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Levomilnacipran
لِوومیلناسیپران
🧠 Nervous SystemSNRI
🤰 Pregnancy:Use with caution🤱 Breastfeeding:Use with caution👶 Children:Dangerous / avoid 🇮🇷 Not found in Iran list⛔ 1 contraindications 🇺🇸 FDA approved (NDA) NDA204168ATC N06AX28
Market / country: 🇺🇸 USA
Fetzima (US)
🧮 Dose calculator
Major depressive disorder · Regimen source: FDA Fetzima · 2.1
- • Start 20 mg for 2 days, then 40 mg; 40 mg steps at ≥2-day intervals. Do not open or chew. With strong CYP3A4 inhibitors max 80 mg. Taper when stopping. FDA Fetzima · 2.1FDA Fetzima · 2.6FDA Fetzima · 2.4
Enter age (weight is optional for this regimen).
🛡️ Safety & information
Contraindications
- ⛔ Hypersensitivity to levomilnacipran or milnacipran; MAOIs concomitantly, within 7 days of stopping this drug or 14 days of stopping the MAOI; linezolid or IV methylene blue. FDA Fetzima · 4
Warnings
- • Boxed warning: increased suicidal thoughts and behaviours in children and young adults — monitor for clinical worsening. FDA Fetzima · Boxed Warning
- • Serotonin syndrome; raised blood pressure and heart rate; bleeding; angle-closure glaucoma; urinary retention; hyponatraemia. FDA Fetzima · 5
Renal adjustment
- • eGFR < 60: CrCl 30–59: max 80 mg; 15–29: max 40 mg. ESRD not recommended. FDA Fetzima · 2.3
Formulations
- 40 mg ER capsule (swallow whole) — capsule 🇺🇸 USA FDA Fetzima · 3
- 20 mg ER capsule (swallow whole) — capsule 🇺🇸 USA FDA Fetzima · 3
- 80 mg ER capsule (swallow whole) — capsule 🇺🇸 USA FDA Fetzima · 3
- 120 mg ER capsule (swallow whole) — capsule 🇺🇸 USA FDA Fetzima · 3
👥 Special populations
- 🤰 PregnancyUse with caution
Label states no clear risk or has limited data; use only if needed, under medical advice. FDA Fetzima · 8.1
“Risk Summary Based on data from published observational studies, exposure to SNRIs, particularly in the month before delivery, has been associated with a less than 2-fold increase in the risk of postpartum hemorrhage [see Warnings and Precautions ( 5.5 ) and Clinical Considerations] .”
- 🤱 BreastfeedingUse with caution
Label: use with caution while breastfeeding; see the label text. FDA Fetzima · 8.2
“Risk Summary There are no available data on the presence of levomilnacipran in human milk; however, racemic milnacipran is present in human milk (see Data ).”
- 👶 ChildrenDangerous / avoid
Boxed warning in the label about children. FDA Fetzima · Boxed Warning
“Antidepressants increased the risk of suicidal thoughts and behaviors in pediatric and young adult patients in short-term studies.”
- 👴 Older adultsNo data
The source for this drug has no section for this group.
- ⚥ Females & males of reproductive potentialNo data
The source for this drug has no section for this group.
🔗 Reference links
- FDA (approval record)NDA204168
- DailyMed (FDA label)FDA Fetzima
- MedlinePlus (NIH)Levomilnacipran
- WHO ATC/DDDN06AX28
- Darooyab (Iran)❌ None
🇮🇷 Not found in Iran list Darooyab · search
Darooyab lists no registered dosage form or brand for this drug. This does not prove it is unavailable.
📚 Reference status for this drug
Shows which sources have references recorded for this drug and which do not.
- FDA label (DailyMed)✅ PresentFDA Fetzima · 3FDA Fetzima · 2.1FDA Fetzima · 2.6FDA Fetzima · 2.4FDA Fetzima · 4FDA Fetzima · Boxed WarningFDA Fetzima · 5FDA Fetzima · 2.3FDA Fetzima · SPL approval / marketing categoryFDA Fetzima · 8.1FDA Fetzima · 8.2
- UK SmPC (eMC / MHRA)❌ Not present
- Published guideline❌ Not present
- Licensed reference (medical school)❌ Not present
- Iranian leaflet (IFDA)❌ Not present
- Pharmacy website (secondary, unreliable)✅ PresentDarooyab · search
- Clinical review⚠ Unverified