Savella is a selective serotonin reuptake inhibitor (SNRI) and norepinephrine. The medications used to cure depression and other mental illnesses are similar. Savella was approved in January 2009 by the FDA to help manage fibromyalgia in adults. It is the first medication to be launched only for that reason, and is available by prescription.
Previous approved drugs for the management of fibromyalgia include Lyrica (pregabalin), a drug for nerve pain and epilepsy, and Cymbalta (duloxetine), another SNRI. Milnacipran affects certain chemicals, called neurotransmitters, in the brain. These chemicals are thought to have an abnormality related to fibromyalgia. Milnacipran is not used to treat depression but it’s similar to how some antidepressants work in the body.
Newest fibromyalgia drug
Milnacipran HCI (Savella) is the latest drug to treat fibromyalgia. It was formally approved in 2009. It was also the first drug made specifically for treating fibromyalgia. This drug is not prescribed for the treatment of depression, but it does work as drugs that treat depression. Milnacipran HCI changes the serotonin and norepinephrine levels within your brain. This can help to soothe pain.
Increase risk of suicidal thinking
Savella is a powerful reuptake inhibitor of serotonin and norepinephrine (SNRI), comparable to certain medications used to relieve stress and other psychological conditions. In short-term studies of major depressive disorder ( MDD) and other psychiatric disorders, antidepressants increased the risk of suicidal thinking and behavior (suicidality) in children, adolescents , and young adults compared with placebo. Anyone considering using such drugs in a child, adolescent, or young adult has to balance this risk with clinical necessity.
Savella is not authorized to be used in treating major depressive disorder. Savella is not licensed for use in pediatric patients. When you first start taking this drug you will have thoughts of suicide, particularly if you are younger than 24 years old. For at least the first 12 weeks of treatment, your doctor will need to check you out at regular visits.
Do not take milnacipran together with thioridazine (Mellaril), or a monoamine oxidase inhibitor (MAOI), such as isocarboxazide(Marplan), phenelzine(Nardil), rasagiline(Azilect), selegiline(Eldepryl, Emsam), (Parnate). After stopping an MAOI you need to wait at least 14 days before you can take milnacipran.
You will wait at least 5 days after you quit taking milnacipran before you continue taking an MAOI. Whether you are resistant to milnacipran, or have chronic or severe narrow-angle glaucoma, you will not be taking this drug.
Effect of savella on fatigue
An antidepressant, milnacipran is one of three drugs that the Food and Drug Administration has approved for the treatment of fibromyalgia. While fibromyalgia pain relief can help people feel less tired, milnacipran appears to have an additional effect on fatigue separate from pain relief.
Savella ‘s prescribed dosage is 100 mg / day (50 mg twice daily). Avella may interfere with blood thinners, clonidine, diuretics (water pills), digoxin, epinephrine, creatine, tramadol, tryptophan, migraine or antidepressant medicines.
Savella, this is a tablet. Per day, you take Savella in two different doses. The first day, you start at 12.5 milligrams. Then, over a period of one week, you increase to 100 milligrams / day. Although the recommended dose is 100 milligrams per day, based on your response to the medication, your doctor may increase it to 200 milligrams / day.
Do not immediately quit using milnacipran or you may experience uncomfortable signs of withdrawal such as dizziness , nausea, feeling irritable, fatigue , headache, ringing in your ears and sleep issues. Talk to your doctor about preventing symptoms of withdrawal if you stop using milnacipran.
Tell your doctor about all of the medications you take. Savella should only be used during pregnancy, if prescribed. Babies born to mothers who have used this medicine during the last 3 months of pregnancy may rarely develop withdrawal symptoms such as difficulties in feeding / breathing, seizures, muscle stiffness or constant weeping. If you notice any of those newborn symptoms, tell your doctor.
How this drug transfers to breast milk is unclear. Discuss the risks and benefits of breastfeeding with your doctor. Do not quit using Savella abruptly or you will have signs of withdrawal such as dizziness , nausea, feeling irritable, fatigue , headache, ringing in your ears and trouble with sleep.
Until you are certain Savella does not affect your mental or physical abilities, do not drive or use machinery. Will not drink alcohol. Talk to your doctor before stopping Savella, and do not stop suddenly; this may cause symptoms of withdrawal. Be sure to inform the doctor before you start taking some other drugs, including over-the-counter medicines.
Take it exactly as the doctor has recommended. Do not carry on larger or lesser amounts or for longer than prescribed. Follow the directions that appear on your prescription label. Occasionally, your doctor may change your dose to ensure you get the best results.
Mechanism of action
Savella enables the movement of more of these neurotransmitters from neuron to neuron. The operations of Savella are not entirely transparent. But increasing neurotransmitter levels will relieve pain and decrease fatigue or help with memory. Not all of those benefits were tested in humans, however. With fibromyalgia, the pain threshold may be lower. Experts believe that this can be due to changes in your nervous system. These adjustments will make you more pain tolerant. This may result from neurotransmitters possessing inappropriate rates. There are molecules which are in the bloodstream.
Common side effects
If you have some of those significant side effects, contact the doctor immediately:
• Chill or goose bumps, memory problems, concentration difficulties,
• Agitation, hallucinations, rapid heart rate, overactive reflexes, nausea , vomiting , diarrhea, coordination loss, fainting;
• Very tense (rigid) muscles, high fever, anxiety, rapid or irregular heartbeats, tremors, felt as though you were going away;
• Elevated blood pressure (heavy headache, blurry vision, ear buzz, chest pain, shortness of breath, irregular heartbeat)
- Savella May Reduce Pain, Alter Brain Activity in Fibromyalgia Patients, Study Suggests via BY JOSE MARQUES LOPES, PHD via Fibromyalgia News Network
- The study, “Using fMRI to evaluate the effects of milnacipran on central pain processing in patients with fibromyalgia,” appeared in the Scandinavian Journal of Pain.