Levomilnacipran (Oral)

Levomilnacipran is an SNRI type of medication prescribed by doctors in extended release capsule form to patients diagnosed with depression and other mood disorders.


Levomilnacipran is a potent, selective inhibitor of norepinephrine and serotonin uptake by the central nervous system. Patients suffering from depression and other mood disorders are often deficient in norepinephrine and serotonin, two natural substances found in the brain. Over time, use of Levomilnacipran will improve sleep and alleviate insomnia symptoms, elevate the mood, increase the appetite and give you a renewed interest in daily life.

A patient deficient in serotonin levels often experiences mood disorders such as depression or anxiety. Serotonin also works to normalize daily functions such as eating, sleeping, digestion, healing and other normal bodily functions and activities. When serotonin levels are balanced, mood is regulated naturally and normally and you feel calm, happy, relaxed and more focused.

Patients who are taking Levomilnacipran are assessed periodically to determine the effectiveness of the drug on their depression symptoms and to make adjustments in dosage if necessary. As each patient is different, the dosage of Levomilnacipran varies depending on the severity of the condition and other factors.

Major depressive disorder may be referred to as depression. MDD patients have symptoms that include low self-esteem, no interest in life or activities they may have enjoyed in the past. Patients lack energy and may even have physical pain that has no explanation or root cause other than the depression itself. Left untreated, MDD can affect a person's private, professional and social lives as well as their overall health. Counseling, along with medications such as Levomilnacipran, can greatly alleviate MDD symptoms; enabling patients to live a more normal life. MDD sufferers aren't the only patients who can benefit from the targeted therapy of Levomilnacipran on their condition.

Conditions Treated

Type Of Medicine

  • SNRI ' Serotonin-norepinephrine reuptake inhibition agent

Side Effects

Levomilnacipran affects chemicals found in the central nervous system including the brain. In doing so, this medication may cause unwanted, unexpected symptoms on your health. Some of these symptoms can be signs of a serious health problem and should be reported immediately to your physician or nursing staff. The following symptoms are such dangerous symptoms:

  • Difficulty urinating or dribbling
  • Irregular, rapid or pounding heart rhythm
  • Anxious demeanor
  • Jaw, back or arm pain
  • Vision is blurred
  • Needles and pins, crawling, burning, itching or numb sensations
  • Uncomfortable pain in chest area
  • Chest heaviness or tightness
  • Urine appears cloudy
  • Confused demeanor
  • Urination amount or frequency is decreased
  • Drooling
  • Mouth dryness
  • Fainting spells
  • Headache
  • Irritable mood
  • Ungainly, out of balance when moving
  • Jerking, stiff or trembling muscles
  • Nausea
  • Urination is painful
  • Ears pound
  • Fast pulse
  • Restless demeanor
  • Shaking muscles
  • Gasping for breath
  • Shuffling rather than walking
  • Sluggish heart rhythm
  • Limb stiffness
  • Sweating
  • Difficulty sleeping, insomnia
  • Twisting body movements
  • Neck, back or face move uncontrollably
  • Fatigue
  • Muscle weakness

Other adverse symptoms may occur when you first start your drug therapy with Levomilnacipran but will disappear over time and with use of the drug. Even so, it is recommended that you report these symptoms, should they occur, as your physician may be able to give you advice on how to alleviate them:

  • Constipation
  • Sweating more than normal
  • Sexual desire, performance, drive or ability has diminished
  • Vomiting
  • Pain in stomach or abdomen
  • Full, bloated feeling
  • Appetite is less than normal
  • Eyes and skin are dry
  • Overall warm feeling
  • Severe, throbbing headache
  • Welts, hives, itching, skin with rash
  • Excess gas
  • Bloodshot eyes
  • Upper chest, neck, face or arms are flushed and red
  • Abruptly sweating for no reason
  • Thirsty
  • Yawning

Any other health or mood symptoms you experience as the result of taking Levomilnacipran should be communicated to medical staff right away to avoid any ill effects on your health that can be lifelong conditions.


Your physician will construct your prescribed dosage amount, frequency and duration based on several criteria involving your overall health, medical history and other factors. You may see general dosage information, such as the information below, but your prescription should be what you follow for your own health and safety. If you have any questions, consult your physician before beginning your Levomilnacipran dosage.

Your medication will come with a written guide in booklet or leaflet form that will tell you all about the effectiveness of the drug on your condition as well as supply you with details on health risks, if any. Read and comprehend this information and ask any questions of your physician or pharmacist that you find necessary.

Levomilnacipran comes in a capsule format that is coated for extended release over time in your body. Swallow the capsule whole and do not open it, crush it or chew on it prior to swallowing. Take this medication with or without food, whichever is more comfortable for you. It is recommended that you take the capsule at the same time every day, not only to provide a steady amount to your system but in order to better remember to take it.

Never take the capsules with alcoholic beverages, as this could cause the medication to release into your body too rapidly, giving you unwanted health symptoms.

Adult patients will be prescribed one 20 milligram extended release format capsule to be taken once per day. Some patients may be prescribed two capsules per day, depending on their doctor's observation of the effectiveness of the drug on their condition. Children are not candidates for treatment with Levomilnacipran for safety reasons.

Missing a dose of this medication should not cause you to double your dosage to make it up; extended release capsules are designed to steadily release medication. If you miss a dose, it is best to skip it and take your next dose on schedule. When in doubt, consult your physician or medical staff if you have accidentally missed a dose of Levomilnacipran.


Patients who have, in the past, experienced hypersensitivity to this medication or others should alert their physician to this fact in case it is a risk once again. Similarly, notify your physician if you have sensitivity to dyes, perfumes, preservatives, animals or certain foods.

Pediatric patients and women who are pregnant or breastfeeding should avoid the use of Levomilnacipran. Safety and effectiveness in these groups have not been determined. If you think you have become pregnant while taking Levomilnacipran, alert your physician right away.

Geriatric patients can take Levomilnacipran with the same effectiveness levels and risks associated with adult patients. Elderly patients with kidney function issues should only be prescribed an adjusted dosage of this medication, as their bodies may not evacuate the drug the same way as patients with healthy kidney functions.

To provide the best possible route for Levomilnacipran to work effectively and safely for you, avoid taking other medications while you are taking this drug. This includes any remedies you take without a prescription, vitamin therapy, herbal and holistic therapies as well.

Combination therapy, in which two or more medications are used in conjunction with each other, can be a safe, effective way to provide whole health treatment to some patients. Other medications should never be combined, as they work against each other and may cause life-threatening results if taken together. Levomilnacipran drug therapy is not an option for patients who are taking the following drugs for their own safety. Let your physician know if you take:

  • Iproniazid
  • Furazolidone
  • Linezolid
  • Isocarboxazid
  • Moclobemide
  • Methylene Blue
  • Procarbazine
  • Phenelzine
  • Safinamide
  • Rasagiline
  • Tranylcypromine
  • Selegiline

Though not recommended, use of the following drugs along with Levomilnacipran may be necessary for you and, with a dosage adjustment by your physician. Let your doctor know if you're taking:

  • Abciximab
  • Acemetacin
  • Aceclofenac
  • Almotriptan
  • Acenocoumarol
  • Amoxapine
  • Amitriptyline
  • Anagrelide
  • Amtolmetin Guacil
  • Ardeparin
  • Apixaban
  • Aspirin
  • Argatroban
  • Bemiparin
  • Atazanavir
  • Boceprevir
  • Bivalirudin
  • Brompheniramine
  • Bromfenac
  • Buprenorphine
  • Bufexamac
  • Buspirone
  • Bupropion
  • Celecoxib
  • Carbamazepine
  • Certoparin
  • Ceritinib
  • Choline Salicylate
  • Chlorpheniramine
  • Citalopram
  • Cilostazol
  • Clomipramine
  • Clarithromycin
  • Clopidogrel
  • Clonixin
  • Cocaine
  • Cobicistat
  • Cyclobenzaprine
  • Conivaptan
  • Dalteparin
  • Dabigatran Etexilate
  • Desipramine
  • Danaparoid
  • Desvenlafaxine
  • Desirudin
  • Dexketoprofen
  • Dexibuprofen
  • Diclofenac
  • Dextromethorphan
  • Dipyridamole
  • Diflunisal
  • Dolasetron
  • Dipyrone
  • Doxepin
  • Donepezil
  • Droxicam
  • Drotrecogin Alfa
  • Edoxaban
  • Duloxetine
  • Eliglustat
  • Eletriptan
  • Eptifibatide
  • Enoxaparin
  • Etodolac
  • Escitalopram
  • Etoricoxib
  • Etofenamate
  • Fenoprofen
  • Felbinac
  • Fepradinol
  • Fentanyl
  • Floctafenine
  • Feprazone
  • Flufenamic Acid
  • Fluconazole
  • Flurbiprofen
  • Fluoxetine
  • Fondaparinux
  • Fluvoxamine
  • Granisetron
  • Frovatriptan
  • Hydroxytryptophan
  • Heparin
  • Idelalisib
  • Ibuprofen
  • Indinavir
  • Imipramine
  • Itraconazole
  • Indomethacin
  • Ketoprofen
  • Ketoconazole
  • Lepirudin
  • Ketorolac
  • Lopinavir
  • Lithium
  • Lornoxicam
  • Lorcaserin
  • Lumiracoxib
  • Loxoprofen
  • Mefenamic Acid
  • Meclofenamate
  • Meperidine
  • Meloxicam
  • Milnacipran
  • Methadone
  • Morniflumate
  • Mirtazapine
  • Nadroparin
  • Nabumetone
  • Naratriptan
  • Naproxen
  • Nelfinavir
  • Nefazodone
  • Niflumic Acid
  • Nepafenac
  • Nimesulide Beta Cyclodextrin
  • Nimesulide
  • Oxaprozin
  • Nortriptyline
  • Oxyphenbutazone
  • Oxycodone
  • Parecoxib
  • Palonosetron
  • Paroxetine
  • Parnaparin
  • Phenindione
  • Pentazocine
  • Phenylbutazone
  • Phenprocoumon
  • Piroxicam
  • Piketoprofen
  • Pranoprofen
  • Posaconazole
  • Proglumetacin
  • Prasugrel
  • Propoxyphene
  • Propionic Acid
  • Proquazone
  • Propyphenazone
  • Reviparin
  • Protein C
  • Rivaroxaban
  • Ritonavir
  • Rofecoxib
  • Rizatriptan
  • Salsalate
  • Salicylic Acid
  • Sertraline
  • Saquinavir
  • Simeprevir
  • Sibutramine
  • St John's Wort
  • Sodium Salicylate
  • Sulindac
  • Sulfinpyrazone
  • Tapentadol
  • Sumatriptan
  • Telithromycin
  • Telaprevir
  • Tiaprofenic Acid
  • Tenoxicam
  • Ticlopidine
  • Ticagrelor
  • Tipranavir
  • Tinzaparin
  • Tolfenamic Acid
  • Tirofiban
  • Tramadol
  • Tolmetin
  • Treprostinil
  • Trazodone
  • Venlafaxine
  • Valdecoxib
  • Voriconazole
  • Vilazodone
  • Warfarin
  • Vortioxetine
  • Zolmitriptan
  • Ziprasidone

Avoid taking your Levomilnacipran with alcoholic beverages, as they could cause the capsule to release the medication faster than is safe for your system. Avoid drinking grapefruit juice while you are taking Levomilnacipran, as this combination could cause an unsafe reaction. Consult with your physician if there are any other foods or beverages to avoid while you are taking Levomilnacipran or if there are special dietary measures you should take.

Patients diagnosed with the following medical conditions may be advised to avoid treatment with Levomilnacipran, as it will worsen their condition or cause a risk for even more adverse effects as the result of taking the drug. Communicate your full medical history to your physician, especially if you have any of the following conditions:


You will be scheduled for regular appointments with your physician if you are on Levomilnacipran so that your physician can monitor the progress the drug is making with alleviating your symptoms as well as determine if the drug is causing harm to your health. Keep these appointments as closely to their regularly scheduled dates as possible.

Avoid MAO inhibitor type drugs such as Marplan, Nardil, Eldepry and Parnate during treatment and for at least two weeks before or after you take Levomilnacipran, as the combination of these drugs can cause dangerous health conditions including agitated, restless and confused demeanor, intestinal and stomach issues, elevated body temperature and blood pressure elevations to the extreme extent, possibly causing convulsions. Alert your physician if you have taken this medication with a form of MAO inhibitor.

Young adult and teenage patients are at a higher risk to become irritable, agitated or have abnormal behavior when taking Levomilnacipran. The drug may even give some patients suicidal thoughts or tendencies or increase their depressed state of mind. Other patients may experience insomnia, sensitive mood, abundance of energy or a reckless demeanor. If you or someone close to you notice that you are experiencing these symptoms, your physician should be alerted immediately. Patients who have bipolar disorder sufferers in their immediate family or family members who have tried to commit suicidal acts should let their physician know of this.

Serotonin syndrome, a serious condition involving the central nervous system, is a high risk with use of Levomilnacipran. Alert your physician if you feel you may have overdosed on this medication or if you have symptoms such as a rapid pulse, sweating, shivering, pupils that are dilated, twitching or jerking motions or agitated muscle reactions to normal situations. Avoid using other medications that elevate your serotonin levels such as Buspar, Abstral, Zyvox, Duragesic, Eskalith, St. John's Wort, Zomig, Frova, Maxalt, Imitrex, Maxalt, Relpax and other pain relievers.

Levomilnacipran may make your blood thinner than normal and put you at risk for severe bleeding. Alert your physician if you are already taking medications that thin your blood such as NSAID pain relievers including Advil, Celebrex, Aleve or Voltaren. Avoid using Coumadin and Jantoven blood thinners during this time without permission from your physician.

Suddenly stopping this medication is not recommended, as you could experience withdrawal symptoms that are severe. Your physician will put you on a gradual reduction plan if you need to stop taking Levomilnacipran. Withdrawal symptoms to be alert for include difficulty breathing, pains in the chest area, agitated mood, diarrhea, lightheaded sensations, rapid heartbeat, nausea and vomiting. Let your doctor know if you have any of these symptoms of withdrawal.

This medication has been known to lower the sodium content of your blood, particularly if you are elderly or if you are taking diuretics, are dehydrated from vomiting or diarrhea or other conditions that deplete your bodily fluids. If you begin to have confused moments, headaches, problems remembering things, difficulty concentrating, weak muscles or unsteady, unbalanced symptoms, alert your physician right away.

Levomilnacipran has been known to cause drowsy, dizzy symptoms and to make some patients less alert and responsive than normal. Before you drive, operate tools or machinery or put yourself or others in danger due to low alertness, make sure you know how this medication affects you.

Avoid combining this medication with others unless they are approved by your physician, even those that are found over the counter or at the health food store. Do not take this medication with alcoholic beverages and avoid grapefruit juice and foods that contain it while you are on this medication.


Store Levomilnacipran extended release capsules in their original container, away from sources of light, heat or moisture. Do not allow Levomilnacipran to freeze. Keep this medication and others out of sight and reach of children and pets for their own safety. Unused or expired medication should be disposed of according to local safety regulations, which can be made known to you by asking your physician or pharmacist.


People from all walks of life in all countries suffer from a mood disorder known as major depressive disorder or MDD. MDD patients often have feelings of despair that don't go away with improved circumstances. This disorder can cause rifts between patients and their families, their co-workers and others in their life. The disease can even begin to affect their physical wellbeing, causing health symptoms of unknown and unexpected origins.

Two enzymes found in the central nervous system, norepinephrine and serotonin, are linked to MDD. Low levels of these two enzymes coincide with depressed mood symptoms that, if left untreated, can affect the health of a patient over time. With a drug treatment regimen involving SNRI medications and counseling, there is hope for patients with depressed mood.

SNRI medications, those that inhibit the reuptake of norepinephrine and serotonin, can affect the mood of depressed patients if used correctly over time. Levomilnacipran is one such SNRI medication, which increases the levels of these two enzymes in the body by stopping the central nervous system from consuming them during normal body functions. Patients will begin to feel calmer, happier and more relaxed as well as more focused.

Levomilnacipran is available in extended release format capsules that are taken once or twice daily depending on the patient's prescription. It is recommended that the capsules be taken at the same time or times each day to prevent patients from missing their dose and to provide a steady level of the medication in the body.

Pediatric patients, elderly patients with kidney issues, breastfeeding women and women who are pregnant should not take Levomilnacipran for their own safety or that of their unborn child or infant. The capsules should not be taken with alcoholic beverages. Young adult patients should be observed for any signs of suicidal thoughts or actions if they are taking Levomilnacipran.

All patients should communicate regularly with their physician if they experience any worsening of their depressed mood or if they have any adverse effects on their health while taking this medication. Avoid the use of any other medications while taking this drug or get permission to combine medications from your physician.