Milnacipran HCl Oral tablet, Milnacipran HCl Oral tablet, Milnacipran HCl Oral tablet

What is this medicine?

MILNACIPRAN (mil NA si pran) is used to treat the pain caused by fibromyalgia.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:

• glaucoma
• heart disease
• if you frequently drink alcohol containing drinks
• irregular heart beat
• kidney disease
• liver disease
• mania or bipolar disorder
• prostate problems
• seizures
• suicidal thoughts, plans, or attempt; a previous suicide attempt by you or a family member
• taken an MAOIs like Carbex, Eldepryl, Marplan, Nardil, and Parnate within 14 days
• an unusual or allergic reaction to milnacipran, other medicines, foods, or preservatives
• pregnant or trying to get pregnant
• breast-feeding

How should I use this medicine?

Take this medicine by mouth with a glass of water. Follow the directions on the prescription label. Do not take your medicine more often than directed. Do not stop taking except on your doctor's advice.

A special MedGuide will be given to you by the pharmacist with each prescription and refill. Be sure to read this information carefully each time.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.
NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

What may interact with this medicine?

Do not take this medicine with any of the following medications:

• medicines called MAO Inhibitors like Nardil, Parnate, Marplan, Eldepryl
• tryptophan

This medicine may also interact with the following medications:

• amphetamine or dextroamphetamine
• aspirin and aspirin-like medicines
• clonidine
• digoxin
• epinephrine
• furazolidone
• linezolid
• lithium
• medicines for blood pressure
• medicines for migraine headache like almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, zolmitriptan
• medicines that treat or prevent blood clots like warfarin, enoxaparin, and dalteparin
• NSAIDS, medicines for pain and inflammation, like ibuprofen or naproxen
• other medicines for depression, anxiety, or psychotic disturbances
• procarbazine
• St. John's wort, Hypericum perforatum
• tramadol

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medicine?

Visit your doctor or health care professional for regular checks on your progress. If you have been taking this medicine for some time, do not suddenly stop taking it. You must gradually reduce the dose to avoid side effects. Ask your doctor or health care professional for advice.

Patients and their families should watch out for depression or thoughts of suicide that get worse. Also watch out for sudden or severe changes in feelings such as feeling anxious, agitated, panicky, irritable, hostile, aggressive, impulsive, severely restless, overly excited and hyperactive, or not being able to sleep. If this happens, especially at the beginning of treatment or after a change in dose, call your health care professional.

This medicine can cause an increase in blood pressure or a faster heart beat. Check with your doctor or health care professional.

You may get drowsy, dizzy or have blurred vision. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medicine affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Alcohol may increase dizziness or drowsiness. Avoid alcoholic drinks.

This medicine can make your mouth dry. Chewing sugarless gum, sucking hard candy and drinking plenty of water will help.

What side effects may I notice from receiving this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:

• allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
• chest pain, fast or irregular heartbeat
• confusion
• fever or chills, sore throat
• hallucination, loss of contact with reality
• increase in blood pressure
• redness, blistering, peeling or loosening of the skin, including inside the mouth
• seizures
• suicidal thoughts or other mood changes
• talking fast and having excited feelings or actions that are out of control
• trouble passing urine or change in the amount of urine
• unusual bleeding or bruising
• unusually weak or tired
• yellowing of the eyes, skin

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

• blurred vision
• change in sex drive or performance
• constipation
• dry mouth
• flushing
• headache
• increased sweating
• nausea
• trouble sleeping

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medicine?

Keep out of the reach of children.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Throw away any unused medicine after the expiration date.

NOTE:This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.