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Side Effects of Milnacipran (Savella)


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Side Effects of Milnacipran (Savella)

Milnacipran, available as the brand Savella, affects certain chemicals in the brain called neurotransmitters. An abnormality in these chemicals is thought to be related to fibromyalgia (a medical condition that causes chronic pain in the muscles and joints). Savella is not used to treat depression but has the same mechanisms as antidepressants used to treat psychiatric disorders.

Savella and Risk of Suicide

Savella can increase suicidal ideation or actions in some children, teenagers, and young adults within the first few months of treatment. Those who have or have a family history of bipolar illness (also called manic-depressive illness) or suicidal thoughts or actions, may have a particularly high risk of having suicidal thoughts or actions.

Precautions Before Taking Savella

To ensure Savella is safe for you, inform your healthcare provider if you have glaucoma (damaged optic nerve and can lead to blindness), liver disease, kidney disease, high blood pressure, seizures or epilepsy, bipolar disorder (manic depression), a bleeding or blood clotting disorder such as hemophilia, low levels of sodium in your blood, urination problems, if you take a blood thinner such as Warfarin (coumadin), or if you drink alcohol (Savella label reported by the FDA).

Common Side Effects

The Savella label reported by the FDA lists the common Savella side effects:


  • Nausea
  • Vomiting
  • Constipation
  • Dry mouth
  • Increased sweating
  • Flushing (warmth, redness, or tingly feeling)
  • Headache
  • Dizziness
  • Insomnia or sleep problems sleep problems
  • High blood pressure
  • Pounding heartbeats

When to Contact Your Doctor

Contact your doctor immediately if you have any of the following symptoms: thoughts about suicide or dying, new or worse irritability, attempts to commit suicide, acting aggressive, being angry, or violent, new or sudden changes in mood, behavior, thoughts, or feelings, and new or worse depression.


In addition, inform your doctor is there is acting on dangerous impulses, new or worse anxiety, an extreme increase in activity and talking, mania (feeling very agitated or restles), panic attacks, other unusual changes in behavior or mood, and insomnia (trouble sleeping).

Drug Interactions

Avoid drinking alcohol while taking Savella as it may increase the risk of liver damage.


Do not use milnacipran if you have used a monoamine oxidase inhibitor (MAOI) in the past 14 days as a dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, and tranylcypromine. After you stop taking milnacipran, you must wait at least 5 days before you start taking an MAOI.


Discuss with your healthcare provider before taking Savella with a sleeping pill, narcotic pain medicine, muscle relaxer, or medicine for anxiety, depression, or seizures as it can worsen the sleepiness effect.

About Pharmacogenetic Testing

The study of pharmacogenetics branched off from the sequencing of the human genome. In genes, there are sequence variations determine the enzymes responsilbe for metabolizing drugs are different in each person. If you experience side effects, it is because you do not metaolize the medication well. If you do not experience side effects, it is because you metabolize the drug too quickly not receving its theraputic benefits.

Know Your Risk with the Rxight® Genetic Test

MD Labs created the Rxight® genetic test that tests the metabolism of medications. Rxight® specializes in providing an analysis of how you might respond to Savella and other clinically relevant prescription and over-the-counter (OTC) medications. Rxight® guides prescribers to create a treatment plan with effective medications and no adverse side effects.


For more information about Rxight®, call us at 1-888-888-1932 or email us at support@Rxight.com.


Contributors to this Article:
Michael Sapko, MD, PhD; and Deborah Kallick, PhD, Medicinal Chemistry

Read more about Rxight® Individualized Medicine