Levomilnacipran is used to treat depression. Levomilnacipran is in a class of medications called selective serotonin and norepinephrine reuptake inhibitors (SNRIs). It works by increasing the amount of serotonin and norepinephrine, natural substances in the brain that helps maintain mental balance.

Side Effects Of Levomilnacipran

Levomilnacipran may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

  • nausea
  • constipation
  • excessive sweating
  • changes in heart rate and blood pressure
  • erectile dysfunction
  • vomiting
  • changes in sex drive or ability
  • decreased appetite

Some side effects can be serious. If you experience any of these symptoms, stop taking levomilnacipran and call your doctor immediately or get emergency medical treatment:

  • rash
  • hives
  • swelling
  • difficulty breathing or swallowing
  • fever, sweating, confusion, fast or irregular heartbeat, and severe muscle stiffness or twitching
  • abnormal bleeding or bruising
  • difficulty urinating or unable to urinate
  • rapid, pounding, or irregular heartbeat

Levomilnacipran may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

Warnings & Precautions

Before taking levomilnacipran:

  • tell your doctor and pharmacist if you are allergic to levomilnacipran, milnacipran, any other medications, or any of the ingredients in the capsules. Ask your pharmacist for a list of the ingredients.
  • tell your doctor if you are taking a monoamine oxidase (MAO) inhibitors, including isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate) or if you have stopped taking an MAO inhibitor within the past 2 weeks or if you are taking linezolid (Zyvox) or methylene blue. Your doctor will probably tell you not to take levomilnacipran. If you stop taking levomilnacipran, you should wait at least one week before you start to take an MAO inhibitor.
  • tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: anticoagulants (‘blood thinners’) such as warfarin (Coumadin, Jantoven); antidepressants (‘mood elevators’) such as amitriptyline (Elavil), amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Adapin, Sinequan), imipramine (Tofranil), nortriptyline (Aventyl, Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil); aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin), and naproxen (Aleve, Naprosyn); buspirone (Buspar); clarithromycin (Biaxin, in Prevac); diuretics (‘water pills’); fentanyl (Actiq, Duragesic, Fentora); ketoconazole (Nizoral); lithium (Eskalith, Lithobid); medications for mental illness such as clozapine (Clozaril) and haloperidol (Haldol); medications for migraine headaches such as almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt), sumatriptan (Imitrex), and zolmitriptan (Zomig); tramadol (Ultram); ritonavir (Norvir); and sibutramine (Meridia; no longer available in the United States. Your doctor may need to change the doses of your medications or monitor you carefully for side effects. Many other medications may also interact with levomilnacipran, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list.
  • tell your doctor what herbal products and nutritional supplements you are taking, especially St. John’s wort and tryptophan.
  • tell your doctor if you have or have ever had high blood pressure, urinary retention or problems urinating, low salt (sodium) levels in your blood, seizures, or kidney or heart disease.
  • tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while taking levomilnacipran, call your doctor.
  • avoid the use of alcoholic beverages while you are taking levomilnacipran.
  • you should know that levomilnacipran may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you.
  • you should know that levomilnacipran may cause high blood pressure. Your blood pressure should be checked regularly while you are receiving levomilnacipran.
  • you should know that levomilnacipran may cause angle-closure glaucoma (a condition where the fluid is suddenly blocked and unable to flow out of the eye causing a quick, severe increase in eye pressure which may lead to a loss of vision). Talk to your doctor about having an eye examination before you start taking this medication. If you have nausea, eye pain, changes in vision, such as seeing colored rings around lights, and swelling or redness in or around the eye, call your doctor or get emergency medical treatment right away.

Levomilnacipran Dosage

Levomilnacipran comes as an extended-release (long-acting) capsule to take by mouth. It is usually taken once daily with or without food. Take levomilnacipran at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take levomilnacipran exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Swallow the capsules whole; do not open, chew, or crush them.

Your doctor may start you on a low dose of levomilnacipran and gradually increase your dose, not more than once every 2 days.

Levomilnacipran controls depression but does not cure it. It may take several weeks or longer before you feel the full benefit of levomilnacipran. Continue to take levomilnacipran even if you feel well. Do not stop taking levomilnacipran without talking to your doctor. Your doctor will probably decrease your dose gradually. If you suddenly stop taking levomilnacipran, you may experience withdrawal symptoms such as mood changes, agitation, irritability, dizziness, ringing in the ears, shock-like sensations, anxiety, confusion, tiredness, difficulty falling asleep or staying asleep, numbness or tingling in the arms, legs, hands, or feet, headache, increased sweating, seizures, or nausea. Tell your doctor if you experience any of these symptoms when your dose of levomilnacipran is decreased.


Keep all appointments with your doctor and the laboratory.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.


All information has been provided courtesy of MedLinePlus from the National Library of Medicine and from the FDA.