic than usual
  • Headache, trouble concentrating, memory problems, unsteadiness
  • Lightheadedness, dizziness, or fainting
  • Unusual behavior, thoughts of hurting yourself or others
  • Unusual bleeding or bruising

If you notice these less serious side effects, talk with your doctor:

  • Constipation, nausea
  • Increased sweating
  • Sexual problems

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088


Last Updated: 4/4/2014

Copyright © 1984- Thomson Micromedex. All rights reserved.

Thomson & A.D.A.M