Levomilnacipran  

Fetzima

Fetzima is an FDA-approved antidepressant that is used to treat major depressive disorder in adult patients. It contains levomilnacipran, which inhibits the reuptake of serotonin and norepinephrine, increasing their availability in the central nervous system, which helps regulate mood and emotional well-being. The prescription medication is available as an extended-release capsule in strengths of 20 mg, 40 mg, 80 mg, and 120 mg, usually taken daily with or without food. Consult your healthcare provider or physician for personalized advice and guidance, and seek their help if you have any queries or concerns regarding the use of the medication. To ensure your medication is genuine, buy Fetzima (levomilnacipran) online from trusted and reliable sources. 

Product Overview

Fetzima contains the main ingredient, levomilnacipran, used to treat and manage major depressive disorder in adult patients. This antidepressant works by inhibiting serotonin and norepinephrine reuptake, increasing their availability in the central nervous system, which helps regulate mood and emotional well-being. Fetzima is available as an extended-release capsule in strengths of 20 mg, 40 mg, 80 mg, and 120 mg. It is typically taken once daily, starting at 20 mg for the first two days, then increased to 40 mg. 

Your doctor may adjust the dosage, to a maximum of 120 mg daily. This medication should be swallowed whole, not chewed or crushed, and can be taken with or without food. It is intended for use by adults diagnosed with major depressive disorder.

Common side effects of Fetzima include nausea, constipation, vomiting, excessive sweating, and erectile dysfunction. More severe side effects can consist of serotonin syndrome, high blood pressure, increased risk of bleeding, urinary difficulties, low sodium levels, seizures, and allergic reactions. 

Patients should be aware of the potential for increased suicidal thoughts, especially during the initial treatment period. Precautions include informing your doctor of any medical history, especially related to heart problems, glaucoma, or bipolar disorder. In case of a missed dose, take it as soon as remembered unless it is close to the next dose. Avoid doubling up doses. Store Fetzima in a cool, dry place away from children and pets. If an overdose occurs, seek immediate medical assistance. Always consult your healthcare provider for advice tailored to your specific health needs.

Uses of Fetzima

It is used to treat and manage:

• Major depressive disorder 

How to Use Fetzima?

Dosage

Fetzima is available in the form of an extended-release capsule that comes in the following strengths:

• 20 mg
• 40 mg
• 80 mg 
• 120 mg 

Recommended Dosage for Different Patients/Fetzima

For Major Depressive Disorder 

• The initial dosage of Fetzima to treat depression is 20 mg, taken orally by mouth once daily for two days.
• After two days, your doctor may increase your dosage to 40 mg, taken orally by mouth once daily. 
• Your doctor may continue increasing your dose by 40 mg every two days until you reach the maximum maintenance dosage, 120 mg daily.
• Usually, based on your symptoms of depression, you may be required to take the medication for several months or even longer. 
• Your doctor will monitor your symptoms every few months to determine whether you still need to take Fetzima.

[Note: Remember, these recommendations may vary from person to person. Discuss it with your doctor, and they’ll customize your dosage accordingly.]

How to Take It?

• Before taking the medication, you should carefully read and follow the instructions in the patient information leaflet included with your prescription. 
• Before using the medication, discuss the potential risks and benefits with your doctor or healthcare provider. 
• If you have any questions or concerns about how to use the medication, consult your physician or pharmacist. 
• You should use this medication exactly as your doctor directed. You must take it orally by mouth, with or without food. 
• Do not chew, crush, break, or open the Fetzima 120 mg capsule. Swallow it whole. 
• If you break the capsule, it can release all medication at once, which may increase your risk of unwanted side effects.
• The medication dosage is based on your medical condition, your body’s response to treatment, and other medications you may be taking. Tell your doctor, healthcare provider, or pharmacist about all your medications, including all prescription medications, over-the-counter and non-prescription drugs, and herbal supplements you may be taking. 
• Your doctor may direct you to start Fetzima at a low dosage and gradually increase your dose to reduce your risk of side effects. Follow all instructions given to you by your doctor carefully. 
• To get the most benefit of your medication, you should maintain consistency in dosage and take Fetzima around the same time daily.
• You can take this medication at any time of day that is convenient for you, but you should try to take it around the same time every day.
• Do not increase your dosage or use this dosage more frequently or for longer than prescribed. Taking your medication more often or in large quantities will not improve your condition any faster, but it will increase your risk of unwanted side effects. 
• You may start feeling improvements in your symptoms as soon as a couple of weeks after taking this medication. 
• It may take around six to eight weeks before you get the full benefit of this medication. 
• Continue taking this medication even if you feel well. 
• You should not abruptly stop taking this medication without consulting your doctor or healthcare provider. Certain conditions may worsen when you suddenly stop taking this medication. 
• Additionally, you may experience symptoms such as headache, fatigue, mood swings, sleep changes, and more when you are stopping treatment with this drug. To prevent this, your doctor will taper your dose gradually. 
• You should report any new or worsening symptoms to your doctor immediately. 
• Tell your doctor if your condition does not improve or worsens after six to eight weeks of treatment. Your doctor may suggest that you take other medication to treat your condition.  

[Note: Your doctor will decide the right amount for you based on your condition, following guidelines and studies on the drug. They’ll adjust it as needed over time.]

How Does Fetzima Work?

Fetzima is an antidepressant approved for the treatment of major depressive disorder in adult patients. The precise mechanism of levomilnacipran’s antidepressant effect is not fully understood. Still, it is presumed to work by inhibiting the reuptake of serotonin and norepinephrine transporters in the central nervous system. Doing so enhances the availability of these neurotransmitters, which play crucial roles in mood regulation and emotional well-being.

Important Safety Information

Side Effects

Common side effects of Fetzima may include:

• nausea
• constipation
• vomiting
• excessive sweating
• erectile dysfunction (inability to have or keep an erection)*
• decreased appetite
• tachycardia (fast heart rate)
• palpitations 

Adverse side effects of Fetzima may include:

• Serotonin syndrome. Its symptoms may include:
  • Changes in your mental status
  • Delirium 
  • Hallucinations 
  • Sweating or feeling flushed
  • Seizures
• High blood pressure or rapid heart rate. Its symptoms may include:
  • Chest pain
  • Dizziness 
  • Headache 
  • Trouble breathing
• Higher risk of bleeding. Its symptoms may include:
  • A stool that appears pink or black
  • Bruising more often than usual
  • Cuts that take longer than usual to heal
  • Nosebleeds 
  • Urine that appears pink or red
• Trouble urinating. Its symptoms may include:
  • Difficulty in urination
  • Pain while urinating
  • Urinary retention
• Low sodium levels in your blood. Its symptoms may include:
  • Coma 
  • Confusion 
  • Fainting 
  • Feeling weak or unsteady
  • Headache 
  • Memory problems
  • Seizures 
  • Trouble concentrating
• Seizures. Its symptoms may include:
  • Confusion 
  • Jerky movements or muscle spasms
  • Loss of consciousness
  • Rapid blinking
• Sexual dysfunction 
• Severe allergic reaction. Its symptoms may include:
  • Difficulty in swallowing
  • Discoloration of skin 
  • Drowsiness
  • Fainting 
  • Itching 
  • Rashes 
  • Swelling in your feet, ankles or toes
  • Swelling in your tongue, throat, or lips
• Suicidal thoughts and behaviors. Its symptoms may include:
  • Acting on impulses
  • Anxiety
  • Being aggressive
  • Changes in behavior
  • Feeling restless
  • Hostility 
  • Insomnia 
  • Irritability 
  • Panic attacks

[Note: This list may not cover all possible side effects. Always consult with your healthcare giver for medical advice about side effects.]

Warnings

• Before taking Fetzima, you should consult your doctor regarding potential side effects and benefits and share your complete medical history with your doctor. This medication may not be right for you if you have certain medical conditions, such as:
  • Bipolar disorder
  • Breastfeeding
  • Difficulty urinating
  • Glaucoma
  • Heart problems 
  • Seizure 
  • Pregnancy 
• Fetzima 120 mg capsule may increase your blood pressure and heart rate. If you have hypertension or heart conduction disorder, this medication may make your condition worse. Consult your doctor about any heart-related or blood pressure-related problems before taking this medication. 
• If you have angle closure glaucoma, this medication may cause further problems with your vision. It may cause your pupil to dilate, triggering a serious reaction known as an angle closure attack. Its symptoms may include eye pressure, severe eye pain, blurred vision, nausea/vomiting, or halos around lights. Call your doctor right away if you experience such symptoms. 
• This medication may cause urinary hesitancy or difficulty urinating in some patients. If you experience trouble urinating, this medication may worsen your condition. If you have urinary problems, consult your doctor. 
• This medication may worsen your symptoms of bipolar disorder, which may lead to manic episodes. If you have bipolar disorder, talk with your doctor before taking this medication.
• This medication may reduce your seizure threshold, which can increase your risk of experiencing seizures. Let your doctor know if you have a history of bipolar disorder.
• It is unknown if this medication causes any harm to the fetus during pregnancy. Other medications that are similar to Fetzima have caused complications in pregnancy when taken during the third trimester. 
• It is not known if this medication is safe to take while breastfeeding a baby. Talk with your doctor to determine whether this medication is safe for use while nursing a baby. 

Boxed Warning 

Fetzima has a boxed warning regarding the increased risk of suicidal thoughts and behaviors, which may also worsen your depression. You are at increased risk during the first few weeks of treatment. If you have any thoughts of self-harm, call your doctor immediately and report your symptoms. Additionally, the FDA does not approve this medication for pediatric patients. In some studies, it was found that this medication may increase the risk of suicidal thoughts and behavior in children, adolescents, and individuals less than 24 years old. 

Precautions

• Before taking Fetzima, let your doctor know if you are allergic to it or any of its ingredients or if you have any other allergies. 
• This medication may cause drowsiness or blurred vision. Consuming alcohol or cannabis may make you more dizzy. You should not consume large amounts of alcohol and avoid beverages and medications that may contain alcohol. 
• You should not drive, operate heavy machinery, or engage in activities that may require clear vision or alertness unless you have determined how this medication may affect you. 
• If you are planning to have surgery, including a dental procedure, let your doctor, surgeon, or dentist know about all the medications you are taking, including fetzima. You should also tell them about all prescription, over-the-counter, and non-prescription drugs, and herbal supplements you may be taking.  
• Geriatric patients may be more sensitive to the side effects caused by this medication, especially bleeding. They may be at an increased risk of mineral imbalance while using this medication, especially if they are taking diuretics. 
• During pregnancy, this medication should only be taken when it is clearly needed, as it may cause harm to the unborn baby. Let your doctor know if you are pregnant, suspect a pregnancy, or if you are planning to become pregnant. 
• Since untreated mental/mood disorders can be a serious condition, you should not stop taking this medication unless directed by your doctor. If you think you may be pregnant, talk to your doctor and discuss with them the risks and benefits of using this medication in your condition. 

Contraindications 

Fetzima is contraindicated for use in patients who:

• Have a hypersensitivity to this medication or any of the ingredients present in the medication. 
• Use Fetzima in conjunction with monoamine oxidase inhibitors due to an increased risk of serotonin syndrome. When starting Fetzima therapy after stopping an MAOI, at least 14 days should pass. You should wait at least seven days after stopping Fetzima before beginning an MAOI.

Missed Dose

• To get the best results from this medication, you should maintain consistency in dosage and take it at the same time every day. 
• If you miss a dose of the Fetzima 120 mg capsule, you should take it as soon as you remember. 
• However, if it is almost time for your next dose, you may omit the missed dose and continue taking the medication according to your regular dosing schedule. 
• You should not take two doses of the same medication simultaneously. 
• You should not take extra or double doses of Fetzima to compensate for the missed dosage. 
• To further avoid missing your dosage for Fetzima, you should try setting a reminder on your phone. 

[Note: If you have missed a medication dose and are still unsure when to take the next one, immediately consult your doctor or pharmacist.]

Overdose 

You should not take Fetzima more than recommended or more frequently than prescribed, as it may cause unwanted side effects. If you experience side effects such as fainting, seizures, or loss of consciousness, seek immediate medical assistance. You can call 911 or head to the nearest emergency room. 

[Note: If you consumed more than the recommended dose, get medical help immediately or call the Poison Help line at 1-800-222-1222.]

Storage

• Keep the medication cool and dry, away from direct sunlight, moisture, or excess heat. 
• Do not keep it in the bathroom, window sill, or inside the car. 
• Keep all medications, including Fetzima, in a safe place away from the sight and reach of children and pets. 
• Do not keep medications that are outdated or no longer needed. 
• Do not throw unwanted medications in the household garbage bin or pour them into the drain. 
• Do not flush it down the toilet or dispose of it in wastewater. 
• Discard the unwanted medications in a way that prevents children, animals, and others from consuming them. 
• The best way to eliminate unwanted medication is to give it away in the medicine take-back program.
• To learn more about properly disposing unwanted medications, consult your healthcare provider, pharmacist, and local waste disposal company. 

[Note: Discuss with your healthcare professional the proper disposal of unused medicine and any questions you may have regarding its storage.]

Fetzima Interactions

The following drugs may interact with Fetzima and affect how it may work. 

• Amitriptyline
• Amoxapine
• Apalutamide
• Apixaban
• Buspirone
• Ceritinib
• Chloramphenicol
• Citalopram
• Clomipramine
• Cobicistat
• Cyclobenzaprine
• Desipramine
• Desvenlafaxine
• Dexmethylphenidate
• Dextromethorphan
• Dolasetron
• Dosulepin
• Doxepin
• Duloxetine
• Epinephrine
• Epinephrine Racemic
• Escitalopram
• Ethanol
• Fexinidazole
• Fluoxetine
• Fluvoxamine
• Granisetron
• Idelalisib
• Imipramine
• Iobenguane
• Isocarboxazid
• Ivosidenib
• Linezolid
• Lofepramine
• Lorcaserin
• Maprotiline
• Meperidine
• Methylene Blue
• Metoclopramide
• Mifepristone
• Milnacipran
• Nefazodone
• Netupitant/Palonosetron
• Norepinephrine
• Nortriptyline
• Ondansetron
• Ozanimod
• Palonosetron
• Paroxetine
• Phenelzine
• Phentermine
• Procarbazine
• Protriptyline
• Pseudoephedrine
• Rasagiline
• Safinamide
• Selegiline
• Selegiline Transdermal
• Serdexmethylphenidate/Dexmethylphenidate
• Sertraline
• St John’s Wort
• Tedizolid
• Tranylcypromine
• Trazodone
• Trimipramine
• Tucatinib
• Venlafaxine
• Vilazodone
• Vortioxetine
• Voxelotor

[Note: This isn’t a complete list, and there could be other drugs that interact with (drug name). Tell your doctor any prescription, over-the-counter medicines, and herbal products you’re taking.]

Fetzima Alternatives

• Celexa (citalopram)
• Trintellix (vortioxetine)
• Savella (milnacipran)
• Lexapro (escitalopram)
• Prozac (fluoxetine)
• Paxil (paroxetine)
• Zoloft (sertraline)
• Viibryd (vilazodone)
• Cymbalta (duloxetine)
• Effexor XR (venlafaxine)
• Pristiq (desvenlafaxine)
• Wellbutrin XL (bupropion)
• Nardil (phenelzine)
• Parnate (tranylcypromine)

[Note: Your doctor will choose what’s best for you. Don’t use any of these alternative medications without consulting your healthcare provider. Taking them by yourself may cause serious side effects.] 

Frequently Asked Questions

Can Fetzima Be Used in Combination with Other Antidepressants?

Fetzima should not be used in conjunction with other antidepressants, particularly monoamine oxidase inhibitors (MAOIs), due to the risk of serotonin syndrome. Always consult your healthcare provider before combining Fetzima with other medications to avoid potential interactions and adverse effects.

How Long Does It Take for Fetzima to Show Improvement in Depression Symptoms?

Patients may begin to notice improvements in their depression symptoms within a few weeks of starting Fetzima. However, it may take six to eight weeks to experience the full therapeutic benefits. Consistent use as prescribed by your doctor is essential for optimal results.

What Should I Do If I Experience Severe Side Effects While Taking Fetzima?

If you experience severe side effects such as serotonin syndrome, high blood pressure, or severe allergic reactions, seek immediate medical attention. Symptoms may include changes in mental status, hallucinations, rapid heart rate, chest pain, difficulty breathing, or severe skin reactions. Contact your healthcare provider for further guidance.

Is It Safe to Use Fetzima During Pregnancy or While Breastfeeding?

The safety of Fetzima during pregnancy and breastfeeding is not well established. Similar medications have caused complications when used during the third trimester. If you are pregnant, planning to become pregnant, or breastfeeding, discuss the risks and benefits with your healthcare provider to determine the best course of action.

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