Savella (Milnacipran)

Savella (milnacipran) is one of the only medicines approved to treat fibromyalgia, it can be very expensive, and requires a strict schedule to take it correctly.

Fibromyalgia is a disorder that causes muscle pain and fatigue. People with fibromyalgia have "tender points" on the body. Tender points are specific places on the neck, shoulders, back, hips, arms, and legs. These points hurt when pressure is put on them.

People with fibromyalgia may also have other symptoms, such as

• Trouble sleeping
• Morning stiffness
• Headaches
• Painful menstrual periods
• Tingling or numbness in hands and feet
• Problems with thinking and memory

No one knows what causes fibromyalgia. Anyone can get it, but it is most common in middle-aged women. People with rheumatoid arthritis and other autoimmune diseases are particularly likely to develop fibromyalgia. There is no cure for fibromyalgia, but medicine can help you manage your symptoms. Getting enough sleep, exercising, and eating well may also help.

Why is this drug prescribed?

Savella (milnacipran) is a serotonin and norepinephrine reuptake inhibitor. While it's not clear how Savella (milnacipran) treats fibromyalgia, it raises the amount of serotonin and norepinephrine in the brain, which might play a role in pain relief.

You have to take it based on a very strict schedule, which can be confusing during the first month. Taking Savella (milnacipran) by itself usually isn't enough to get relief from fibromyalgia.

Buy Savella

Reasons to buy Savella:

• Savella (milnacipran) is considered a first choice medicine for treating fibromyalgia.
• Savella (milnacipran) can be taken with or without food.
• Can help with ADHD symptoms.
• There are programs to make the copay for Savella (milnacipran) more affordable.

Discover what Savella can offer to patients with fibromyalgia. If you have fibromyalgia, Savella can help you manage your condition, which may be keeping you from doing the daily activities you need to do.

Savella is clinically proven to improve fibromyalgia. In clinical studies that compared Savella to placebo, patients who took Savella said:

• They felt less pain
• their fibromyalgia overall was improved
• their physical function was improved

Savella is a medication approved for the management of fibromyalgia shown to help people feel these benefits at the same time

Savella relieves symptoms of fibromyalgia. Some patients who experienced overall improvement with Savella also experienced pain reduction as early as week one of taking a stable dose (the same dose every day). It may take several weeks for patients to feel the effect of Savella.

How should this medicine be used?

Savella is non-narcotic and is not scheduled. Dosing may be titrated according to the following schedule, but titration can be adjusted based on efficacy and tolerability:

Recommended dose: 100 mg/day (50 mg twice daily) The dose may be increased to 200 mg/day (100 mg twice daily), based on individual patient response. Doses above 200 mg/day have not been studied.

Taking Savella with a meal may improve tolerability. Savella should be tapered and not abruptly discontinued after extended use.

No dosage adjustment needed for patients with hepatic impairment or mild renal impairment. As with any drug, caution should be exercised in patients with severe hepatic impairment. Savella should ordinarily not be prescribed to patients with substantial alcohol use or evidence of chronic liver disease. Savella should be used with caution in patients with moderate renal impairment. In patients with severe renal impairment, the maintenance dose should be reduced by 50%. Savella is not recommended for patients with end-stage renal disease.

Warnings and Precautions

All patients being treated with drugs inhibiting the reuptake of norepinephrine and/or serotonin for any indication should be monitored appropriately and observed closely for clinical worsening, suicidality, and unusual changes in behavior, especially during the initial few months of treatment and when increasing or decreasing the dose.

Do not stop SAVELLA without first talking to your healthcare provider. Stopping SAVELLA too quickly may cause serious symptoms, including:

• anxiety, irritability, or confusion
• feeling tired or problems sleeping
• headache, dizziness, seizures
• electric shock-like sensations, ringing in ears

SAVELLA is not for everyone. Do not take SAVELLA if you:

• Take a Monoamine Oxidase Inhibitor (MAOI), including the antibiotic linezolid. Taking SAVELLA close in time to these medications can cause serious or even life-threatening side effects.

Consider changing the therapeutic regimen, including possibly discontinuing the medication, in patients whose depression is worsening or includes symptoms of anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia, hypomania, mania, or suicidality that are severe, abrupt in onset, or were not part of the patient's presenting symptoms. Families and caregivers of patients being treated with drugs that inhibit the reuptake of norepinephrine and/or serotonin should be alerted about the need to monitor patients daily. Prescriptions for SAVELLA should be written for the smallest quantity of capsules consistent with good patient management, in order to reduce the risk of overdose.