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Levomilnacipran is available as 20 mg, 40 mg, 80 mg, and 120 mg extended-release oral capsule.

• Levomilnacipran is a SNRI and is used to treat depression

Levomilnacipran is a serotonin and norepinephrine reuptake inhibitor (SNRI) antidepressant. It raises the serotonin and norepinephrine activity in your brain, which helps your regulate mood.

• Levomilnacipran is typically started at 20 mg by mouth once a day for 2 days. Then, your dose will be raised to 40 mg by mouth once a day. Your provider will adjust your dose based on how you respond to the medication. The maximum dose is 120 mg per day
• If you have kidney problems, the maximum dose is 40 or 80 mg per day, depending on the severity of your kidney condition. Ask your provider what the maximum amount oflevomilnacipran you can take

Levomilnacipran is a safe and effective treatment when used for FDA licensed indications. However, like all medications, they may give you unwanted side effects. You should always discuss potential side effects with your physician to ensure the medication is suitable and right for you. You should not use this medication if any of the following applies:

• Hypersensitivity to Levomilnacipran, milnacipran HCl, or any excipient in the Levomilnacipran formulation
• Do not use MAOIs intended to treat psychiatric disorders with Levomilnacipran or within 7 days of stopping treatment with Levomilnacipran. Do not use Levomilnacipran within 14 days of stopping an MAOI intended to treat psychiatric disorders. In addition, do not start Levomilnacipran in a patient who is being treated with linezolid or intravenous methylene blue

Common side effects of Levomilnacipran:

• Nausea
• Constipation
• Sweating
• Fast heart rate
• Erectile dysfunction
• Vomiting

Serious side effects are rare with Levomilnacipran. Contact your healthcare provider immediately if you experience any of the following.

• Allergic reaction
• Suicidal thoughts or behaviors
• Unusual mood changes
• Serotonin syndrome: Fast heart rate, high fever, sweating, muscle stiffness or spasms, confusion
• Withdrawal: Nausea, anxiety, agitation, flu-like symptoms, trouble sleeping, dizziness
• Bleeding: Easy bruising or bleeding, blood in the urine or stools
• Low sodium: Weakness, confusion, difficulty
• concentrating, headache, memory problems
  Blurred vision, eye pain, or changes in vision
• Chest pain
• Seizure
• Shortness of breath

The following medications may interact with Levomilnacipran:

• Strong CYP3A4 inhibitors: Maximum recommended dosage is 80 mg once daily

Various FDA-approved generic manufacturers

Levomilnacipran use during the third trimester use may increase risk for symptoms of poor adaptation (respiratory distress, temperature instability, feeding difficulty, hypotonia, tremor, irritability) in the neonate. If you become pregnant while receiving Levomilnacipran, talk to your healthcare provider. There is a pregnancy exposure registry that monitors pregnancy outcomes in women exposed to antidepressants during pregnancy. Healthcare providers are encouraged to advise patients to register by calling the National Pregnancy Registry for Antidepressants at 1-844-405-6185 or visiting online at MGH Center for womens mental health.

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