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global assessment (pgic). Impairment of Fertility Although administration of milnacipran to male and female rats had no statistically significant effect on mating or fertility at doses up to 80 mg/kg/day (4 times the mrhd on an mg/m2 basis there was an apparent dose-related decrease in the fertility index. The increases of bilirubin observed in the fibromyalgia clinical trials were not clinically significant. Because of underreporting, it is impossible to provide an accurate estimate of the true incidence of these reactions. Keep the, storage size at 50GB, fill the, label box. 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. However those clinical trials excluded patients with current major depressive episode. The absolute bioavailability is approximately 85. In addition, a larger proportion of patients treated with Savella met the criteria for treatment response, as measured by the composite endpoint that concurrently evaluated improvement in pain (VAS physical function (SF-36 PCS and patient global assessment (pgic in fibromyalgia as compared to placebo. Clinically Important Interactions with Select Cardiovascular Agents Digoxin: Use of Savella concomitantly with digoxin may be associated with potentiation of adverse hemodynamic effects. It has an empirical formula of C15H23ClN2O and a molecular weight of 282.8 g/mol.

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In the controlled fibromyalgia trials, dysuria occurred more frequently in patients treated with Savella (1) than in placebo-treated patients (0.5). Data forms may also be downloaded from the registry website. In clinical trials, cases of acute ingestions up to 1000 mg, alone or in combination with other drugs, were reported with none being fatal. USE IN specific populations Pregnancy Pregnancy Category C Risk Summary There are no adequate or well-controlled studies in pregnant women. Do not start or stop any medicine while taking Savella without talking to your healthcare provider first. Preclinical studies have shown that milnacipran is a potent inhibitor of neuronal norepinephrine and serotonin reuptake; milnacipran inhibits norepinephrine uptake with approximately 3-fold higher potency in vitro than serotonin without directly affecting the uptake of dopamine or other neurotransmitters. Based on individual patient response, the dose may be increased to 200 mg/day (100 mg twice daily). Metabolism and Elimination Milnacipran and its metabolites are eliminated primarily by renal excretion.