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Savella (milnacipran) is a medication that shares some characteristics with antidepressants, and thus it carries similar risks and precautions. It is important to be aware of these safety considerations and discuss any concerns with your healthcare provider.

• Suicidal Thoughts and Behavior: Use of Savella can increase the risk of depression symptoms and suicidal thoughts or behaviors, particularly in individuals under 24 years old or those with a history of depression. It is crucial to consult your prescriber about these risks, especially when starting the medication or changing the dose.

• Serotonin Syndrome: Although rare, this condition can occur due to excess serotonin in the brain, especially if combined with other serotonin-affecting drugs like certain antidepressants, opioids, or triptans. Inform your healthcare provider about all other medications you are taking to assess the risk.

• Blood Pressure and Heart Rate: Savella may lead to increased blood pressure and heart rate. Those with pre-existing hypertension or heart rate concerns should discuss potential risks with their prescriber before starting Savella.

• Increased Bleeding Risk: The medication can heighten the likelihood of bleeding or bruising, especially when taken with blood thinners or NSAIDs. Discuss this risk with your healthcare provider if you are using such medications.

• Urination Problems: Some users experience difficulty or pain during urination. If you have a history of urinary issues, including an enlarged prostate, notify your prescriber.

• Sexual Side Effects: Decreased libido, erectile dysfunction, or difficulties with orgasm may occur. Report any changes in sexual function to your healthcare provider for evaluation and management.

• Liver Damage: Savella can elevate liver enzyme levels, indicating potential liver damage. It is generally not recommended for individuals with chronic liver conditions or those who consume alcohol heavily.

• Glaucoma Worsening: In people with narrow-angle or angle-closure glaucoma, Savella may exacerbate the condition. Seek immediate medical attention if you experience sudden vision changes or eye pain, which may signal an urgent issue.

• Contraindications: Do not use Savella if you are currently taking a monoamine oxidase inhibitor (MAOI) or have done so within the past 14 days, as this combination can pose serious health risks.

If any adverse effects or unusual symptoms occur while taking Savella, it is important to contact your healthcare provider promptly to ensure your safety and well-being.

When taking this medication, some common side effects you might experience include nausea, headache, constipation, trouble sleeping, hot flashes, and dizziness. These are generally mild and should not cause alarm unless they persist or worsen, in which case you should contact your healthcare provider.

There are other side effects that some individuals report, such as vomiting, dry mouth, excessive sweating, migraine, upper respiratory infection, and an increased heart rate or high blood pressure. Additionally, some may encounter sexual issues like a decreased sex drive or difficulties with erections or orgasms.

Serious side effects are less common but require immediate medical attention. These include suicidal thoughts or behaviors, serotonin syndrome (characterized by fever, sweating, movement problems, and hallucinations), and liver damage, which may present as yellowing of the skin or eyes, upper stomach pain, and dark urine. Low sodium levels can also occur, leading to symptoms such as headache, confusion, weakness, and in severe cases, seizures. Unusual bleeding or bruising and seizures are also critical signs to watch for.

In rare instances, a severe allergic reaction may occur, manifesting as a rash, itching, swelling, severe dizziness, or trouble breathing. If you notice any of these symptoms, seek medical help immediately. Always inform your healthcare provider about any persistent or concerning side effects.

Milnacipran, commonly known as Savella, can interact with various medications and supplements. It is crucial to inform your doctor and pharmacist about any drugs or supplements you are taking, whether prescribed, over-the-counter, or herbal.

Some interactions can be serious. For instance, taking Savella with MAO inhibitors, such as isocarboxazid, linezolid, or tranylcypromine, can lead to a severe and potentially fatal reaction. Therefore, MAO inhibitors should be avoided during treatment with Savella and generally should not be taken for two weeks before and at least five days after stopping Savella. Always consult your doctor about when to start or discontinue these medications.

Additionally, using aspirin alongside Savella can heighten the risk of bleeding. However, if your doctor has prescribed low-dose aspirin for heart attack or stroke prevention, continue its use unless advised otherwise. Discuss any concerns with your doctor or pharmacist.

The likelihood of developing serotonin syndrome, a potentially dangerous condition, increases if Savella is combined with other serotonin-boosting drugs. These include certain antidepressants like SSRIs (e.g., fluoxetine, paroxetine) and SNRIs (e.g., duloxetine, venlafaxine), as well as street drugs like MDMA, St. John's wort, and tryptophan. The risk is particularly heightened when starting or increasing the dosage of these medications.

Lastly, avoid using levomilnacipran while taking milnacipran, as they are quite similar. Always follow your healthcare professional's advice regarding medication use.