| name | Levomilnacipran |
| classification | Selective Norepinephrine and Dopamine Reuptake Inhibitor (SNRI) |
| pharmacokinetics | | absorption | Well absorbed after oral administration; peak plasma concentrations typically reached within 2-4 hours. | | distribution | Distributed throughout the body, including the brain. Significant binding to plasma proteins. | | metabolism | Metabolized primarily by the cytochrome P450 (CYP) enzyme system, primarily CYP2D6. | | excretion | Excreted primarily as metabolites in urine. |
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| suggested dosage | | initial | 20mg daily, with titration to achieve therapeutic effects, usually in increments of 20mg every 1-2 weeks. | | maintenance | Commonly in the range of 40-80mg daily, but may vary based on individual response and tolerability. | | important notes | Always follow the prescribing physician's instructions for dosage and schedule. Do not adjust dosage on your own. |
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| indications | Treatment of major depressive disorder (MDD) and generalized anxiety disorder (GAD). |
| safety in pregnancy | | category | C | | description | Limited human data available, potential risks to the fetus have not been ruled out. Levomilnacipran should be used in pregnancy only if the potential benefit justifies the potential risk. | | additional note | Consult with your doctor. |
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| safety in breastfeeding | | description | It is unknown whether levomilnacipran is excreted into human breast milk. Due to the potential for adverse effects in the infant, a decision on whether to continue breastfeeding while taking levomilnacipran should be made in consultation with a doctor. | | additional note | Potential for adverse effects on the infant needs to be considered. |
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| side effects | | 1 | Nausea, vomiting, diarrhea, constipation, headache, dizziness, insomnia, dry mouth, sweating | | 2 | anxiety, agitation, restlessness, tremor, sexual dysfunction | | 3 | weight change | | 4 | increased blood pressure | | 5 | tachycardia (rapid heartbeat) | | 6 | hyponatremia (low sodium levels) | | 7 | seizures (rare) in patients with pre-existing seizure disorders | | 8 | increased risk of suicidal ideation or behavior, especially in adolescents and young adults |
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| alternatives | |
| contraindications | | 1 | Known hypersensitivity to levomilnacipran or any component of the formulation | | 2 | Severe hepatic impairment | | 3 | Concurrent use with MAOIs | | 4 | Severe cardiovascular disease or unstable angina |
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| interactions | | 1 | Certain medications like MAOIs, serotonergic drugs (e.g., other antidepressants, triptans), anticholinergics, and drugs that affect CYP2D6 metabolism | | 2 | alcohol consumption |
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| warnings and precautions | | 1 | Increased risk of suicidal ideation, particularly in adolescents and young adults. Close monitoring is essential, especially in patients with a history of depression or other psychiatric disorders. | | 2 | Careful monitoring of blood pressure and heart rate | | 3 | Do not discontinue abruptly; gradual tapering is recommended | | 4 | Careful consideration of patients with pre-existing cardiovascular problems | | 5 | Caution in patients with liver or kidney disease | | 6 | Potential for serotonin syndrome if used in combination with other serotonergic agents | | 7 | Increased risk of mania in patients with bipolar disorder | | 8 | Potential for elevated blood pressure and pulse rates |
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| additional informations | Levomalnacipran should be used with caution in patients with a history of seizures, mania, or other neurological conditions, particularly those taking drugs that lower the seizure threshold. |
| patient specific details | |
| disclaimer | This information is for educational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional for diagnosis and treatment. |
