Fetzima (levomilnacipran) is prescribed to treat depression. The drug comes as an extended-release capsule. That means the drug releases into your body slowly over some time. You usually swallow it once daily.

Fetzima is used in adults to treat major depressive disorder, which is commonly called depression.

The active ingredient in Fetzima is levomilnacipran. Fetzima belongs to a group of drugs called serotonin-norepinephrine reuptake inhibitors.

This article describes the dosage of Fetzima, as well as its strengths and how to take it. To learn more about Fetzima, see this in-depth article.

This section describes the usual dosages of Fetzima. Keep reading to learn more.

What is Fetzima’s form?

Fetzima is available as an extended-release oral capsule.

What strengths does Fetzima come in?

Fetzima comes in four strengths:

  • 20 milligrams (mg)
  • 40 mg
  • 80 mg
  • 120 mg

What are the usual dosages of Fetzima?

Your doctor will likely start you on a low dosage and adjust it over time to reach the right amount for you. They’ll ultimately prescribe the smallest dosage that provides the desired effect.

The information below describes dosages that are commonly used or recommended. But be sure to take the dosage your doctor prescribes for you. They’ll determine the best dosage to fit your needs. In some cases, doctors may adjust your dosage from those shown below.

Dosage for depression

The typical starting dosage of Fetzima for adults with major depressive disorder is 20 mg once daily for 2 days. After this, your doctor may increase your dosage to 40 mg once daily.

Your doctor will monitor how you tolerate the dose and your body’s response to treatment. If needed, they may increase your dose slowly by 40 mg every 2 or more days. They’ll continue this until you reach the right amount to manage your symptoms.

After the starting dosage, you’ll take a maintenance dosage for ongoing treatment. The recommended maintenance dosage of Fetzima is between 40 mg and 120 mg once daily. The recommended maximum dosage of Fetzima is 120 mg once daily.

Talk with your doctor if you have questions about your dosage.

How to take Fetzima

Fetzima is available as an extended-release oral capsule. You can take Fetzima with or without food. But try to take the medication around the same time daily. This helps keep steady levels of the medication in your body to help manage your condition.

Do not cut, crush, or chew Fetzima extended-release capsules. This can affect how the medication works. If you have difficulty swallowing capsules, see this article for tips on how to take this form of medication.

Talk with your doctor or pharmacist if you have questions about how to take Fetzima.

Is Fetzima taken long term?

It’s possible that Fetzima may be taken as a long-term treatment. You and your doctor can discuss whether it’s safe and effective for treating your condition. If you agree that it is, you may take it long term.

Your doctor will monitor how your body responds to Fetzima and discuss how long you’ll likely take it.

Below are answers to some commonly asked questions about Fetzima’s dosage.

Should I take my dose of Fetzima in the morning or at night?

You may take Fetzima in the morning or at night. You can take Fetzima based on a schedule that suits your lifestyle best. But it’s important to take the medication around the same time daily. This helps keep steady levels of the medication in your body to manage your symptoms.

Ask your doctor or pharmacist if you have questions about the timing of your doses of Fetzima.

How long does it take for Fetzima to start working?

Fetzima starts to work after your first dose. But it may take several weeks of treatment before your symptoms lessen. When you begin treatment, your doctor will increase your dose slowly every 2 or more days. They’ll continue this until you reach the right amount to manage your symptoms.

Certain risks are higher in the first few weeks of treatment or with any dosage changes. These include worsening depression or suicidal thoughts and behaviors. Due to these risks, your doctor will monitor you closely throughout treatment. But tell your doctor immediately if you have any of the following:

  • worsening signs of depression
  • changes in your mood
  • changes in your thoughts or behavior

Note: Fetzima has a boxed warning about the risk of suicidal thoughts and behaviors. You can read more about this warning at the beginning of this article. There you’ll also find information on support and emergency numbers if you’re having any of the above symptoms. This article also provides resources.

If you have other questions about what to expect from your Fetzima treatment, talk with your doctor.

What should I do if I miss a dose of Fetzima?

If you miss a dose of Fetzima, take it as soon as you remember. But if it’s almost time for your next dose, skip the missed dose and take your next dose at its usual time. Do not take two doses of Fetzima to make up for a missed dose. This can increase your risk of side effects.

If you need help remembering to take your dose of Fetzima on time, try using a medication reminder. This can include setting an alarm or downloading a reminder app on your phone.

Is there a risk of withdrawal and dependence with Fetzima?

It’s possible that taking Fetzima can lead to physical dependence. This condition occurs when your body needs a drug to function as usual.

Studies have not been done to determine whether Fetzima causes dependence. But Fetzima’s drugmaker recommends not suddenly stopping Fetzima. If you stop taking it suddenly, you may experience withdrawal side effects. This is called discontinuation syndrome. (Read more about this here.)

Examples of these side effects include:

If you’re considering stopping Fetzima, talk with your doctor about your concerns. If you both agree to discontinue Fetzima, your doctor will lower your dose slowly before stopping it altogether. This can lower your risk of discontinuation syndrome.

Talk with your doctor if you have questions about withdrawal and dependence with Fetzima.

Do not take more Fetzima than your doctor prescribes, as this can lead to harmful effects.

Symptoms of overdose

Symptoms caused by an overdose can include:

What to do in case you take too much Fetzima

Call your doctor right away if you think you’ve taken too much Fetzima. You can also call 800-222-1222 to reach America’s Poison Centers or use its online resource. But if you have severe symptoms, immediately call 911 (or your local emergency number) or go to the nearest emergency room.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.