Levomilnacipran: Difference between revisions

Latest revision as of 04:01, 13 February 2025

Overview[edit]

Levomilnacipran is a serotonin-norepinephrine reuptake inhibitor (SNRI) used primarily in the treatment of major depressive disorder (MDD) in adults. It is the active enantiomer of milnacipran, which is also used to treat fibromyalgia. Levomilnacipran is marketed under the brand name Fetzima.

Mechanism of Action[edit]

Levomilnacipran functions by inhibiting the reuptake of two important neurotransmitters in the brain: serotonin and norepinephrine. By preventing the reabsorption of these neurotransmitters, levomilnacipran increases their availability in the synaptic cleft, which is believed to contribute to its antidepressant effects.

Pharmacokinetics[edit]

Levomilnacipran is administered orally and is well absorbed from the gastrointestinal tract. It undergoes hepatic metabolism primarily via the cytochrome P450 enzyme system, particularly CYP3A4. The drug and its metabolites are excreted mainly through the urinary system.

Clinical Use[edit]

Levomilnacipran is indicated for the treatment of major depressive disorder in adults. It is typically prescribed when other antidepressants have not been effective. The usual starting dose is 20 mg per day, which may be increased based on the patient's response and tolerability.

Side Effects[edit]

Common side effects of levomilnacipran include nausea, constipation, hyperhidrosis (excessive sweating), tachycardia (increased heart rate), and erectile dysfunction. Patients may also experience increased blood pressure and heart rate, so regular monitoring is recommended.

Contraindications[edit]

Levomilnacipran is contraindicated in patients with uncontrolled narrow-angle glaucoma, and it should not be used in conjunction with monoamine oxidase inhibitors (MAOIs) due to the risk of serotonin syndrome.

Related Pages[edit]

@@ Line 1: / Line 1: @@
-{{intro}}
+{{DISPLAYTITLE:Levomilnacipran}}
-Levomilnacipran is a serotonin and norepinephrine reuptake inhibitor used to treat major depressive disorders. Levomilnacipran is an enantiomer of milnacipran, which is used to treat fibromyalgia.
-{{livtox}}
+== Overview ==
-Levomilnacipran and milnacipran have been associated with a low rate of transient elevations in serum aminotransferase levels during treatment and with rare instances of clinically apparent acute liver injury with jaundice.
+[[File:Fetzima_1.jpg|thumb|right|Levomilnacipran capsule]]
+'''Levomilnacipran''' is a [[serotonin-norepinephrine reuptake inhibitor]] (SNRI) used primarily in the treatment of [[major depressive disorder]] (MDD) in adults. It is the active enantiomer of [[milnacipran]], which is also used to treat [[fibromyalgia]]. Levomilnacipran is marketed under the brand name '''Fetzima'''.
-{{moa}}
+== Mechanism of Action ==
-Levomilnacipran (lee’ voe mil na’ si pran) is an oral serotonin and norepinephrine reuptake inhibitor (SNRI) that is used as a first line therapy of major [[depression]]. Levomilnacipran is the more active enantiomer of milnacipran (mil na’ si pran), which is used to treat fibromyalgia. Unlike other SNRIs such as duxoletine and venlafaxine, levomilnacipran is a more potent inhibitor of norepinephrine reuptake than serotonin reuptake.
+Levomilnacipran functions by inhibiting the reuptake of two important neurotransmitters in the brain: [[serotonin]] and [[norepinephrine]]. By preventing the reabsorption of these neurotransmitters, levomilnacipran increases their availability in the [[synaptic cleft]], which is believed to contribute to its antidepressant effects.
-{{fda}}
+== Pharmacokinetics ==
-{{PAGENAME}} was approved for use in the United States in 2007 and levomilnacipran in 2013. Despite the fact that they are identical in chemical structure, the only official current indication for milnacipran is fibromyalgia, and the sole indication for levomilnacipran is the treatment of major depressive disorders. Levomilnacipran has been evaluated as therapy of fibromyalgia and phantom limb syndrome, but is not approved for those uses.
+Levomilnacipran is administered orally and is well absorbed from the [[gastrointestinal tract]]. It undergoes hepatic metabolism primarily via the [[cytochrome P450]] enzyme system, particularly CYP3A4. The drug and its metabolites are excreted mainly through the [[urinary system]].
-{{dose}}
+== Clinical Use ==
-Milnacripran is available in 12.5, 25, 50 and 100 mg tablets and the recommended dosage is 50 mg twice daily after a 7 day titration schedule. Levomilnacipran is available in extended release capsules of 20, 40 80 and 120 mg under the brand name Fetzima. The recommended starting dosage is 20 mg once daily, with titration upwards by 20 mg every 2 days to a maximum daily dose of 120 mg.
+Levomilnacipran is indicated for the treatment of major depressive disorder in adults. It is typically prescribed when other antidepressants have not been effective. The usual starting dose is 20 mg per day, which may be increased based on the patient's response and tolerability.
-{{se}}
+== Side Effects ==
-Common side effects of milnacipran and levomilnacipran include [[nausea]], [[vomiting]], constipation, [[headache]], sweating, increased heart rate, palpitations, testicular pain, urinary hesitancy and erectile dysfunction. When used with other serotonin reuptake inhibitors, milnacipran and levomilnacipran can be associated with acute [[serotonin syndrome]] of [[fever]], tachycardia, anxiety and flushing.
+Common side effects of levomilnacipran include [[nausea]], [[constipation]], [[hyperhidrosis]] (excessive sweating), [[tachycardia]] (increased heart rate), and [[erectile dysfunction]]. Patients may also experience increased blood pressure and heart rate, so regular monitoring is recommended.
-{{antidepresants}}
+== Contraindications ==
+Levomilnacipran is contraindicated in patients with uncontrolled narrow-angle [[glaucoma]], and it should not be used in conjunction with [[monoamine oxidase inhibitors]] (MAOIs) due to the risk of [[serotonin syndrome]].
-{{coststubd}}
+== Related Pages ==
+* [[Serotonin-norepinephrine reuptake inhibitor]]
+* [[Major depressive disorder]]
+* [[Milnacipran]]
+* [[Serotonin syndrome]]
+[[Category:Antidepressants]]
+[[Category:Serotonin-norepinephrine reuptake inhibitors]]