levomilnacipran (Savella)

Introduction

see milnacipran

Dosage

• start 20 mg
• max 120 mg

Tabs: 20, 40, 80, 120 mg sustained release release tablets

Dosage adjustment in renal failure

• max dose
  • 80 mg daily with moderate renal impairment
  • 40 mg daily with severe renal impairment

Pharmacokinetics

• metabolized by CYP3A4

Monitor

• blood pressure

Drug interactions

• concurent use of strong CYP3A4 inhibitors (ketoconazole ...) increase levels of levomilnacipran

• drug interaction(s) of triptans with SNRIs
• drug interaction(s) of methylene blue with SNRIs
• drug interaction(s) of linezolid with SNRIs
• drug interaction(s) of benzodiazepines with antidepressants
• drug interaction(s) of antidepressants with benzodiazepines
• drug interaction(s) of NSAIDs with antidepressants

Mechanism of action

• stronger inhibition of norepinephrine reuptake than serotonin reuptake

More general terms

• milnacipran (Savella)