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Savella Warnings and Precautions

There is a lot of information that you should be aware of before taking Savella. Precautions and warnings include watching out for potential drug interactions, avoiding the medication if you have uncontrolled narrow-angle glaucoma, and monitoring your blood pressure and heart rate regularly during treatment. You should not take Savella if you have taken an MAOI within the past two weeks.

What Should I Tell My Healthcare Provider Before Taking Savella?

You should talk with your healthcare provider prior to taking Savella® (milnacipran hydrochloride) if you have:
Also, let your healthcare provider know if you:
  • Are pregnant or thinking of becoming pregnant
  • Are breastfeeding
  • Drink alcohol regularly.
Make sure to tell your healthcare provider about any other medications you are taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.

Specific Precautions and Warnings for Savella

Warnings and precautions to be aware of prior to taking Savella include the following:
  • Antidepressants may increase the risk of suicidal thinking or behavior in children, teenagers, and adults (see Depression and Suicide for more information). Even though Savella is not approved for depression treatment in the United States, it is in the same drug category as some antidepressants. Therefore, if you notice any changes in depression symptoms or new symptoms, talk to your healthcare provider immediately. Some of these symptoms may include:
    • Anxiety
    • Hostility
    • Agitation
    • Panic
    • Restlessness
    • Hallucinations
    • Extreme hyperactivity
    • Suicidal thinking or behavior.
  • Taking Savella with other medications that affect serotonin can increase your risk of a dangerous group of symptoms called serotonin syndrome. These other medications include other antidepressants, triptans (migraine medications), and other medications (see Savella Drug Interactions for more information). Contact your healthcare provider immediately if you have any possible symptoms of serotonin syndrome, including:
    • Confusion or other mental changes
    • A rapid heart rate
    • Nausea
    • Vomiting
    • Diarrhea
    • Hallucinations
    • Blood pressure changes
    • Overactive reflexes
    • Fever
    • Shivering
    • Shakiness
    • Agitation
    • Sweating
    • Seizures
    • Coma.
  • Savella has been reported to cause liver problems, including hepatitis. It is not recommended for people who have liver problems or who drink large amounts of alcohol regularly, due to an increased risk of liver damage.
  • This medication can cause low blood pressure (hypotension). This may be more common if you are also taking other medications, especially high blood pressure medications. Tell your healthcare provider if you have symptoms of low blood pressure, including lightheadedness, dizziness, or fainting.
  • Savella can increase blood pressure and heart rate. Your healthcare provider should monitor these while you are taking Savella. If you already have high blood pressure, you should be adequately treated for this condition before starting Savella.
  • Savella may increase the risk of seizures. Talk to your healthcare professional before taking this medication if you have a history of seizures.
  • If you are stopping Savella, you should be monitored by a healthcare provider for withdrawal symptoms. If you do develop any symptoms of withdrawal (such as irritability, anxiety, confusion, headache, lethargy, or insomnia), your healthcare provider may slow down the rate at which the medication is stopped.
  • If you are elderly or taking a diuretic, Savella could cause low salt levels in the blood (hyponatremia). This generally returns to normal when the medication is discontinued, but can be serious in severe cases. Signs of hyponatremia include:
    • Headaches
    • Difficulty concentration, memory problems, or confusion
    • Unsteadiness or falling
    • Hallucinations
    • Fainting
    • Seizures
    • Coma.
  • This medication can increase the risk of bleeding, including dangerous internal bleeding. Check with your healthcare provider before taking Savella if you have a bleeding disorder or if you take any anticoagulant, "blood thinning" medications (see Savella Drug Interactions).
  • Savella can increase the risk of mania (often noticed as an extreme increase in activity and talking), especially in people with a history of mood disorders such as bipolar disorder. Make sure your healthcare provider knows your full mental health history before you take this drug.
  • Savella can make narrow-angle glaucoma worse. If your glaucoma is under control, your healthcare provider should monitor your glaucoma to make sure it is not getting worse. If your glaucoma is not under control, you should not take this medication.
  • Savella can cause painful urination or other bladder or urination problems, especially in men with problems such as an enlarged prostate (benign prostatic hypertrophy). Make sure to tell your healthcare provider about any urinary problems you have before taking this drug or any bladder problems that develop while taking it.
  • People who drink alcohol frequently should not take Savella, as heavy alcohol use may increase the risk of liver damage.
  • Savella is considered a pregnancy Category C medication. This means that it may not be safe to use during pregnancy. Talk to your healthcare provider about the risks and benefits of using the drug during pregnancy (see Savella and Pregnancy for more information).
  • It is not known if Savella passes through breast milk. Therefore, if you are breastfeeding or plan to start, be sure to talk with your healthcare provider before taking this drug (see Savella and Breastfeeding).
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