1 What is Savella?

Generic: Milnacipran

Savella is used to treat longstanding pain caused by fibromyalgia. Savella (Milnacipran HCI) is a prescription drug that belongs to selective serotonin and norepinephrine reuptake inhibitors (SNRIs).

Savella  is primarily used to treat fibromyalgia, a condition characterized by muscle pain and stiffness.

Savella , like any other SNRIs, works by increasing the activity of serotonin and norepinephrine in the brain.

2 What to Know Before Using

You can only use Savella as directed by the doctor. For Savella, you and your doctor must consider the following:


If you have any unusual reaction to any medicine, be sure to tell your doctor about it. Additionally, disclose other types of allergies - foods, preservatives, animals, or dyes, if there are any. Read the package ingredients carefully and make sure you are not allergic to any of its 

Pediatric patients

There are no appropriate studies performed to establish safety and efficacy of Savella to children.

Elderly patients 

Studies show no problems regarding use of Savella to elderly patients. Nonetheless, utmost caution must be considered when giving this medicine to the elderly since they are more likely to suffer from age-related kidney, liver, or heart diseases.


While there are no adequate studies done in pregnant women, animal studies show an adverse effect of Savella use in the fetus.


No adequate studies were done determine the effect of Savella to infants during breastfeeding. When taking Savella, always call the doctor first before breastfeeding.

Drug Interactions

Certain medicines have adverse effects when used together. When you are receiving Savella, inform your doctor about other drugs you are taking so that alterations and precautions will be made if necessary. Talk to your doctor about possible interactions if you are taking other medications, both prescription and over-the-counter.

Interactions with tobacco and alcohol

Savella may interact with tobacco and alcohol, or with certain foods, may cause interactions. Ask your doctor about the risks if you are smoking or drinking alcohol, or if there are certain foods you have to avoid when taking this drug.

Other medical issues

Before taking Savella, make sure the doctor know if you have the following problems:

3 Proper Usage

The doctor will determine your dosage of Savella. The doctor will determine your dose of Savella based on your age, weight, and symptoms. Follow your doctor’s instructions in taking this medicine. 

Do not change the dosage the doctor indicated unless he or she told you otherwise. 

For the treatment of fibromyalgia in adults, doctors usually prescribe 12.5 mg once a day at day 1; 12 mg twice a day at days 2 and 3; 25 mg twice a day at days 4-7.

After day 7, the dosage will be increased to 50 mg twice a day or as directed by your doctor.

If you missed a dose, take the missed dose as soon as possible. In case it is almost time for the next dose, skip the missed one and follow your regular dosing schedule. Never take double doses.

Keep Savella in an airtight container at normal room temperature. Keep it away from direct light, heat, and moisture. Do not let it freeze.

Do not take it out from the blister pack unless it is your time to take the medicine. Keep the medicine out of children’s reach.

4 Precautions to Take

You should be monitored by your doctor when receiving Savella. When using Savella, it is important to have regular visits to your doctor check for any side effects and determine if the drug is working or if it needs adjustment in dosage.

In some people, Savella may cause agitation, irritability, or display of abnormal behaviors. Some people may also experience depression and suicidal thoughts. If you think you are experiencing any of these, inform your doctor right away.

Do not take Savella 14 days after stopping intake of certain drugs, such as monoamine oxidase inhibitor, methylene blue injection, phenelzine, linezolid, selegiline, or tranylcypromine.

After treatment is finished, do not take an MAO inhibitor for no less than 5 days after your last Savella dose. Moreover, if you are taking other NSAIDs, blood thinners, or aspirin, or any other medications, make sure to inform your doctor before taking Savella.

Close monitoring of your blood pressure or pulse rate before starting and while using Savella. Moreover, this medicine may cause some people to be less alert, so driving or using machines may not be advisable. Taking milnacipran may also cause liver problems in some.

Do not stop taking Savella abruptly without your doctor’s advice. Discontinuing Savella requires gradual tapering of dose, and abrupt stopping use can result to serious side effects. 

5 Potential Side Effects

Savella may cause side effects that you should report to your doctor at once. Not all people may suffer from these side effects, but if they do, immediate medical attention may be needed.

Contact your doctor as soon as possible if you encounter any of the following:

  • blurred vision
  • fever
  • chills
  • cough
  • Breathing difficulties
  • dizziness
  • ear congestion
  • fast, irregular, pounding or racing heartbeat
  • headache
  • fast heartbeat
  • increased sweating
  • loss of voice
  • nasal congestion
  • trouble sleeping
  • fear or nervousness
  • pounding in the ears
  • a runny nose slow
  • sneezing
  • sore throat
  • unusual tiredness or weakness
  • back pain
  • burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • pain or discomfort in the chest
  • the decrease in frequency of urination
  • the decrease in urine volume
  • difficult or painful urination
  • body aches or pain
  • difficulty in passing urine (dribbling)
  • frequent urination
  • groin pain
  • muscle aches
  • pain or burning sensation with urination
  • shakiness in the legs, arms, hands, or feet
  • swollen, tender prostate
  • tightness in the chest
  • bladder pain
  • bloating or swelling of the face, arms, hands, lower legs, or feet
  • bloody or cloudy urine
  • bruise
  • feeling sad or empty
  • frequent urge to urinate
  • full or bloated feeling
  • heartburn
  • increased or decreased weight
  • irritability
  • tingling of the hands or feet
  • lack of appetite
  • trouble concentrating
  • loss of interest or pleasure
  • lower back or side pain
  • pressure in the stomach
  • vomiting
  • swelling of the abdominal or stomach area
  • tiredness
  • unusual weight gains or loss

While most of these side effects usually diminish as the body adjusts to the drug, calling your doctor may be needed.

Some patients may experience side effects not listed above. If you want to report side effects, you may do so by calling the FDA at 1-800-FDA-1088.