Buy Milnacipran (Savella) online

How and where to order Savella (Milnacipran Hydrochloride) 50 mg tablets or capsules online:

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Sellers: MILNACIPRAN STORES

Prices: from $1.16 per pill

Forms: 50 mg tablets

Quantity: 10-120 pills

Type: Milna brand, Milborn brand, Savella generic

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Indications and usage:

Savella (Milnacipran HCl) is a selective serotonin and norepinephrine reuptake inhibitor (SNRI) indicated for the management of fibromyalgia, major depressive disorder, clinical depression, social anxiety; to improve impulse control in adult patients.

Contraindications:

Serotonin syndrome and MAOIs: do not use MAOIs intended to treat psychiatric disorders with Savella or within 5 days of stopping treatment with this medication. Do not use milnacipran within 14 days of stopping an MAOI intended to treat psychiatric disorders. In addition, do not start this drug in a patient who is being treated with linezolid or intravenous methylene blue.

Dosage forms and strengths:

Savella (Milnacipran Hydrochloride) tablets 12.5 mg, 25 mg, 50 mg, 100 mg.

Dosage and administration:

Administer Savella in two divided doses per day.

Based on efficacy and tolerability, dosing may be titrated according to the following schedule:
Day 1: 12.5 mg once
Days 2-3: 25 mg/day (12.5 mg twice daily)
Days 4-7: 50 mg/day (25 mg twice daily)
After Day 7: 100 mg/day (50 mg twice daily)

Recommended dose is 100 mg/day.

May be increased to 200 mg/day based on individual patient response.

Adjust dose in patients with severe renal impairment.

Warnings and precautions:

Suicidality: monitor for worsening of depressive symptoms and suicide risk.

Serotonin syndrome: increased risk when co-administered with other serotonergic agents, but also when taken alone. If it occurs, discontinue Milnacipran HCl and any other serotonergic agents, and initiate supportive treatment.

Elevated blood pressure and heart rate: Savella may increase blood pressure and heart rate. Measure blood pressure and heart rate prior to initiating treatment with this medicine and monitor periodically throughout treatment.

Seizures: cases have been reported with Savella therapy. Prescribe this medication with care in patients with a history of seizure disorder.

Hepatotoxicity: Savella (Milnacipran Hydrochloride) pills may cause elevations of ALT and AST. Avoid concomitant use of this drug in patients with substantial alcohol use or chronic liver disease.

Discontinuation: withdrawal symptoms have been reported in patients when discontinuing treatment with Savella. A gradual dose reduction is recommended.

Increased risk of bleeding: this medicine may increase the risk of bleeding events. Caution patients about the risk of bleeding associated with the concomitant use of Savella (Milnacipran) and NSAIDs, aspirin, or other drugs that affect coagulation.

History of dysuria: male patients with a history of obstructive uropathies may experience higher rates of genitourinary adverse events.

Sexual dysfunction: this medication use may cause symptoms of sexual dysfunction.

Overdosage:

Clinical presentation

There is limited clinical experience with Savella tablets overdose in humans. In clinical trials, cases of acute ingestions up to 1000 mg, alone or in combination with other drugs, were reported with none being fatal.

Management of overdose

There is no specific antidote to milnacipran, but if serotonin syndrome ensues, specific treatment (such as with cyproheptadine and/or temperature control) may be considered. In case of acute overdose, treatment should consist of those general measures employed in the management of overdose with any drug.

Side effects, adverse reactions:

The most frequently occurring adverse reactions (>= 5% and greater than placebo) of milnacipran pills were nausea, headache, constipation, dizziness, insomnia, hot flush, hyperhidrosis, vomiting, palpitations, heart rate increased, dry mouth, and hypertension.

To report suspected side effects of Savella (Milnacipran Hydrochloride) tablets contact AbbVie pharmaceutical company or your local FDA.

Drug interactions:

Savella is unlikely to be involved in clinically significant pharmacokinetic drug interactions.

Pharmacodynamic interactions of this medication with other drugs can occur.

Usage in specific populations:

Pregnancy

Third trimester use may increase risk for symptoms of poor adaptation (respiratory distress, temperature instability, feeding difficulty, hypotonia, tremor, irritability) in the neonate.

Lactation

Milnacipran is present in human milk. There are no reports on the effects of this medicine on the breastfed child and on milk production/excretion.

Pediatric use

Safety and effectiveness of Savella in a fibromyalgia pediatric population below the age of 18 have not been established. The use of this drug is not recommended in pediatric patients.

Geriatric use

In controlled clinical studies of Savella (Milnacipran HCl) tablets, 402 patients were 60 years or older, and no overall differences in safety and efficacy were observed between these patients and younger patients.

Drug abuse and dependence:

Controlled substance

Milnacipran is not a controlled substance in most of countries worldwide.

Abuse

This medication did not produce behavioral signs indicative of abuse potential in animal or human studies.

Dependence

Milnacipran produces physical dependence, as evidenced by the emergence of withdrawal symptoms following drug discontinuation, similar to other SNRIs and SSRIs. These withdrawal symptoms can be severe. Thus, taper Savella and do not abruptly discontinue after extended use.

Patient counseling information:

Advise the patient to read the FDA-approved patient labeling and medication guide.

Advise patients of the following issues and to alert their prescriber if these occur while taking Savella (Milnacipran Hydrochloride) tablets:

Clinical worsening and suicide risk

Advise patients, their families, and their caregivers that patients with depression may be at increased risk for clinical worsening and/or suicidal ideation if they stop taking anti-depressant medication, change the dose, or start a new medication.

Encourage patients, their families, and their caregivers to be alert to the emergence of anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia (psychomotor restlessness), hypomania, or other unusual changes in behavior, worsening of depression, and suicidal ideation, especially early during treatment with Savella or other drugs that inhibit the reuptake of norepinephrine and/or serotonin, and when the dose is adjusted up or down. Advise families and caregivers to observe for the emergence of such symptoms on a day-to-day basis, since changes may be abrupt and to report such symptoms to the patient's prescriber or health professional, especially if they are severe, abrupt in onset, or were not part of the patient's presenting symptoms.

Serotonin syndrome

Inform patients about the risk of serotonin syndrome with use of this medicine as well as the increased risk when taken concomitantly with other serotonergic drugs including triptans, tricyclic antidepressants, opioids, lithium, tryptophan, buspirone, amphetamines and St. John's Wort, and with drugs that impair metabolism of serotonin (in particular MAOIs, both those intended to treat psychiatric disorders and also others, such as linezolid).

Advise patients of the signs and symptoms associated with serotonin syndrome and to seek medical care immediately if they experience these symptoms.

Elevated blood pressure and heart rate

Advise patients that Savella may increase their blood pressure and heart rate and that they should have their blood pressure and heart rate monitored at regular intervals when receiving treatment with this drug.

Increased risk of bleeding

Advise patients that the concomitant use of drugs that interfere with serotonin reuptake, including Savella, and NSAIDs, aspirin, or anticoagulants has been associated with an increased risk of abnormal bleeding.

Angle closure glaucoma

Advise patients that taking this medication can cause mild pupillary dilation which, in susceptible individuals, can lead to an episode of angle closure glaucoma.

Ability to drive and use machinery

Advise patients not to operate machinery or drive motor vehicles until they are reasonably certain that Savella (Milnacipran) treatment does not affect their ability to engage in such activities.

Alcohol

Inform patients of the risks associated with drinking alcohol while taking this medicine.

Sexual dysfunction

Advise patients that use of Savella may cause symptoms of sexual dysfunction in both male and female patients. Inform patients that they should discuss any changes in sexual function and potential management strategies with their healthcare provider.

Discontinuation

Advise patients that withdrawal symptoms can occur when discontinuing treatment with this drug, particularly when discontinuation is abrupt.

Missing a dose

Advise patients that if they miss a dose, they should skip the missed dose and take the next dose at their regular time.

Pregnancy registry

Advise patients that there is a pregnancy exposure registry that monitors pregnancy outcomes in women exposed to Savella (Milnacipran HCl) during pregnancy.

Pregnancy

Advise pregnant women to notify their healthcare provider if they become pregnant or intend to become pregnant during treatment with this medication.

Advise patients that Savella may increase the risk of neonatal complications requiring prolonged hospitalization, respiratory support, and tube feeding.

Lactation

Advise breastfeeding women using this medicine to monitor infants for sedation, agitation, irritability, poor feeding, and poor weight gain and to seek medical care if they notice these signs.

Where to buy milnacipran online:

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Here is a list of popular medications containing milnacipran hydrochloride as a main active pharmaceutical ingredient; their trade names, forms, doses, companies - manufacturers, distributors, suppliers, researchers and developers:

Trade name of the drug	Pharmaceutical forms and doses	Companies
Ixel	Capsules; Oral; 25 mg, 50 mg Tablets; Oral; 25 mg, 50 mg	Pierre Fabre Janssen Roche
Milborn	Capsules; Oral; 25 mg, 50 mg	Sun Pharmaceutical Industries
Milna	Tablets; Oral; 50 mg	Elikem Pharmaceuticals
Savella	Tablets; Oral; 12.5 mg, 25 mg, 50 mg, 100 mg	AbbVie Allergan Pierre Fabre