Milnacipran (US brand name Savella®) is a serotonin and norepinephrine reuptake inhibitor (SNRI). Here is basic information about this medication.
Management of fibromyalgia
Milnacipran is administered orally in two divided doses per day with or without food. Dosage needs to be titrated according to the following schedule based upon efficacy and tolerability.
Day 1: 12.5 mg once
Days 2-3: 25 mg/day (12.5 mg once daily)
Days 4-7: 50 mg/day (25 mg twice daily)
After Day 7: 100 mg/day (50 mg twice daily)
Recommended dose: 100 mg/day
Maximum dose: 200 mg/day (100 mg twice daily)
1. Renal Insufficiency
Mild: No dosage adjustment is needed
Moderate: Use with caution
Severe: Maintenance dose should be reduced by 50% to 50 mg/day (25 mg twice daily. Based on individual patient response, the dose may be increased to 100 mg/day (50 mg twice daily)
End-stage renal disease: Not recommended
2. Hepatic insufficiency
No dosage adjustment is necessary. However caution should be exercised in patient with severe hepatic impairment.
Dosage forms and strengths
Tablets: 12.5 mg, 25 mg, 50 mg, and 100 mg
Please refer to Prescribing Information (see link below) for complete discussion of dosage, administration, warnings and precautions, contraindications, etc.
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