Identification

Name
Milnacipran
Accession Number
DB04896
Type
Small Molecule
Groups
Approved
Description

Milnacipran is an antidepressant of the serotonin-norepinephrine reuptake inhibitor class. It more potently inhibits norepinephrine uptake than serotonin. It is provided as a racemic mixture. FDA approved in January 2009.

Structure
Thumb
Synonyms
  • (-)-milnacipran
  • Midalcipran
  • Milnacipran
  • Milnacipranum
External IDs
F2207
Product Ingredients
IngredientUNIICASInChI Key
Milnacipran HydrochlorideRNZ43O5WW5101152-94-7XNCDYJFPRPDERF-PBCQUBLHSA-N
Product Images
Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
SavellaTablet, film coated12.5 mg/1OralAllergan2009-04-17Not applicableUs00456 1512 60 nlmimage10 313f1888
SavellaTablet, film coated100 mg/1OralStat Rx USA2009-04-17Not applicableUs
SavellaTablet, film coated50 mg/1OralLake Erie Medical &Surgical Supply Dba Quality Care Products Llc2011-11-17Not applicableUs
SavellaTablet, film coated50 mg/1OralCardinal Health2009-04-17Not applicableUs00456 1550 60 nlmimage10 0d1c8694
SavellaTablet, film coated100 mg/1OralPhysicians Total Care, Inc.2010-01-19Not applicableUs
SavellaTablet, film coated50 mg/1OralAllergan2009-04-17Not applicableUs
SavellaTablet, film coated50 mg/1OralRebel Distributors2009-04-17Not applicableUs
SavellaTablet, film coated100 mg/1OralAllergan2009-04-17Not applicableUs00456 1510 60 nlmimage10 011c8094
SavellaTablet, film coated25 mg/1OralUnit Dose Services2009-04-17Not applicableUs
SavellaTablet, film coated50 mg/1OralStat Rx USA2009-04-17Not applicableUs
Generic Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
Milnacipran hydrochlorideTablet, film coated12.5 mg/1OralRanbaxy Inc.2014-11-27Not applicableUs
Milnacipran hydrochlorideTablet, film coated50 mg/1OralRanbaxy Inc.2014-11-27Not applicableUs
Milnacipran hydrochlorideTablet, film coated25 mg/1OralRanbaxy Inc.2014-11-27Not applicableUs
Milnacipran hydrochlorideTablet, film coated100 mg/1OralRanbaxy Inc.2014-11-27Not applicableUs
International/Other Brands
Dalcipran / Ixel / Toledomin
Categories
UNII
ES1O38J3C4
CAS number
92623-85-3
Weight
Average: 246.348
Monoisotopic: 246.173213336
Chemical Formula
C15H22N2O
InChI Key
GJJFMKBJSRMPLA-HIFRSBDPSA-N
InChI
InChI=1S/C15H22N2O/c1-3-17(4-2)14(18)15(10-13(15)11-16)12-8-6-5-7-9-12/h5-9,13H,3-4,10-11,16H2,1-2H3/t13-,15+/m1/s1
IUPAC Name
(1R,2S)-2-(aminomethyl)-N,N-diethyl-1-phenylcyclopropane-1-carboxamide
SMILES
CCN(CC)C(=O)[[email protected]@]1(C[[email protected]@H]1CN)C1=CC=CC=C1

Pharmacology

Indication

Milnacipran is used to treat moderate to severe clinical depression but this indication is not yet FDA-approved in the USA. Milnacipran is labelled for the treatment of fibromyalgia pain.

Structured Indications
Pharmacodynamics

Although milnacipran prolongs the QTc interval, the increase is not considered clinically significant.

Mechanism of action

Milnacipran inhibits norepinephrine and serotonin reuptake in a 3:1 ratio, in practical use this means a balanced (equal) action upon both transmitters. The serotonin reuptake inhibition is likely to improve depression, while the norepinephrine reuptake inihibition probably improves chronic pain. Milnacipran exerts no significant actions on postynaptic H1, alpha-1, D1, D2, and muscarinic receptors, as well as on benzodiazepine/opiate binding sites. [Wikipedia]

TargetActionsOrganism
ASodium-dependent serotonin transporter
inhibitor
Human
ASodium-dependent noradrenaline transporter
inhibitor
Human
UNMDA receptor
inhibitor
Human
Absorption

Milnacipran is well absorbed following oral administration with an absolute bioavailability of 85-90%. Meals have no effect on absorption. Peak concentrations occur 2 -4 hours post-administration and is delayed in elderly patients. Time to steady state = 36 - 48 hours;

Volume of distribution

400 L, following a single IV dose to a healthy subject.

Protein binding

Plasma protein binding is 13%.

Metabolism

Hepatic metabolism of milnacipran occurs via glucuronidation. No involvement of CYP450 isozymes or active metabolites found.

Route of elimination

It is excreted predominantly unchanged in urine (50%- 60%, 24% as l-milnacipran and 31% as d-milnacipran). The l-milnacipran carbamoyl-O-glucuronide was the major metabolite excreted in urine and accounted for approximately 17% of the dose; approximately 2% of the dose was excreted in urine as d-milnacipran carbamoyl-O-glucuronide. Approximately 8% of the dose was excreted in urine as the N-desethyl milnacipran metabolite.

Half life

The terminal elimination half-life, when given to healthy subjects is 6-8 hours. When given to severe renal impairment patients is 7 - 10 hours. The active enantiomer, d-milnacipran, has a longer elimination half-life (8-10 hours) than the l-enantiomer (4-6 hours).

Clearance
Not Available
Toxicity

LD50, oral, rat: 213 mg/kg. The most frequently occurring adverse reactions (≥ 5% and greater than placebo) were nausea, headache, constipation, dizziness, insomnia, hot flush, hyperhidrosis, vomiting, palpitations, heart rate increased, dry mouth, and hypertension.

Affected organisms
  • Humans and other mammals
Pathways
Not Available
Pharmacogenomic Effects/ADRs
Not Available

Interactions

Drug Interactions
DrugInteractionDrug group
4-MethoxyamphetamineMilnacipran may decrease the antihypertensive activities of 4-Methoxyamphetamine.Experimental, Illicit
7-NitroindazoleThe risk or severity of adverse effects can be increased when 7-Nitroindazole is combined with Milnacipran.Experimental
7,8-Dichloro-1,2,3,4-tetrahydroisoquinoline7,8-Dichloro-1,2,3,4-tetrahydroisoquinoline may increase the serotonergic activities of Milnacipran.Experimental
AcarboseMilnacipran may increase the hypoglycemic activities of Acarbose.Approved, Investigational
AcebutololThe serum concentration of Acebutolol can be increased when it is combined with Milnacipran.Approved
AcenocoumarolThe risk or severity of adverse effects can be increased when Milnacipran is combined with Acenocoumarol.Approved
AcepromazineThe risk or severity of adverse effects can be increased when Acepromazine is combined with Milnacipran.Approved, Vet Approved
AceprometazineThe risk or severity of adverse effects can be increased when Milnacipran is combined with Aceprometazine.Approved
AcetophenazineThe risk or severity of adverse effects can be increased when Milnacipran is combined with Acetophenazine.Approved
Acetylsalicylic acidMilnacipran may increase the antiplatelet activities of Acetylsalicylic acid.Approved, Vet Approved
AdipiplonThe risk or severity of adverse effects can be increased when Adipiplon is combined with Milnacipran.Investigational
AdrafinilMilnacipran may increase the tachycardic activities of Adrafinil.Withdrawn
AgmatineMilnacipran may decrease the antihypertensive activities of Agmatine.Experimental, Investigational
AgomelatineThe risk or severity of adverse effects can be increased when Agomelatine is combined with Milnacipran.Approved, Investigational
AlaproclateMilnacipran may increase the serotonergic activities of Alaproclate.Experimental
AlbiglutideMilnacipran may increase the hypoglycemic activities of Albiglutide.Approved
AlfaxaloneThe risk or severity of adverse effects can be increased when Alfaxalone is combined with Milnacipran.Vet Approved
AlfentanilAlfentanil may increase the serotonergic activities of Milnacipran.Approved, Illicit
AlimemazineThe risk or severity of adverse effects can be increased when Alimemazine is combined with Milnacipran.Approved, Vet Approved
AllopregnanoloneThe risk or severity of adverse effects can be increased when Allopregnanolone is combined with Milnacipran.Investigational
AlmotriptanThe risk or severity of adverse effects can be increased when Almotriptan is combined with Milnacipran.Approved, Investigational
AlogliptinMilnacipran may increase the hypoglycemic activities of Alogliptin.Approved
AlphacetylmethadolAlphacetylmethadol may increase the serotonergic activities of Milnacipran.Experimental, Illicit
AlphaprodineAlphaprodine may increase the serotonergic activities of Milnacipran.Illicit
AlprazolamThe risk or severity of adverse effects can be increased when Alprazolam is combined with Milnacipran.Approved, Illicit, Investigational
AlprenololThe serum concentration of Alprenolol can be increased when it is combined with Milnacipran.Approved, Withdrawn
AmibegronMilnacipran may increase the tachycardic activities of Amibegron.Investigational
AmisulprideThe risk or severity of adverse effects can be increased when Milnacipran is combined with Amisulpride.Approved, Investigational
AmitrazMilnacipran may increase the tachycardic activities of Amitraz.Vet Approved
AmitriptylineThe risk or severity of adverse effects can be increased when Amitriptyline is combined with Milnacipran.Approved
AmobarbitalThe risk or severity of adverse effects can be increased when Amobarbital is combined with Milnacipran.Approved, Illicit
AmoxapineThe risk or severity of adverse effects can be increased when Amoxapine is combined with Milnacipran.Approved
AmperozideThe risk or severity of adverse effects can be increased when Milnacipran is combined with Amperozide.Experimental
AmphetamineThe risk or severity of adverse effects can be increased when Milnacipran is combined with Amphetamine.Approved, Illicit
AnisodamineMilnacipran may increase the tachycardic activities of Anisodamine.Investigational
ApomorphineMilnacipran may decrease the antihypertensive activities of Apomorphine.Approved, Investigational
ApraclonidineMilnacipran may increase the tachycardic activities of Apraclonidine.Approved
ArbutamineMilnacipran may increase the tachycardic activities of Arbutamine.Approved
ArformoterolMilnacipran may increase the tachycardic activities of Arformoterol.Approved, Investigational
AripiprazoleThe risk or severity of adverse effects can be increased when Milnacipran is combined with Aripiprazole.Approved, Investigational
ArotinololThe serum concentration of Arotinolol can be increased when it is combined with Milnacipran.Approved, Investigational
ArticaineThe risk or severity of adverse effects can be increased when Articaine is combined with Milnacipran.Approved
AsenapineThe risk or severity of adverse effects can be increased when Milnacipran is combined with Asenapine.Approved
AtenololThe serum concentration of Atenolol can be increased when it is combined with Milnacipran.Approved
AzaperoneThe risk or severity of adverse effects can be increased when Milnacipran is combined with Azaperone.Investigational, Vet Approved
AzelastineThe risk or severity of adverse effects can be increased when Azelastine is combined with Milnacipran.Approved
BaclofenThe risk or severity of adverse effects can be increased when Baclofen is combined with Milnacipran.Approved
BarbitalThe risk or severity of adverse effects can be increased when Barbital is combined with Milnacipran.Illicit
BefunololMilnacipran may increase the tachycardic activities of Befunolol.Experimental
BendroflumethiazideMilnacipran may increase the hyponatremic activities of Bendroflumethiazide.Approved
BenmoxinBenmoxin may increase the serotonergic activities of Milnacipran.Withdrawn
BenperidolThe risk or severity of adverse effects can be increased when Milnacipran is combined with Benperidol.Investigational
BenzocaineThe risk or severity of adverse effects can be increased when Benzocaine is combined with Milnacipran.Approved
BenzphetamineMilnacipran may decrease the antihypertensive activities of Benzphetamine.Approved, Illicit
Benzyl alcoholThe risk or severity of adverse effects can be increased when Benzyl alcohol is combined with Milnacipran.Approved
BetaxololThe serum concentration of Betaxolol can be increased when it is combined with Milnacipran.Approved
BethanidineMilnacipran may decrease the antihypertensive activities of Bethanidine.Approved
BevantololThe serum concentration of Bevantolol can be increased when it is combined with Milnacipran.Approved
BezitramideBezitramide may increase the serotonergic activities of Milnacipran.Experimental, Illicit, Withdrawn
BifeprunoxThe risk or severity of adverse effects can be increased when Milnacipran is combined with Bifeprunox.Investigational
BisoprololThe serum concentration of Bisoprolol can be increased when it is combined with Milnacipran.Approved
BitolterolMilnacipran may increase the tachycardic activities of Bitolterol.Withdrawn
BL-1020The risk or severity of adverse effects can be increased when BL-1020 is combined with Milnacipran.Investigational
BopindololThe serum concentration of Bopindolol can be increased when it is combined with Milnacipran.Approved
BrexpiprazoleThe risk or severity of adverse effects can be increased when Milnacipran is combined with Brexpiprazole.Approved
BrimonidineMilnacipran may increase the tachycardic activities of Brimonidine.Approved
BrofaromineThe risk or severity of adverse effects can be increased when Milnacipran is combined with Brofaromine.Experimental
BromazepamThe risk or severity of adverse effects can be increased when Bromazepam is combined with Milnacipran.Approved, Illicit
BromisovalThe risk or severity of adverse effects can be increased when Bromisoval is combined with Milnacipran.Experimental
BromocriptineThe risk or severity of adverse effects can be increased when Bromocriptine is combined with Milnacipran.Approved, Investigational
BromperidolThe risk or severity of adverse effects can be increased when Milnacipran is combined with Bromperidol.Investigational
BrompheniramineThe risk or severity of adverse effects can be increased when Brompheniramine is combined with Milnacipran.Approved
BrotizolamThe risk or severity of adverse effects can be increased when Brotizolam is combined with Milnacipran.Approved, Investigational, Withdrawn
BucindololThe serum concentration of Bucindolol can be increased when it is combined with Milnacipran.Investigational
BufuralolThe serum concentration of Bufuralol can be increased when it is combined with Milnacipran.Experimental, Investigational
BupivacaineThe risk or severity of adverse effects can be increased when Bupivacaine is combined with Milnacipran.Approved, Investigational
BupranololThe serum concentration of Bupranolol can be increased when it is combined with Milnacipran.Approved
BuprenorphineBuprenorphine may increase the serotonergic activities of Milnacipran.Approved, Illicit, Investigational, Vet Approved
BuspironeBuspirone may increase the serotonergic activities of Milnacipran.Approved, Investigational
ButabarbitalThe risk or severity of adverse effects can be increased when Butabarbital is combined with Milnacipran.Approved, Illicit
ButacaineThe risk or severity of adverse effects can be increased when Butacaine is combined with Milnacipran.Vet Approved
ButalbitalThe risk or severity of adverse effects can be increased when Butalbital is combined with Milnacipran.Approved, Illicit
ButambenThe risk or severity of adverse effects can be increased when Butamben is combined with Milnacipran.Approved
ButaperazineThe risk or severity of adverse effects can be increased when Milnacipran is combined with Butaperazine.Experimental
ButethalThe risk or severity of adverse effects can be increased when Butethal is combined with Milnacipran.Approved, Illicit
ButorphanolButorphanol may increase the serotonergic activities of Milnacipran.Approved, Illicit, Vet Approved
CabergolineThe risk or severity of adverse effects can be increased when Cabergoline is combined with Milnacipran.Approved
CanagliflozinMilnacipran may increase the hypoglycemic activities of Canagliflozin.Approved
CanertinibThe risk or severity of adverse effects can be increased when Canertinib is combined with Milnacipran.Investigational
CarbamazepineThe metabolism of Carbamazepine can be decreased when combined with Milnacipran.Approved, Investigational
CarbinoxamineThe risk or severity of adverse effects can be increased when Carbinoxamine is combined with Milnacipran.Approved
CarfentanilCarfentanil may increase the serotonergic activities of Milnacipran.Illicit, Investigational, Vet Approved
CariprazineThe risk or severity of adverse effects can be increased when Milnacipran is combined with Cariprazine.Approved
CarisoprodolThe risk or severity of adverse effects can be increased when Carisoprodol is combined with Milnacipran.Approved
CaroxazoneCaroxazone may increase the serotonergic activities of Milnacipran.Withdrawn
CarteololThe serum concentration of Carteolol can be increased when it is combined with Milnacipran.Approved
CarvedilolThe serum concentration of Carvedilol can be increased when it is combined with Milnacipran.Approved, Investigational
CelecoxibMilnacipran may increase the antiplatelet activities of Celecoxib.Approved, Investigational
CeliprololThe serum concentration of Celiprolol can be increased when it is combined with Milnacipran.Approved, Investigational
CetirizineThe risk or severity of adverse effects can be increased when Cetirizine is combined with Milnacipran.Approved
Chloral hydrateThe risk or severity of adverse effects can be increased when Chloral hydrate is combined with Milnacipran.Approved, Illicit, Vet Approved
ChlordiazepoxideThe risk or severity of adverse effects can be increased when Chlordiazepoxide is combined with Milnacipran.Approved, Illicit
ChlormezanoneThe risk or severity of adverse effects can be increased when Chlormezanone is combined with Milnacipran.Approved, Investigational, Withdrawn
ChloroprocaineThe risk or severity of adverse effects can be increased when Chloroprocaine is combined with Milnacipran.Approved
ChlorothiazideMilnacipran may increase the hyponatremic activities of Chlorothiazide.Approved, Vet Approved
ChlorphenamineThe risk or severity of adverse effects can be increased when Chlorphenamine is combined with Milnacipran.Approved
ChlorproethazineThe risk or severity of adverse effects can be increased when Chlorproethazine is combined with Milnacipran.Experimental
ChlorpromazineThe risk or severity of adverse effects can be increased when Chlorpromazine is combined with Milnacipran.Approved, Vet Approved
ChlorpropamideMilnacipran may increase the hypoglycemic activities of Chlorpropamide.Approved
ChlorprothixeneThe risk or severity of adverse effects can be increased when Milnacipran is combined with Chlorprothixene.Approved, Investigational, Withdrawn
ChlorthalidoneMilnacipran may increase the hyponatremic activities of Chlorthalidone.Approved
ChlorzoxazoneThe risk or severity of adverse effects can be increased when Chlorzoxazone is combined with Milnacipran.Approved
CimetidineThe metabolism of Milnacipran can be decreased when combined with Cimetidine.Approved
CinchocaineThe risk or severity of adverse effects can be increased when Cinchocaine is combined with Milnacipran.Approved, Vet Approved
CirazolineMilnacipran may increase the tachycardic activities of Cirazoline.Experimental
CitalopramThe risk or severity of adverse effects can be increased when Citalopram is combined with Milnacipran.Approved
ClemastineThe risk or severity of adverse effects can be increased when Clemastine is combined with Milnacipran.Approved
ClenbuterolMilnacipran may increase the tachycardic activities of Clenbuterol.Approved, Investigational, Vet Approved
ClidiniumThe risk or severity of adverse effects can be increased when Clidinium is combined with Milnacipran.Approved
ClobazamThe risk or severity of adverse effects can be increased when Clobazam is combined with Milnacipran.Approved, Illicit
clomethiazoleThe risk or severity of adverse effects can be increased when clomethiazole is combined with Milnacipran.Investigational
ClomipramineThe risk or severity of adverse effects can be increased when Clomipramine is combined with Milnacipran.Approved, Vet Approved
ClonazepamThe risk or severity of adverse effects can be increased when Clonazepam is combined with Milnacipran.Approved, Illicit
ClonidineMilnacipran may increase the tachycardic activities of Clonidine.Approved
ClopenthixolThe risk or severity of adverse effects can be increased when Milnacipran is combined with Clopenthixol.Experimental
CloranololThe serum concentration of Cloranolol can be increased when it is combined with Milnacipran.Experimental
ClorazepateThe risk or severity of adverse effects can be increased when Clorazepate is combined with Milnacipran.Approved, Illicit
ClorindioneThe risk or severity of adverse effects can be increased when Milnacipran is combined with Clorindione.Experimental
ClothiapineThe risk or severity of adverse effects can be increased when Milnacipran is combined with Clothiapine.Experimental
ClozapineThe serum concentration of Clozapine can be increased when it is combined with Milnacipran.Approved
CocaineThe risk or severity of adverse effects can be increased when Cocaine is combined with Milnacipran.Approved, Illicit
CodeineCodeine may increase the serotonergic activities of Milnacipran.Approved, Illicit
CyamemazineThe risk or severity of adverse effects can be increased when Milnacipran is combined with Cyamemazine.Approved
CyclizineThe risk or severity of adverse effects can be increased when Cyclizine is combined with Milnacipran.Approved
CyclobenzaprineThe risk or severity of adverse effects can be increased when Cyclobenzaprine is combined with Milnacipran.Approved
CyclopenthiazideMilnacipran may increase the hyponatremic activities of Cyclopenthiazide.Experimental
CyproheptadineThe therapeutic efficacy of Milnacipran can be decreased when used in combination with Cyproheptadine.Approved
DantroleneThe risk or severity of adverse effects can be increased when Dantrolene is combined with Milnacipran.Approved
DapagliflozinMilnacipran may increase the hypoglycemic activities of Dapagliflozin.Approved
DapiprazoleThe risk or severity of adverse effects can be increased when Milnacipran is combined with Dapiprazole.Approved
DapoxetineThe risk or severity of adverse effects can be increased when Dapoxetine is combined with Milnacipran.Investigational
DeramciclaneThe risk or severity of adverse effects can be increased when Deramciclane is combined with Milnacipran.Investigational
DesfluraneThe risk or severity of adverse effects can be increased when Desflurane is combined with Milnacipran.Approved
DesipramineThe risk or severity of adverse effects can be increased when Desipramine is combined with Milnacipran.Approved
DesloratadineThe risk or severity of adverse effects can be increased when Desloratadine is combined with Milnacipran.Approved, Investigational
DesmopressinThe risk or severity of adverse effects can be increased when Milnacipran is combined with Desmopressin.Approved
DesvenlafaxineThe risk or severity of adverse effects can be increased when Milnacipran is combined with Desvenlafaxine.Approved
DetomidineMilnacipran may increase the tachycardic activities of Detomidine.Vet Approved
DexbrompheniramineThe risk or severity of adverse effects can be increased when Dexbrompheniramine is combined with Milnacipran.Approved
DexmedetomidineMilnacipran may increase the tachycardic activities of Dexmedetomidine.Approved, Vet Approved
DextromethorphanMilnacipran may increase the serotonergic activities of Dextromethorphan.Approved
DextromoramideDextromoramide may increase the serotonergic activities of Milnacipran.Experimental, Illicit
DextropropoxypheneDextropropoxyphene may increase the serotonergic activities of Milnacipran.Approved, Illicit, Investigational, Withdrawn
DezocineDezocine may increase the serotonergic activities of Milnacipran.Approved, Investigational
DiazepamThe risk or severity of adverse effects can be increased when Diazepam is combined with Milnacipran.Approved, Illicit, Vet Approved
DicoumarolThe risk or severity of adverse effects can be increased when Milnacipran is combined with Dicoumarol.Approved
Diethyl etherThe risk or severity of adverse effects can be increased when Diethyl ether is combined with Milnacipran.Experimental
DifenoxinThe risk or severity of adverse effects can be increased when Difenoxin is combined with Milnacipran.Approved, Illicit
DigoxinThe risk or severity of adverse effects can be increased when Milnacipran is combined with Digoxin.Approved
DihydrocodeineDihydrocodeine may increase the serotonergic activities of Milnacipran.Approved, Illicit
DihydroergotamineThe risk or severity of adverse effects can be increased when Dihydroergotamine is combined with Milnacipran.Approved
DihydroetorphineDihydroetorphine may increase the serotonergic activities of Milnacipran.Experimental, Illicit
DihydromorphineDihydromorphine may increase the serotonergic activities of Milnacipran.Experimental, Illicit
DimenhydrinateThe risk or severity of adverse effects can be increased when Dimenhydrinate is combined with Milnacipran.Approved
DiphenadioneThe risk or severity of adverse effects can be increased when Milnacipran is combined with Diphenadione.Experimental
DiphenhydramineThe risk or severity of adverse effects can be increased when Diphenhydramine is combined with Milnacipran.Approved
DiphenoxylateDiphenoxylate may increase the serotonergic activities of Milnacipran.Approved, Illicit
DipivefrinMilnacipran may increase the tachycardic activities of Dipivefrin.Approved
DisopyramideMilnacipran may increase the hypoglycemic activities of Disopyramide.Approved
DixyrazineThe risk or severity of adverse effects can be increased when Milnacipran is combined with Dixyrazine.Experimental
DobutamineMilnacipran may increase the tachycardic activities of Dobutamine.Approved
DolasetronDolasetron may increase the serotonergic activities of Milnacipran.Approved
DopexamineMilnacipran may increase the tachycardic activities of Dopexamine.Investigational
DoramectinThe risk or severity of adverse effects can be increased when Doramectin is combined with Milnacipran.Vet Approved
DosulepinThe serum concentration of Dosulepin can be increased when it is combined with Milnacipran.Approved
DoxepinThe risk or severity of adverse effects can be increased when Doxepin is combined with Milnacipran.Approved
DoxylamineThe risk or severity of adverse effects can be increased when Doxylamine is combined with Milnacipran.Approved, Vet Approved
DPDPEDPDPE may increase the serotonergic activities of Milnacipran.Experimental
DroperidolThe risk or severity of adverse effects can be increased when Milnacipran is combined with Droperidol.Approved, Vet Approved
DrotebanolThe risk or severity of adverse effects can be increased when Drotebanol is combined with Milnacipran.Experimental, Illicit
DroxidopaMilnacipran may increase the tachycardic activities of Droxidopa.Approved, Investigational
DulaglutideMilnacipran may increase the hypoglycemic activities of Dulaglutide.Approved
DuloxetineThe risk or severity of adverse effects can be increased when Duloxetine is combined with Milnacipran.Approved
DyclonineThe risk or severity of adverse effects can be increased when Dyclonine is combined with Milnacipran.Approved
EcgonineThe risk or severity of adverse effects can be increased when Ecgonine is combined with Milnacipran.Experimental, Illicit
EcopipamThe risk or severity of adverse effects can be increased when Milnacipran is combined with Ecopipam.Investigational
EfavirenzThe risk or severity of adverse effects can be increased when Efavirenz is combined with Milnacipran.Approved, Investigational
EletriptanThe risk or severity of adverse effects can be increased when Eletriptan is combined with Milnacipran.Approved, Investigational
EltanoloneThe risk or severity of adverse effects can be increased when Eltanolone is combined with Milnacipran.Investigational
EmpagliflozinMilnacipran may increase the hypoglycemic activities of Empagliflozin.Approved
EnfluraneThe risk or severity of adverse effects can be increased when Enflurane is combined with Milnacipran.Approved, Investigational, Vet Approved
EntacaponeThe risk or severity of adverse effects can be increased when Entacapone is combined with Milnacipran.Approved, Investigational
EpanololThe serum concentration of Epanolol can be increased when it is combined with Milnacipran.Experimental
EphedraMilnacipran may decrease the antihypertensive activities of Ephedra.Approved, Nutraceutical, Withdrawn
EphedrineMilnacipran may increase the tachycardic activities of Ephedrine.Approved
EpinastineMilnacipran may increase the tachycardic activities of Epinastine.Approved, Investigational
EpinephrineMilnacipran may increase the tachycardic activities of Epinephrine.Approved, Vet Approved
Ergoloid mesylateThe risk or severity of adverse effects can be increased when Ergoloid mesylate is combined with Milnacipran.Approved
ErgonovineThe risk or severity of adverse effects can be increased when Ergonovine is combined with Milnacipran.Approved
ErgotamineThe risk or severity of adverse effects can be increased when Ergotamine is combined with Milnacipran.Approved
EscitalopramThe risk or severity of adverse effects can be increased when Escitalopram is combined with Milnacipran.Approved, Investigational
EsmololThe serum concentration of Esmolol can be increased when it is combined with Milnacipran.Approved
EstazolamThe risk or severity of adverse effects can be increased when Estazolam is combined with Milnacipran.Approved, Illicit
EszopicloneThe risk or severity of adverse effects can be increased when Eszopiclone is combined with Milnacipran.Approved
EthanolThe risk or severity of adverse effects can be increased when Ethanol is combined with Milnacipran.Approved
EthchlorvynolThe risk or severity of adverse effects can be increased when Ethchlorvynol is combined with Milnacipran.Approved, Illicit, Withdrawn
EthosuximideThe risk or severity of adverse effects can be increased when Ethosuximide is combined with Milnacipran.Approved
EthotoinThe risk or severity of adverse effects can be increased when Ethotoin is combined with Milnacipran.Approved
Ethyl biscoumacetateThe risk or severity of adverse effects can be increased when Milnacipran is combined with Ethyl biscoumacetate.Withdrawn
Ethyl carbamateThe risk or severity of adverse effects can be increased when Ethyl carbamate is combined with Milnacipran.Withdrawn
Ethyl chlorideThe risk or severity of adverse effects can be increased when Ethyl chloride is combined with Milnacipran.Experimental, Investigational
Ethyl loflazepateThe risk or severity of adverse effects can be increased when Ethyl loflazepate is combined with Milnacipran.Approved, Illicit
EthylmorphineEthylmorphine may increase the serotonergic activities of Milnacipran.Approved, Illicit
EtidocaineThe risk or severity of adverse effects can be increased when Etidocaine is combined with Milnacipran.Approved
EtifoxineThe risk or severity of adverse effects can be increased when Etifoxine is combined with Milnacipran.Investigational, Withdrawn
EtilefrineMilnacipran may increase the tachycardic activities of Etilefrine.Withdrawn
EtizolamThe risk or severity of adverse effects can be increased when Etizolam is combined with Milnacipran.Approved
EtodolacMilnacipran may increase the antiplatelet activities of Etodolac.Approved, Investigational, Vet Approved
EtomidateMilnacipran may decrease the antihypertensive activities of Etomidate.Approved
EtoperidoneEtoperidone may increase the serotonergic activities of Milnacipran.Withdrawn
EtoricoxibMilnacipran may increase the antiplatelet activities of Etoricoxib.Approved, Investigational
EtorphineEtorphine may increase the serotonergic activities of Milnacipran.Illicit, Vet Approved
ExenatideMilnacipran may increase the hypoglycemic activities of Exenatide.Approved, Investigational
EzogabineThe risk or severity of adverse effects can be increased when Ezogabine is combined with Milnacipran.Approved
FelbamateThe risk or severity of adverse effects can be increased when Felbamate is combined with Milnacipran.Approved
FencamfamineThe risk or severity of adverse effects can be increased when Milnacipran is combined with Fencamfamine.Approved, Illicit, Withdrawn
FenfluramineMilnacipran may increase the serotonergic activities of Fenfluramine.Illicit, Investigational, Withdrawn
FenoterolMilnacipran may increase the tachycardic activities of Fenoterol.Approved, Investigational
FentanylThe risk or severity of adverse effects can be increased when Fentanyl is combined with Milnacipran.Approved, Illicit, Investigational, Vet Approved
FexofenadineThe risk or severity of adverse effects can be increased when Fexofenadine is combined with Milnacipran.Approved
FlibanserinThe risk or severity of adverse effects can be increased when Flibanserin is combined with Milnacipran.Approved
FluanisoneThe risk or severity of adverse effects can be increased when Milnacipran is combined with Fluanisone.Experimental
FludiazepamThe risk or severity of adverse effects can be increased when Fludiazepam is combined with Milnacipran.Approved, Illicit
FluindioneThe risk or severity of adverse effects can be increased when Milnacipran is combined with Fluindione.Investigational
FlunarizineThe risk or severity of adverse effects can be increased when Flunarizine is combined with Milnacipran.Approved
FlunitrazepamThe risk or severity of adverse effects can be increased when Flunitrazepam is combined with Milnacipran.Approved, Illicit
FluoxetineThe risk or severity of adverse effects can be increased when Fluoxetine is combined with Milnacipran.Approved, Vet Approved
FlupentixolThe risk or severity of adverse effects can be increased when Milnacipran is combined with Flupentixol.Approved, Withdrawn
FluphenazineThe risk or severity of adverse effects can be increased when Fluphenazine is combined with Milnacipran.Approved
FlurazepamThe risk or severity of adverse effects can be increased when Flurazepam is combined with Milnacipran.Approved, Illicit
FluspirileneThe risk or severity of adverse effects can be increased when Milnacipran is combined with Fluspirilene.Approved, Investigational
Fluticasone propionateThe risk or severity of adverse effects can be increased when Fluticasone propionate is combined with Milnacipran.Approved
FluvoxamineThe risk or severity of adverse effects can be increased when Fluvoxamine is combined with Milnacipran.Approved, Investigational
FormoterolMilnacipran may increase the tachycardic activities of Formoterol.Approved, Investigational
FosphenytoinThe risk or severity of adverse effects can be increased when Fosphenytoin is combined with Milnacipran.Approved
FospropofolThe risk or severity of adverse effects can be increased when Fospropofol is combined with Milnacipran.Approved, Illicit, Investigational
FrovatriptanThe risk or severity of adverse effects can be increased when Frovatriptan is combined with Milnacipran.Approved, Investigational
FurazolidoneFurazolidone may increase the serotonergic activities of Milnacipran.Approved, Investigational, Vet Approved
GabapentinThe risk or severity of adverse effects can be increased when Gabapentin is combined with Milnacipran.Approved, Investigational
Gabapentin EnacarbilThe risk or severity of adverse effects can be increased when Gabapentin Enacarbil is combined with Milnacipran.Approved
GalantamineThe metabolism of Galantamine can be decreased when combined with Milnacipran.Approved
Gamma Hydroxybutyric AcidThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Milnacipran.Approved, Illicit, Investigational
GepironeThe risk or severity of adverse effects can be increased when Gepirone is combined with Milnacipran.Investigational
GliclazideMilnacipran may increase the hypoglycemic activities of Gliclazide.Approved
GlimepirideMilnacipran may increase the hypoglycemic activities of Glimepiride.Approved
GlipizideMilnacipran may increase the hypoglycemic activities of Glipizide.Approved
GlutethimideThe risk or severity of adverse effects can be increased when Glutethimide is combined with Milnacipran.Approved, Illicit
GlyburideMilnacipran may increase the hypoglycemic activities of Glyburide.Approved
GranisetronGranisetron may increase the serotonergic activities of Milnacipran.Approved, Investigational
GuanabenzMilnacipran may increase the tachycardic activities of Guanabenz.Approved, Investigational
GuanfacineMilnacipran may increase the tachycardic activities of Guanfacine.Approved, Investigational
HalazepamThe risk or severity of adverse effects can be increased when Halazepam is combined with Milnacipran.Approved, Illicit, Withdrawn
HaloperidolThe risk or severity of adverse effects can be increased when Milnacipran is combined with Haloperidol.Approved
HalothaneThe risk or severity of adverse effects can be increased when Halothane is combined with Milnacipran.Approved, Vet Approved
HarmalineThe risk or severity of adverse effects can be increased when Milnacipran is combined with Harmaline.Experimental
HeroinHeroin may increase the serotonergic activities of Milnacipran.Approved, Illicit, Investigational
HexobarbitalThe risk or severity of adverse effects can be increased when Hexobarbital is combined with Milnacipran.Approved
HexoprenalineMilnacipran may increase the tachycardic activities of Hexoprenaline.Approved, Withdrawn
HigenamineMilnacipran may increase the tachycardic activities of Higenamine.Investigational
HydracarbazineHydracarbazine may increase the serotonergic activities of Milnacipran.Experimental
HydrochlorothiazideMilnacipran may increase the hyponatremic activities of Hydrochlorothiazide.Approved, Vet Approved
HydrocodoneHydrocodone may increase the serotonergic activities of Milnacipran.Approved, Illicit
HydroflumethiazideMilnacipran may increase the hyponatremic activities of Hydroflumethiazide.Approved, Investigational
HydromorphoneHydromorphone may increase the serotonergic activities of Milnacipran.Approved, Illicit
HydroxyzineThe risk or severity of adverse effects can be increased when Hydroxyzine is combined with Milnacipran.Approved
IloperidoneThe risk or severity of adverse effects can be increased when Milnacipran is combined with Iloperidone.Approved
ImipramineThe risk or severity of adverse effects can be increased when Imipramine is combined with Milnacipran.Approved
IndalpineMilnacipran may increase the serotonergic activities of Indalpine.Investigational, Withdrawn
IndapamideMilnacipran may increase the hyponatremic activities of Indapamide.Approved
IndenololThe serum concentration of Indenolol can be increased when it is combined with Milnacipran.Withdrawn
IndiplonThe risk or severity of adverse effects can be increased when Indiplon is combined with Milnacipran.Investigational
Insulin AspartMilnacipran may increase the hypoglycemic activities of Insulin Aspart.Approved
Insulin DetemirMilnacipran may increase the hypoglycemic activities of Insulin Detemir.Approved
Insulin GlargineMilnacipran may increase the hypoglycemic activities of Insulin Glargine.Approved
Insulin GlulisineMilnacipran may increase the hypoglycemic activities of Insulin Glulisine.Approved
Insulin HumanMilnacipran may increase the hypoglycemic activities of Insulin Human.Approved, Investigational
Insulin LisproMilnacipran may increase the hypoglycemic activities of Insulin Lispro.Approved
IobenguaneThe therapeutic efficacy of Iobenguane can be decreased when used in combination with Milnacipran.Approved, Investigational
Ioflupane I-123Milnacipran may decrease effectiveness of Ioflupane I-123 as a diagnostic agent.Approved
IproclozideIproclozide may increase the serotonergic activities of Milnacipran.Withdrawn
IproniazidIproniazid may increase the serotonergic activities of Milnacipran.Withdrawn
IsocarboxazidThe risk or severity of adverse effects can be increased when Isocarboxazid is combined with Milnacipran.Approved
IsoetarineMilnacipran may increase the tachycardic activities of Isoetarine.Approved
IsofluraneThe risk or severity of adverse effects can be increased when Isoflurane is combined with Milnacipran.Approved, Vet Approved
IsoprenalineMilnacipran may increase the tachycardic activities of Isoprenaline.Approved
IsoxsuprineMilnacipran may increase the tachycardic activities of Isoxsuprine.Approved, Withdrawn
KetamineThe risk or severity of adverse effects can be increased when Ketamine is combined with Milnacipran.Approved, Vet Approved
KetazolamThe risk or severity of adverse effects can be increased when Ketazolam is combined with Milnacipran.Approved
KetobemidoneKetobemidone may increase the serotonergic activities of Milnacipran.Approved, Investigational
L-TryptophanL-Tryptophan may increase the serotonergic activities of Milnacipran.Approved, Nutraceutical, Withdrawn
LabetalolThe serum concentration of Labetalol can be increased when it is combined with Milnacipran.Approved
LamotrigineThe risk or severity of adverse effects can be increased when Lamotrigine is combined with Milnacipran.Approved, Investigational
LandiololThe serum concentration of Landiolol can be increased when it is combined with Milnacipran.Investigational
LevetiracetamThe risk or severity of adverse effects can be increased when Levetiracetam is combined with Milnacipran.Approved, Investigational
LevobunololThe serum concentration of Levobunolol can be increased when it is combined with Milnacipran.Approved
LevobupivacaineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Milnacipran.Approved, Investigational
LevocabastineThe risk or severity of adverse effects can be increased when Levocabastine is combined with Milnacipran.Approved
LevocetirizineThe risk or severity of adverse effects can be increased when Levocetirizine is combined with Milnacipran.Approved
LevodopaThe risk or severity of adverse effects can be increased when Levodopa is combined with Milnacipran.Approved
Levomethadyl AcetateLevomethadyl Acetate may increase the serotonergic activities of Milnacipran.Approved, Investigational
LevomilnacipranThe risk or severity of adverse effects can be increased when Milnacipran is combined with Levomilnacipran.Approved
LevonordefrinMilnacipran may decrease the antihypertensive activities of Levonordefrin.Approved
LevorphanolLevorphanol may increase the serotonergic activities of Milnacipran.Approved
LevothyroxineThe therapeutic efficacy of Levothyroxine can be decreased when used in combination with Milnacipran.Approved
LidocaineThe risk or severity of adverse effects can be increased when Lidocaine is combined with Milnacipran.Approved, Vet Approved
LinezolidLinezolid may increase the serotonergic activities of Milnacipran.Approved, Investigational
LiothyronineThe therapeutic efficacy of Liothyronine can be decreased when used in combination with Milnacipran.Approved, Vet Approved
LiotrixThe therapeutic efficacy of Liotrix can be decreased when used in combination with Milnacipran.Approved
LiraglutideMilnacipran may increase the hypoglycemic activities of Liraglutide.Approved
LithiumLithium may increase the serotonergic activities of Milnacipran.Approved
LofentanilLofentanil may increase the serotonergic activities of Milnacipran.Illicit
LofexidineMilnacipran may increase the tachycardic activities of Lofexidine.Approved, Investigational
LoprazolamThe risk or severity of adverse effects can be increased when Loprazolam is combined with Milnacipran.Experimental
LoratadineThe risk or severity of adverse effects can be increased when Loratadine is combined with Milnacipran.Approved
LorazepamThe risk or severity of adverse effects can be increased when Lorazepam is combined with Milnacipran.Approved
LorcaserinThe risk or severity of adverse effects can be increased when Lorcaserin is combined with Milnacipran.Approved
LormetazepamThe risk or severity of adverse effects can be increased when Lormetazepam is combined with Milnacipran.Approved
LoxapineThe risk or severity of adverse effects can be increased when Milnacipran is combined with Loxapine.Approved
LumiracoxibMilnacipran may increase the antiplatelet activities of Lumiracoxib.Approved, Investigational
LurasidoneThe risk or severity of adverse effects can be increased when Milnacipran is combined with Lurasidone.Approved
Magnesium SulfateThe risk or severity of adverse effects can be increased when Magnesium Sulfate is combined with Milnacipran.Approved, Vet Approved
MaprotilineThe risk or severity of adverse effects can be increased when Maprotiline is combined with Milnacipran.Approved
MebanazineMebanazine may increase the serotonergic activities of Milnacipran.Withdrawn
MebicarThe risk or severity of adverse effects can be increased when Mebicar is combined with Milnacipran.Experimental
MecaserminMilnacipran may increase the hypoglycemic activities of Mecasermin.Approved, Investigational
MeclizineThe risk or severity of adverse effects can be increased when Meclizine is combined with Milnacipran.Approved
MedazepamThe risk or severity of adverse effects can be increased when Medazepam is combined with Milnacipran.Experimental
MedetomidineMilnacipran may increase the tachycardic activities of Medetomidine.Vet Approved
MelatoninThe risk or severity of adverse effects can be increased when Melatonin is combined with Milnacipran.Approved, Nutraceutical, Vet Approved
MelperoneThe risk or severity of adverse effects can be increased when Milnacipran is combined with Melperone.Approved, Investigational
MephentermineMilnacipran may increase the tachycardic activities of Mephentermine.Approved
MepindololThe serum concentration of Mepindolol can be increased when it is combined with Milnacipran.Experimental
MepivacaineThe risk or severity of adverse effects can be increased when Mepivacaine is combined with Milnacipran.Approved, Vet Approved
MeprobamateThe risk or severity of adverse effects can be increased when Meprobamate is combined with Milnacipran.Approved, Illicit
MeptazinolMeptazinol may increase the serotonergic activities of Milnacipran.Experimental
MesoridazineThe risk or severity of adverse effects can be increased when Mesoridazine is combined with Milnacipran.Approved, Investigational
MetaraminolMilnacipran may increase the tachycardic activities of Metaraminol.Approved, Investigational
MetaxaloneThe risk or severity of adverse effects can be increased when Metaxalone is combined with Milnacipran.Approved
MetforminMilnacipran may increase the hypoglycemic activities of Metformin.Approved
MethadoneThe metabolism of Methadone can be decreased when combined with Milnacipran.Approved
Methadyl AcetateMethadyl Acetate may increase the serotonergic activities of Milnacipran.Approved, Illicit
MethamphetamineMilnacipran may decrease the antihypertensive activities of Methamphetamine.Approved, Illicit
MethapyrileneThe risk or severity of adverse effects can be increased when Methapyrilene is combined with Milnacipran.Withdrawn
MethaqualoneThe risk or severity of adverse effects can be increased when Methaqualone is combined with Milnacipran.Illicit, Withdrawn
MethocarbamolThe risk or severity of adverse effects can be increased when Methocarbamol is combined with Milnacipran.Approved, Vet Approved
MethohexitalThe risk or severity of adverse effects can be increased when Methohexital is combined with Milnacipran.Approved
MethotrimeprazineThe risk or severity of adverse effects can be increased when Methotrimeprazine is combined with Milnacipran.Approved
MethoxamineMilnacipran may increase the tachycardic activities of Methoxamine.Approved, Investigational
MethoxyfluraneThe risk or severity of adverse effects can be increased when Methoxyflurane is combined with Milnacipran.Approved, Investigational, Vet Approved
MethoxyphenamineMilnacipran may increase the tachycardic activities of Methoxyphenamine.Experimental
MethsuximideThe risk or severity of adverse effects can be increased when Methsuximide is combined with Milnacipran.Approved
MethyclothiazideMilnacipran may increase the hyponatremic activities of Methyclothiazide.Approved
MethyldopaMilnacipran may increase the tachycardic activities of Methyldopa.Approved
MethylecgonineThe risk or severity of adverse effects can be increased when Methylecgonine is combined with Milnacipran.Experimental
Methylene blueMilnacipran may increase the serotonergic activities of Methylene blue.Approved, Investigational
MethylphenobarbitalThe risk or severity of adverse effects can be increased when Methylphenobarbital is combined with Milnacipran.Approved
MetipranololThe serum concentration of Metipranolol can be increased when it is combined with Milnacipran.Approved
MetoclopramideThe risk or severity of adverse effects can be increased when Metoclopramide is combined with Milnacipran.Approved, Investigational
MetolazoneMilnacipran may increase the hyponatremic activities of Metolazone.Approved
MetoprololThe serum concentration of Metoprolol can be increased when it is combined with Milnacipran.Approved, Investigational
MetyrosineThe risk or severity of adverse effects can be increased when Metyrosine is combined with Milnacipran.Approved
MexiletineThe metabolism of Mexiletine can be decreased when combined with Milnacipran.Approved
MidazolamThe risk or severity of adverse effects can be increased when Midazolam is combined with Milnacipran.Approved, Illicit
MidodrineMilnacipran may increase the tachycardic activities of Midodrine.Approved
MifepristoneMilnacipran may increase the hypoglycemic activities of Mifepristone.Approved, Investigational
MiglitolMilnacipran may increase the hypoglycemic activities of Miglitol.Approved
MinaprineMinaprine may increase the serotonergic activities of Milnacipran.Approved
MirabegronMilnacipran may increase the tachycardic activities of Mirabegron.Approved
MirtazapineThe risk or severity of adverse effects can be increased when Mirtazapine is combined with Milnacipran.Approved
MoclobemideThe risk or severity of adverse effects can be increased when Moclobemide is combined with Milnacipran.Approved
MolindoneThe risk or severity of adverse effects can be increased when Milnacipran is combined with Molindone.Approved
MoperoneThe risk or severity of adverse effects can be increased when Milnacipran is combined with Moperone.Experimental
MoricizineThe risk or severity of adverse effects can be increased when Moricizine is combined with Milnacipran.Approved, Investigational, Withdrawn
MorphineMorphine may increase the serotonergic activities of Milnacipran.Approved, Investigational
MosapramineThe risk or severity of adverse effects can be increased when Milnacipran is combined with Mosapramine.Experimental
MoxonidineMilnacipran may decrease the antihypertensive activities of Moxonidine.Approved, Investigational
NabiloneThe risk or severity of adverse effects can be increased when Nabilone is combined with Milnacipran.Approved, Investigational
NabumetoneMilnacipran may increase the antiplatelet activities of Nabumetone.Approved
NadololThe serum concentration of Nadolol can be increased when it is combined with Milnacipran.Approved
NalbuphineNalbuphine may increase the serotonergic activities of Milnacipran.Approved
NaphazolineMilnacipran may increase the tachycardic activities of Naphazoline.Approved
NaratriptanThe risk or severity of adverse effects can be increased when Naratriptan is combined with Milnacipran.Approved, Investigational
NateglinideMilnacipran may increase the hypoglycemic activities of Nateglinide.Approved, Investigational
NebivololMilnacipran may increase the tachycardic activities of Nebivolol.Approved, Investigational
NefazodoneThe risk or severity of adverse effects can be increased when Nefazodone is combined with Milnacipran.Approved, Withdrawn
NialamideNialamide may increase the serotonergic activities of Milnacipran.Withdrawn
NicomorphineNicomorphine may increase the serotonergic activities of Milnacipran.Experimental
NitrazepamThe risk or severity of adverse effects can be increased when Nitrazepam is combined with Milnacipran.Approved
Nitrous oxideThe risk or severity of adverse effects can be increased when Nitrous oxide is combined with Milnacipran.Approved, Vet Approved
NorepinephrineMilnacipran may increase the tachycardic activities of Norepinephrine.Approved
NorfenefrineMilnacipran may increase the tachycardic activities of Norfenefrine.Experimental
NorfluraneThe risk or severity of adverse effects can be increased when Norflurane is combined with Milnacipran.Investigational
NormethadoneNormethadone may increase the serotonergic activities of Milnacipran.Approved, Illicit
NortriptylineThe risk or severity of adverse effects can be increased when Nortriptyline is combined with Milnacipran.Approved
NylidrinMilnacipran may increase the tachycardic activities of Nylidrin.Approved
OctamoxinOctamoxin may increase the serotonergic activities of Milnacipran.Withdrawn
OctopamineMilnacipran may increase the tachycardic activities of Octopamine.Experimental
OlanzapineMilnacipran may increase the serotonergic activities of Olanzapine.Approved, Investigational
OlodaterolMilnacipran may increase the tachycardic activities of Olodaterol.Approved
OlopatadineThe risk or severity of adverse effects can be increased when Olopatadine is combined with Milnacipran.Approved
OndansetronOndansetron may increase the serotonergic activities of Milnacipran.Approved
OpiumOpium may increase the serotonergic activities of Milnacipran.Approved, Illicit
OrciprenalineMilnacipran may increase the tachycardic activities of Orciprenaline.Approved
OrphenadrineThe risk or severity of adverse effects can be increased when Orphenadrine is combined with Milnacipran.Approved
OsanetantThe risk or severity of adverse effects can be increased when Milnacipran is combined with Osanetant.Investigational
OxazepamThe risk or severity of adverse effects can be increased when Oxazepam is combined with Milnacipran.Approved
OxethazaineThe risk or severity of adverse effects can be increased when Oxethazaine is combined with Milnacipran.Approved, Investigational
OxprenololThe serum concentration of Oxprenolol can be increased when it is combined with Milnacipran.Approved
OxybuprocaineThe risk or severity of adverse effects can be increased when Oxybuprocaine is combined with Milnacipran.Approved
OxycodoneOxycodone may increase the serotonergic activities of Milnacipran.Approved, Illicit, Investigational
OxyfedrineMilnacipran may increase the tachycardic activities of Oxyfedrine.Experimental
OxymetazolineMilnacipran may increase the tachycardic activities of Oxymetazoline.Approved
OxymorphoneOxymorphone may increase the serotonergic activities of Milnacipran.Approved, Investigational, Vet Approved
OxypertineThe risk or severity of adverse effects can be increased when Milnacipran is combined with Oxypertine.Experimental
PaliperidoneMilnacipran may decrease the antihypertensive activities of Paliperidone.Approved
PalonosetronPalonosetron may increase the serotonergic activities of Milnacipran.Approved, Investigational
ParaldehydeThe risk or severity of adverse effects can be increased when Paraldehyde is combined with Milnacipran.Approved, Investigational
ParecoxibMilnacipran may increase the antiplatelet activities of Parecoxib.Approved
PargylinePargyline may increase the serotonergic activities of Milnacipran.Approved
ParoxetineThe risk or severity of adverse effects can be increased when Paroxetine is combined with Milnacipran.Approved, Investigational
PenbutololThe serum concentration of Penbutolol can be increased when it is combined with Milnacipran.Approved, Investigational
PenfluridolThe risk or severity of adverse effects can be increased when Milnacipran is combined with Penfluridol.Experimental
PentamidineMilnacipran may increase the hypoglycemic activities of Pentamidine.Approved
PentazocinePentazocine may increase the serotonergic activities of Milnacipran.Approved, Vet Approved
PentobarbitalThe risk or severity of adverse effects can be increased when Pentobarbital is combined with Milnacipran.Approved, Vet Approved
PerampanelThe risk or severity of adverse effects can be increased when Perampanel is combined with Milnacipran.Approved
PerazineThe risk or severity of adverse effects can be increased when Perazine is combined with Milnacipran.Investigational
PergolideMilnacipran may decrease the antihypertensive activities of Pergolide.Approved, Investigational, Vet Approved, Withdrawn
PerospironeThe risk or severity of adverse effects can be increased when Milnacipran is combined with Perospirone.Approved
PerphenazineThe risk or severity of adverse effects can be increased when Perphenazine is combined with Milnacipran.Approved
PethidineThe risk or severity of adverse effects can be increased when Pethidine is combined with Milnacipran.Approved
PhenazocinePhenazocine may increase the serotonergic activities of Milnacipran.Experimental
PhenelzineThe risk or severity of adverse effects can be increased when Phenelzine is combined with Milnacipran.Approved
PhenibutThe risk or severity of adverse effects can be increased when Phenibut is combined with Milnacipran.Experimental
PhenindioneThe risk or severity of adverse effects can be increased when Milnacipran is combined with Phenindione.Approved, Investigational
PheniprazinePheniprazine may increase the serotonergic activities of Milnacipran.Withdrawn
PhenobarbitalThe risk or severity of adverse effects can be increased when Phenobarbital is combined with Milnacipran.Approved
PhenoperidinePhenoperidine may increase the serotonergic activities of Milnacipran.Experimental
PhenoxyethanolThe risk or severity of adverse effects can be increased when Phenoxyethanol is combined with Milnacipran.Approved
PhenoxypropazinePhenoxypropazine may increase the serotonergic activities of Milnacipran.Withdrawn
PhenprocoumonThe risk or severity of adverse effects can be increased when Milnacipran is combined with Phenprocoumon.Approved, Investigational
PhenylephrineMilnacipran may increase the tachycardic activities of Phenylephrine.Approved
PhenylpropanolamineMilnacipran may increase the tachycardic activities of Phenylpropanolamine.Approved, Vet Approved, Withdrawn
PhenytoinThe risk or severity of adverse effects can be increased when Phenytoin is combined with Milnacipran.Approved, Vet Approved
PimozideThe risk or severity of adverse effects can be increased when Milnacipran is combined with Pimozide.Approved
PindololThe serum concentration of Pindolol can be increased when it is combined with Milnacipran.Approved
PioglitazoneMilnacipran may increase the hypoglycemic activities of Pioglitazone.Approved, Investigational
PipamperoneThe risk or severity of adverse effects can be increased when Milnacipran is combined with Pipamperone.Approved, Investigational
PipotiazineThe risk or severity of adverse effects can be increased when Milnacipran is combined with Pipotiazine.Approved, Investigational
PirbuterolMilnacipran may increase the tachycardic activities of Pirbuterol.Approved
PiritramidePiritramide may increase the serotonergic activities of Milnacipran.Investigational
PirlindolePirlindole may increase the serotonergic activities of Milnacipran.Approved
PivhydrazinePivhydrazine may increase the serotonergic activities of Milnacipran.Withdrawn
PizotifenThe risk or severity of adverse effects can be increased when Pizotifen is combined with Milnacipran.Approved
Platelet Activating FactorThe serum concentration of Platelet Activating Factor can be increased when it is combined with Milnacipran.Experimental
PolythiazideMilnacipran may increase the hyponatremic activities of Polythiazide.Approved
PomalidomideThe risk or severity of adverse effects can be increased when Pomalidomide is combined with Milnacipran.Approved
PractololThe serum concentration of Practolol can be increased when it is combined with Milnacipran.Approved
PramlintideMilnacipran may increase the hypoglycemic activities of Pramlintide.Approved, Investigational
PramocaineThe risk or severity of adverse effects can be increased when Pramocaine is combined with Milnacipran.Approved
PrazepamThe risk or severity of adverse effects can be increased when Prazepam is combined with Milnacipran.Approved, Illicit
PregabalinThe risk or severity of adverse effects can be increased when Pregabalin is combined with Milnacipran.Approved, Illicit, Investigational
PrenalterolMilnacipran may increase the tachycardic activities of Prenalterol.Experimental
PrilocaineThe risk or severity of adverse effects can be increased when Prilocaine is combined with Milnacipran.Approved
PrimidoneThe risk or severity of adverse effects can be increased when Primidone is combined with Milnacipran.Approved, Vet Approved
ProcaineThe risk or severity of adverse effects can be increased when Procaine is combined with Milnacipran.Approved, Investigational, Vet Approved
ProcarbazineThe risk or severity of adverse effects can be increased when Procarbazine is combined with Milnacipran.Approved
ProcaterolMilnacipran may increase the tachycardic activities of Procaterol.Approved, Investigational
ProchlorperazineThe risk or severity of adverse effects can be increased when Prochlorperazine is combined with Milnacipran.Approved, Vet Approved
PromazineThe risk or severity of adverse effects can be increased when Promazine is combined with Milnacipran.Approved, Vet Approved
PromethazineThe risk or severity of adverse effects can be increased when Promethazine is combined with Milnacipran.Approved
PropanididThe risk or severity of adverse effects can be increased when Propanidid is combined with Milnacipran.Experimental
ProparacaineThe risk or severity of adverse effects can be increased when Proparacaine is combined with Milnacipran.Approved, Vet Approved
PropericiazineThe risk or severity of adverse effects can be increased when Milnacipran is combined with Propericiazine.Approved
PropiopromazineThe risk or severity of adverse effects can be increased when Propiopromazine is combined with Milnacipran.Vet Approved
PropofolThe risk or severity of adverse effects can be increased when Propofol is combined with Milnacipran.Approved, Investigational, Vet Approved
PropoxycaineThe risk or severity of adverse effects can be increased when Propoxycaine is combined with Milnacipran.Approved
PropranololThe serum concentration of Propranolol can be increased when it is combined with Milnacipran.Approved, Investigational
ProthipendylThe risk or severity of adverse effects can be increased when Milnacipran is combined with Prothipendyl.Investigational
ProtriptylineThe risk or severity of adverse effects can be increased when Protriptyline is combined with Milnacipran.Approved
ProxibarbalThe risk or severity of adverse effects can be increased when Proxibarbal is combined with Milnacipran.Experimental
PSD502The risk or severity of adverse effects can be increased when PSD502 is combined with Milnacipran.Investigational
PseudoephedrineMilnacipran may increase the tachycardic activities of Pseudoephedrine.Approved
QuazepamThe risk or severity of adverse effects can be increased when Quazepam is combined with Milnacipran.Approved, Illicit
QuetiapineThe risk or severity of adverse effects can be increased when Milnacipran is combined with Quetiapine.Approved
QuinethazoneMilnacipran may increase the hyponatremic activities of Quinethazone.Approved
QuinineMilnacipran may increase the hypoglycemic activities of Quinine.Approved
QuinisocaineThe risk or severity of adverse effects can be increased when Quinisocaine is combined with Milnacipran.Experimental
RacepinephrineMilnacipran may increase the tachycardic activities of Racepinephrine.Approved
RacloprideThe risk or severity of adverse effects can be increased when Milnacipran is combined with Raclopride.Investigational
RactopamineMilnacipran may increase the tachycardic activities of Ractopamine.Vet Approved
RamelteonThe risk or severity of adverse effects can be increased when Ramelteon is combined with Milnacipran.Approved, Investigational
RasagilineThe risk or severity of adverse effects can be increased when Rasagiline is combined with Milnacipran.Approved
RemifentanilRemifentanil may increase the serotonergic activities of Milnacipran.Approved
RemoxiprideThe risk or severity of adverse effects can be increased when Milnacipran is combined with Remoxipride.Approved, Withdrawn
RepaglinideMilnacipran may increase the hypoglycemic activities of Repaglinide.Approved, Investigational
ReproterolMilnacipran may increase the tachycardic activities of Reproterol.Investigational
ReserpineThe risk or severity of adverse effects can be increased when Milnacipran is combined with Reserpine.Approved, Investigational
RilmenidineMilnacipran may increase the tachycardic activities of Rilmenidine.Investigational
RimiterolMilnacipran may increase the tachycardic activities of Rimiterol.Experimental
RisperidoneThe metabolism of Risperidone can be decreased when combined with Milnacipran.Approved, Investigational
RitanserinThe risk or severity of adverse effects can be increased when Milnacipran is combined with Ritanserin.Investigational
RitobegronMilnacipran may increase the tachycardic activities of Ritobegron.Investigational
RitodrineMilnacipran may increase the tachycardic activities of Ritodrine.Approved, Investigational
RizatriptanThe risk or severity of adverse effects can be increased when Rizatriptan is combined with Milnacipran.Approved
RofecoxibMilnacipran may increase the antiplatelet activities of Rofecoxib.Investigational, Withdrawn
RomifidineMilnacipran may increase the tachycardic activities of Romifidine.Vet Approved
RopiniroleMilnacipran may decrease the antihypertensive activities of Ropinirole.Approved, Investigational
RopivacaineThe risk or severity of adverse effects can be increased when Ropivacaine is combined with Milnacipran.Approved
RosiglitazoneMilnacipran may increase the hypoglycemic activities of Rosiglitazone.Approved, Investigational
SafrazineSafrazine may increase the serotonergic activities of Milnacipran.Withdrawn
SalbutamolMilnacipran may increase the tachycardic activities of Salbutamol.Approved, Vet Approved
SalmeterolMilnacipran may increase the tachycardic activities of Salmeterol.Approved
SaxagliptinMilnacipran may increase the hypoglycemic activities of Saxagliptin.Approved
ScopolamineThe risk or severity of adverse effects can be increased when Scopolamine is combined with Milnacipran.Approved
SecobarbitalThe risk or severity of adverse effects can be increased when Secobarbital is combined with Milnacipran.Approved, Vet Approved
SelegilineThe risk or severity of adverse effects can be increased when Selegiline is combined with Milnacipran.Approved, Investigational, Vet Approved
SepranoloneThe risk or severity of adverse effects can be increased when Sepranolone is combined with Milnacipran.Investigational
SertindoleThe risk or severity of adverse effects can be increased when Milnacipran is combined with Sertindole.Approved, Investigational, Withdrawn
SertralineThe risk or severity of adverse effects can be increased when Sertraline is combined with Milnacipran.Approved
SevofluraneThe risk or severity of adverse effects can be increased when Sevoflurane is combined with Milnacipran.Approved, Vet Approved
SitagliptinMilnacipran may increase the hypoglycemic activities of Sitagliptin.Approved, Investigational
Sodium oxybateThe risk or severity of adverse effects can be increased when Sodium oxybate is combined with Milnacipran.Approved
SolabegronMilnacipran may increase the tachycardic activities of Solabegron.Investigational
SotalolThe serum concentration of Sotalol can be increased when it is combined with Milnacipran.Approved
StiripentolThe risk or severity of adverse effects can be increased when Stiripentol is combined with Milnacipran.Approved
SufentanilSufentanil may increase the serotonergic activities of Milnacipran.Approved, Investigational
SulfadiazineMilnacipran may increase the hypoglycemic activities of Sulfadiazine.Approved, Vet Approved
SulfamethoxazoleMilnacipran may increase the hypoglycemic activities of Sulfamethoxazole.Approved
SulfisoxazoleMilnacipran may increase the hypoglycemic activities of Sulfisoxazole.Approved, Vet Approved
SulpirideThe risk or severity of adverse effects can be increased when Milnacipran is combined with Sulpiride.Approved, Investigational
SultoprideThe risk or severity of adverse effects can be increased when Milnacipran is combined with Sultopride.Experimental
SumatriptanThe risk or severity of adverse effects can be increased when Sumatriptan is combined with Milnacipran.Approved, Investigational
SunitinibMilnacipran may increase the hypoglycemic activities of Sunitinib.Approved, Investigational
SuvorexantThe risk or severity of adverse effects can be increased when Suvorexant is combined with Milnacipran.Approved
SynephrineMilnacipran may increase the tachycardic activities of Synephrine.Experimental
TacrolimusThe metabolism of Tacrolimus can be decreased when combined with Milnacipran.Approved, Investigational
TalinololThe serum concentration of Talinolol can be increased when it is combined with Milnacipran.Investigational
TandospironeThe risk or severity of adverse effects can be increased when Tandospirone is combined with Milnacipran.Investigational
TapentadolThe risk or severity of adverse effects can be increased when Milnacipran is combined with Tapentadol.Approved
TasimelteonThe risk or severity of adverse effects can be increased when Tasimelteon is combined with Milnacipran.Approved
Tedizolid PhosphateTedizolid Phosphate may increase the serotonergic activities of Milnacipran.Approved
TemazepamThe risk or severity of adverse effects can be increased when Temazepam is combined with Milnacipran.Approved
TerbutalineMilnacipran may increase the tachycardic activities of Terbutaline.Approved
TertatololThe serum concentration of Tertatolol can be increased when it is combined with Milnacipran.Experimental
TetrabenazineThe risk or severity of adverse effects can be increased when Tetrabenazine is combined with Milnacipran.Approved
TetracaineThe risk or severity of adverse effects can be increased when Tetracaine is combined with Milnacipran.Approved, Vet Approved
TetrahydropalmatineThe risk or severity of adverse effects can be increased when Milnacipran is combined with Tetrahydropalmatine.Investigational
TetrodotoxinThe risk or severity of adverse effects can be increased when Tetrodotoxin is combined with Milnacipran.Investigational
ThalidomideThe risk or severity of adverse effects can be increased when Thalidomide is combined with Milnacipran.Approved, Investigational, Withdrawn
ThiamylalThe risk or severity of adverse effects can be increased when Thiamylal is combined with Milnacipran.Approved, Vet Approved
ThiazinamThe risk or severity of adverse effects can be increased when Thiazinam is combined with Milnacipran.Experimental
ThiethylperazineThe risk or severity of adverse effects can be increased when Thiethylperazine is combined with Milnacipran.Withdrawn
ThiopentalThe risk or severity of adverse effects can be increased when Thiopental is combined with Milnacipran.Approved, Vet Approved
ThiopropazateThe risk or severity of adverse effects can be increased when Milnacipran is combined with Thiopropazate.Experimental
ThioproperazineThe risk or severity of adverse effects can be increased when Milnacipran is combined with Thioproperazine.Approved
ThioridazineThe risk or severity of adverse effects can be increased when Thioridazine is combined with Milnacipran.Approved, Withdrawn
ThiothixeneThe risk or severity of adverse effects can be increased when Milnacipran is combined with Thiothixene.Approved
Thyroid, porcineThe therapeutic efficacy of Thyroid, porcine can be decreased when used in combination with Milnacipran.Approved
TiagabineThe risk or severity of adverse effects can be increased when Tiagabine is combined with Milnacipran.Approved
TiaprideThe risk or severity of adverse effects can be increased when Milnacipran is combined with Tiapride.Approved, Investigational
TiletamineThe risk or severity of adverse effects can be increased when Tiletamine is combined with Milnacipran.Vet Approved
TilidineTilidine may increase the serotonergic activities of Milnacipran.Experimental
TimololThe serum concentration of Timolol can be increased when it is combined with Milnacipran.Approved
TioclomarolThe risk or severity of adverse effects can be increased when Milnacipran is combined with Tioclomarol.Experimental
TizanidineMilnacipran may increase the tachycardic activities of Tizanidine.Approved
TolazamideMilnacipran may increase the hypoglycemic activities of Tolazamide.Approved
TolbutamideMilnacipran may increase the hypoglycemic activities of Tolbutamide.Approved
TolcaponeThe risk or severity of adverse effects can be increased when Tolcapone is combined with Milnacipran.Approved, Withdrawn
ToloxatoneToloxatone may increase the serotonergic activities of Milnacipran.Approved
TopiramateThe risk or severity of adverse effects can be increased when Topiramate is combined with Milnacipran.Approved
TramadolMilnacipran may increase the neuroexcitatory activities of Tramadol.Approved, Investigational
Trans-2-PhenylcyclopropylamineThe risk or severity of adverse effects can be increased when Trans-2-Phenylcyclopropylamine is combined with Milnacipran.Experimental
TranylcypromineThe risk or severity of adverse effects can be increased when Tranylcypromine is combined with Milnacipran.Approved
TrazodoneThe risk or severity of adverse effects can be increased when Trazodone is combined with Milnacipran.Approved, Investigational
TretoquinolMilnacipran may increase the tachycardic activities of Tretoquinol.Experimental
TriazolamThe risk or severity of adverse effects can be increased when Triazolam is combined with Milnacipran.Approved
Tricaine methanesulfonateThe risk or severity of adverse effects can be increased when Tricaine methanesulfonate is combined with Milnacipran.Vet Approved
TrichlormethiazideMilnacipran may increase the hyponatremic activities of Trichlormethiazide.Approved, Vet Approved
TrichloroethyleneThe risk or severity of adverse effects can be increased when Trichloroethylene is combined with Milnacipran.Approved
TrifluoperazineThe risk or severity of adverse effects can be increased when Trifluoperazine is combined with Milnacipran.Approved
TrifluperidolThe risk or severity of adverse effects can be increased when Milnacipran is combined with Trifluperidol.Experimental
TriflupromazineThe risk or severity of adverse effects can be increased when Triflupromazine is combined with Milnacipran.Approved, Vet Approved
TrimipramineThe risk or severity of adverse effects can be increased when Trimipramine is combined with Milnacipran.Approved
TriprolidineThe risk or severity of adverse effects can be increased when Triprolidine is combined with Milnacipran.Approved
TropisetronTropisetron may increase the serotonergic activities of Milnacipran.Approved, Investigational
TulobuterolMilnacipran may increase the tachycardic activities of Tulobuterol.Investigational
ValdecoxibMilnacipran may increase the antiplatelet activities of Valdecoxib.Investigational, Withdrawn
Valproic AcidThe risk or severity of adverse effects can be increased when Valproic Acid is combined with Milnacipran.Approved, Investigational
VemurafenibThe risk or severity of QTc prolongation can be increased when Vemurafenib is combined with Milnacipran.Approved
VenlafaxineThe risk or severity of adverse effects can be increased when Venlafaxine is combined with Milnacipran.Approved
VeraliprideThe risk or severity of adverse effects can be increased when Milnacipran is combined with Veralipride.Experimental
VigabatrinThe risk or severity of adverse effects can be increased when Vigabatrin is combined with Milnacipran.Approved
VilazodoneThe risk or severity of adverse effects can be increased when Vilazodone is combined with Milnacipran.Approved
Vinyl etherThe risk or severity of adverse effects can be increased when Vinyl ether is combined with Milnacipran.Experimental
VortioxetineThe risk or severity of adverse effects can be increased when Vortioxetine is combined with Milnacipran.Approved
WarfarinThe risk or severity of adverse effects can be increased when Milnacipran is combined with Warfarin.Approved
XamoterolMilnacipran may increase the tachycardic activities of Xamoterol.Experimental
XenonThe risk or severity of adverse effects can be increased when Xenon is combined with Milnacipran.Experimental
XylazineMilnacipran may increase the tachycardic activities of Xylazine.Vet Approved
XylometazolineMilnacipran may decrease the antihypertensive activities of Xylometazoline.Approved
YM-178Milnacipran may increase the tachycardic activities of YM-178.Investigational
ZaleplonThe risk or severity of adverse effects can be increased when Zaleplon is combined with Milnacipran.Approved, Illicit, Investigational
ZiconotideThe risk or severity of adverse effects can be increased when Ziconotide is combined with Milnacipran.Approved
ZimelidineMilnacipran may increase the serotonergic activities of Zimelidine.Withdrawn
ZiprasidoneThe risk or severity of adverse effects can be increased when Milnacipran is combined with Ziprasidone.Approved
ZolazepamThe risk or severity of adverse effects can be increased when Zolazepam is combined with Milnacipran.Vet Approved
ZolmitriptanThe risk or severity of adverse effects can be increased when Zolmitriptan is combined with Milnacipran.Approved, Investigational
ZolpidemThe risk or severity of adverse effects can be increased when Zolpidem is combined with Milnacipran.Approved
ZonisamideThe risk or severity of adverse effects can be increased when Zonisamide is combined with Milnacipran.Approved, Investigational
ZopicloneThe risk or severity of adverse effects can be increased when Zopiclone is combined with Milnacipran.Approved
ZotepineThe risk or severity of adverse effects can be increased when Milnacipran is combined with Zotepine.Approved, Investigational
ZuclopenthixolThe risk or severity of adverse effects can be increased when Milnacipran is combined with Zuclopenthixol.Approved, Investigational
Food Interactions
Not Available

References

Synthesis Reference

Jean Deregnaucourt, "Use of the (1S,2R) enantiomer of milnacipran for the preparation of a drug." U.S. Patent US20040259953, issued December 23, 2004.

US20040259953
General References
  1. Leo RJ, Brooks VL: Clinical potential of milnacipran, a serotonin and norepinephrine reuptake inhibitor, in pain. Curr Opin Investig Drugs. 2006 Jul;7(7):637-42. [PubMed:16869117]
  2. Sato S, Yamakawa Y, Terashima Y, Ohta H, Asada T: Efficacy of milnacipran on cognitive dysfunction with post-stroke depression: preliminary open-label study. Psychiatry Clin Neurosci. 2006 Oct;60(5):584-9. [PubMed:16958942]
  3. Simon LS: Is milnacipran effective in treating pain in patients with fibromyalgia? Nat Clin Pract Rheumatol. 2006 Mar;2(3):126-7. [PubMed:16932669]
  4. Soya A, Terao T, Nakajima M, Kojima H, Okamoto T, Inoue Y, Iwakawa M, Shinkai K, Yoshimura R, Ueta Y, Nakamura J: Effects of repeated milnacipran administration on brain serotonergic and noradrenergic functions in healthy volunteers. Psychopharmacology (Berl). 2006 Sep;187(4):526-7. Epub 2006 Jul 8. [PubMed:16830129]
  5. King T, Rao S, Vanderah T, Chen Q, Vardanyan A, Porreca F: Differential blockade of nerve injury-induced shift in weight bearing and thermal and tactile hypersensitivity by milnacipran. J Pain. 2006 Jul;7(7):513-20. [PubMed:16814690]
  6. Moojen VK, Martins MR, Reinke A, Feier G, Agostinho FR, Cechin EM, Quevedo J: Effects of milnacipran in animal models of anxiety and memory. Neurochem Res. 2006 Apr;31(4):571-7. Epub 2006 May 9. [PubMed:16758367]
  7. Moret C, Charveron M, Finberg JP, Couzinier JP, Briley M: Biochemical profile of midalcipran (F 2207), 1-phenyl-1-diethyl-aminocarbonyl-2-aminomethyl-cyclopropane (Z) hydrochloride, a potential fourth generation antidepressant drug. Neuropharmacology. 1985 Dec;24(12):1211-9. [PubMed:3005901]
  8. Briley M, Prost JF, Moret C: Preclinical pharmacology of milnacipran. Int Clin Psychopharmacol. 1996 Sep;11 Suppl 4:9-14. [PubMed:8923122]
  9. Puozzo C, Panconi E, Deprez D: Pharmacology and pharmacokinetics of milnacipran. Int Clin Psychopharmacol. 2002 Jun;17 Suppl 1:S25-35. [PubMed:12369608]
  10. Leinonen E, Lepola U, Koponen H, Mehtonen OP, Rimon R: Long-term efficacy and safety of milnacipran compared to clomipramine in patients with major depression. Acta Psychiatr Scand. 1997 Dec;96(6):497-504. [PubMed:9421348]
  11. Papakostas GI, Fava M: A meta-analysis of clinical trials comparing milnacipran, a serotonin--norepinephrine reuptake inhibitor, with a selective serotonin reuptake inhibitor for the treatment of major depressive disorder. Eur Neuropsychopharmacol. 2007 Jan;17(1):32-6. Epub 2006 Jun 8. [PubMed:16762534]
  12. Kako Y, Niwa Y, Toyomaki A, Yamanaka H, Kitagawa N, Denda K, Koyama T: A case of adult attention-deficit/hyperactivity disorder alleviated by milnacipran. Prog Neuropsychopharmacol Biol Psychiatry. 2007 Apr 13;31(3):772-5. Epub 2007 Jan 12. [PubMed:17300859]
  13. Bernstein CD, Albrecht KL, Marcus DA: Milnacipran for fibromyalgia: a useful addition to the treatment armamentarium. Expert Opin Pharmacother. 2013 May;14(7):905-16. doi: 10.1517/14656566.2013.779670. Epub 2013 Mar 19. [PubMed:23506481]
External Links
Human Metabolome Database
HMDB15602
KEGG Drug
D08222
PubChem Compound
65833
PubChem Substance
46506141
ChemSpider
59245
BindingDB
86420
ChEBI
94468
ChEMBL
CHEMBL252923
Therapeutic Targets Database
DAP001155
PharmGKB
PA164752812
RxList
RxList Drug Page
Drugs.com
Drugs.com Drug Page
Wikipedia
Milnacipran
ATC Codes
N06AX17 — Milnacipran
FDA label
Download (332 KB)
MSDS
Download (83.2 KB)

Clinical Trials

Clinical Trials
PhaseStatusPurposeConditionsCount
1CompletedBasic ScienceFibromyalgia1
2CompletedTreatmentFibromyalgia Syndrome1
2CompletedTreatmentLow Back Pain (LBP)1
2RecruitingTreatmentPain, Neuropathic1
2TerminatedTreatmentFibromyalgia, Primary1
2TerminatedTreatmentIrritable Bowel Syndrome (IBS)1
2TerminatedTreatmentPrimary Fibromyalgia Syndrome1
2Unknown StatusTreatmentFibromylagia1
2, 3CompletedTreatmentFibromyalgia1
2, 3RecruitingTreatmentDepression1
3CompletedTreatmentDepression1
3CompletedTreatmentFibromyalgia3
3CompletedTreatmentFibromyalgia Syndrome2
3CompletedTreatmentFibromyalgia / Neurocognition1
3CompletedTreatmentVestibulodynia / Vulvodynia1
3TerminatedTreatmentFibromyalgia2
3WithdrawnTreatmentBack Pain1
4CompletedBasic ScienceFibromyalgia1
4CompletedTreatmentAsperger's Syndrome / Aspergers Syndrome / Autism Spectrum Conditions/Disorders1
4CompletedTreatmentDegenerative Joint Disease / Knee Osteoarthritis (Knee OA) / Pain, Chronic1
4CompletedTreatmentFibromyalgia3
4CompletedTreatmentFibromyalgia / Sleep / Sleep disorders and disturbances1
4CompletedTreatmentKnee Pain After Total Knee Arthroplasty / Osteoarthritis Pain1
4CompletedTreatmentRadicular Pain Related to Lumbosacral Disc Disease1
4CompletedTreatmentRheumatoid Arthritis2
4CompletedTreatmentShoulder Pain Chronic1
4Unknown StatusPreventionChronic Migraine / Migraine With Aura / Migraine Without Aura1
4Unknown StatusTreatmentFibromyalgia1
4Unknown StatusTreatmentOsteoarthritis (OA)1
4WithdrawnTreatmentFibromyalgia / Systemic Lupus Erythematosus (SLE) / Widespread Pain1
Not AvailableActive Not RecruitingTreatmentDepression2
Not AvailableCompletedPreventionChronic Migraine1
Not AvailableRecruitingTreatmentAdverse Reaction to Drug / Depression1
Not AvailableRecruitingTreatmentDepression / Depressive Symptoms1
Not AvailableRecruitingTreatmentPain, Chronic / Post Treatment Lyme Syndrome (PTLS)1
Not AvailableTerminatedTreatmentIdiopathic Peripheral Neuropathy1
Not AvailableUnknown StatusPreventionDepression / Stroke, Ischemic1
Not AvailableUnknown StatusTreatmentMajor Depressive Disorder (MDD)1

Pharmacoeconomics

Manufacturers
Not Available
Packagers
Dosage forms
FormRouteStrength
Tablet, film coatedOral12.5 mg/1
KitOral
Tablet, film coatedOral100 mg/1
Tablet, film coatedOral25 mg/1
Tablet, film coatedOral50 mg/1
Prices
Unit descriptionCostUnit
Savella 100 mg tablet2.13USD tablet
Savella 12.5 mg tablet2.13USD tablet
Savella 25 mg tablet2.13USD tablet
Savella 50 mg tablet2.13USD tablet
DrugBank does not sell nor buy drugs. Pricing information is supplied for informational purposes only.
Patents
Patent NumberPediatric ExtensionApprovedExpires (estimated)
US6602911No2003-01-142023-01-14Us
US6992110No2001-11-052021-11-05Us
US7888342No2001-11-052021-11-05Us
US7994220No2009-09-192029-09-19Us

Properties

State
Solid
Experimental Properties
PropertyValueSource
melting point (°C)179°C Bernstein CD, Albrecht KL, Marcus DA: Milnacipran for fibromyalgia: a useful addition to the treatment armamentarium. Expert Opin Pharmacother. 2013 Mar 19. "Pubmed":http://www.ncbi.nlm.nih.gov/pubmed/23506481
water solubility19 mg/mLMSDS
Predicted Properties
PropertyValueSource
Water Solubility1.23 mg/mLALOGPS
logP1.72ALOGPS
logP1.42ChemAxon
logS-2.3ALOGPS
pKa (Strongest Basic)9.83ChemAxon
Physiological Charge1ChemAxon
Hydrogen Acceptor Count2ChemAxon
Hydrogen Donor Count1ChemAxon
Polar Surface Area46.33 Å2ChemAxon
Rotatable Bond Count5ChemAxon
Refractivity73.81 m3·mol-1ChemAxon
Polarizability28.03 Å3ChemAxon
Number of Rings2ChemAxon
Bioavailability1ChemAxon
Rule of FiveYesChemAxon
Ghose FilterYesChemAxon
Veber's RuleNoChemAxon
MDDR-like RuleNoChemAxon
Predicted ADMET features
PropertyValueProbability
Human Intestinal Absorption+1.0
Blood Brain Barrier+0.9889
Caco-2 permeable+0.5914
P-glycoprotein substrateSubstrate0.5928
P-glycoprotein inhibitor INon-inhibitor0.902
P-glycoprotein inhibitor IINon-inhibitor0.8787
Renal organic cation transporterNon-inhibitor0.8119
CYP450 2C9 substrateNon-substrate0.8494
CYP450 2D6 substrateNon-substrate0.9116
CYP450 3A4 substrateNon-substrate0.6514
CYP450 1A2 substrateNon-inhibitor0.6383
CYP450 2C9 inhibitorNon-inhibitor0.7697
CYP450 2D6 inhibitorNon-inhibitor0.7718
CYP450 2C19 inhibitorNon-inhibitor0.8587
CYP450 3A4 inhibitorNon-inhibitor0.6327
CYP450 inhibitory promiscuityLow CYP Inhibitory Promiscuity0.7004
Ames testNon AMES toxic0.8013
CarcinogenicityNon-carcinogens0.5456
BiodegradationNot ready biodegradable0.9972
Rat acute toxicity2.6162 LD50, mol/kg Not applicable
hERG inhibition (predictor I)Weak inhibitor0.993
hERG inhibition (predictor II)Non-inhibitor0.6823
ADMET data is predicted using admetSAR, a free tool for evaluating chemical ADMET properties. (23092397)

Spectra

Mass Spec (NIST)
Not Available
Spectra
SpectrumSpectrum TypeSplash Key
Predicted GC-MS Spectrum - GC-MSPredicted GC-MSNot Available
Predicted MS/MS Spectrum - 10V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 20V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 40V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 10V, Negative (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 20V, Negative (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 40V, Negative (Annotated)Predicted LC-MS/MSNot Available
MS/MS Spectrum - , positiveLC-MS/MSsplash10-001i-1590000000-14ea613049f0be797cc6

Taxonomy

Description
This compound belongs to the class of organic compounds known as phenylacetamides. These are amide derivatives of phenylacetic acids.
Kingdom
Organic compounds
Super Class
Benzenoids
Class
Benzene and substituted derivatives
Sub Class
Phenylacetamides
Direct Parent
Phenylacetamides
Alternative Parents
Aralkylamines / Cyclopropanecarboxylic acids and derivatives / Tertiary carboxylic acid amides / Amino acids and derivatives / Organopnictogen compounds / Organic oxides / Monoalkylamines / Hydrocarbon derivatives / Carbonyl compounds
Substituents
Phenylacetamide / Aralkylamine / Cyclopropanecarboxylic acid or derivatives / Tertiary carboxylic acid amide / Amino acid or derivatives / Carboxamide group / Carboxylic acid derivative / Organopnictogen compound / Organic oxygen compound / Primary amine
Molecular Framework
Aromatic homomonocyclic compounds
External Descriptors
Not Available

Targets

Kind
Protein
Organism
Human
Pharmacological action
Yes
Actions
Inhibitor
General Function
Serotonin:sodium symporter activity
Specific Function
Serotonin transporter whose primary function in the central nervous system involves the regulation of serotonergic signaling via transport of serotonin molecules from the synaptic cleft back into t...
Gene Name
SLC6A4
Uniprot ID
P31645
Uniprot Name
Sodium-dependent serotonin transporter
Molecular Weight
70324.165 Da
References
  1. Leo RJ, Brooks VL: Clinical potential of milnacipran, a serotonin and norepinephrine reuptake inhibitor, in pain. Curr Opin Investig Drugs. 2006 Jul;7(7):637-42. [PubMed:16869117]
  2. Moret C, Charveron M, Finberg JP, Couzinier JP, Briley M: Biochemical profile of midalcipran (F 2207), 1-phenyl-1-diethyl-aminocarbonyl-2-aminomethyl-cyclopropane (Z) hydrochloride, a potential fourth generation antidepressant drug. Neuropharmacology. 1985 Dec;24(12):1211-9. [PubMed:3005901]
Kind
Protein
Organism
Human
Pharmacological action
Yes
Actions
Inhibitor
General Function
Norepinephrine:sodium symporter activity
Specific Function
Amine transporter. Terminates the action of noradrenaline by its high affinity sodium-dependent reuptake into presynaptic terminals.
Gene Name
SLC6A2
Uniprot ID
P23975
Uniprot Name
Sodium-dependent noradrenaline transporter
Molecular Weight
69331.42 Da
References
  1. Leo RJ, Brooks VL: Clinical potential of milnacipran, a serotonin and norepinephrine reuptake inhibitor, in pain. Curr Opin Investig Drugs. 2006 Jul;7(7):637-42. [PubMed:16869117]
  2. Moret C, Charveron M, Finberg JP, Couzinier JP, Briley M: Biochemical profile of midalcipran (F 2207), 1-phenyl-1-diethyl-aminocarbonyl-2-aminomethyl-cyclopropane (Z) hydrochloride, a potential fourth generation antidepressant drug. Neuropharmacology. 1985 Dec;24(12):1211-9. [PubMed:3005901]
Kind
Protein group
Organism
Human
Pharmacological action
Unknown
Actions
Inhibitor
General Function
Voltage-gated cation channel activity
Specific Function
NMDA receptor subtype of glutamate-gated ion channels with high calcium permeability and voltage-dependent sensitivity to magnesium. Mediated by glycine. This protein plays a key role in synaptic p...

Components:
References
  1. Kohno T, Kimura M, Sasaki M, Obata H, Amaya F, Saito S: Milnacipran inhibits glutamatergic N-methyl-D-aspartate receptor activity in spinal dorsal horn neurons. Mol Pain. 2012 Jun 19;8:45. doi: 10.1186/1744-8069-8-45. [PubMed:22716121]
  2. Shuto S, Takada H, Mochizuki D, Tsujita R, Hase Y, Ono S, Shibuya N, Matsuda A: (+/-)-(Z)-2-(aminomethyl)-1-phenylcyclopropanecarboxamide derivatives as a new prototype of NMDA receptor antagonists. J Med Chem. 1995 Jul 21;38(15):2964-8. [PubMed:7636857]

Drug created on October 21, 2007 16:23 / Updated on December 01, 2017 17:11