Do you also have to live with pain, stiffness and constant fatigue all over your body? Your doctor may have called this condition fibromyalgia . It is a very annoying condition. So, one special medicine that doctors recommend to help you in times like these is Milnacipran. Today, we will talk about this medicine, how it works, what it can do and what you should be aware of, very simply, as if you were talking to a friend.
What kind of medicine is Milnacipran?
Simply put, Milnacipran is a medication used to treat your Fibromyalgia condition. It belongs to a class of medications called SNRI (Serotonin-Norepinephrine Reuptake Inhibitor). Don't think, "Oh, what's this big word?" I'll explain it simply.
Imagine that there are little messengers inside our brains that carry messages back and forth. We call them neurotransmitters. Serotonin and Norepinephrine are two of these very important messengers. They help to keep our mood happy and control pain. People with fibromyalgia may have some changes in the functioning of these messengers.
So, what Milnacipran does is increase the levels of these serotonin and norepinephrine in the brain, which helps control the way you feel pain and your mood. So the pain and other discomfort you feel will gradually start to decrease.
Things you should tell your doctor before taking this medicine
This is very important. Before you start Milnacipran, you should give your doctor a complete description of your health condition. Do not hide anything because it is a small thing. Because even those small things can affect your treatment.
If you have any of the conditions listed in the table below, be sure to tell your doctor about it.
| Condition or habit | Why is that important? |
|---|---|
| Bleeding disorders | This medicine may slightly increase the risk of bleeding. |
| If you drink alcohol frequently | Liver damage and other side effects may increase. |
| Glaucoma condition | It can cause increased eye pressure. |
| Heart disease, high blood pressure, heart rhythm disorders | This medicine can affect blood pressure and heart rate. |
| Kidney or liver disease | The dosage may need to be changed as it affects the elimination of the medication from the body. |
| Mania or bipolar states | These situations are likely to escalate. |
| Prostate diseases | Difficulty urinating may occur. |
| If you have a seizure disorder | The risk may increase. |
| If you or someone in your family has had suicidal thoughts | This is very important. You should be especially careful about these thoughts during the initial stages of starting the medication. |
| If you have taken an MAOI medication within the last 14 days | This can cause a very dangerous reaction. |
| If you are trying to get pregnant, are pregnant, or are a breastfeeding mother | Be sure to inform your doctor about this. |
How should I use the medicine?
This medicine should be taken orally with a glass of water. You can take it before or after meals. However, if you feel upset, it is better to take it with food. Make sure to take the prescribed dose at the prescribed time, as prescribed by the doctor . Do not increase or decrease the dose as you feel, or take it more often than prescribed.
The most important thing is that stopping this medication suddenly can cause serious side effects. Or your fibromyalgia condition may worsen. Therefore, never stop taking this medication suddenly without your doctor's advice.
What to do if you miss a dose of medicine?
Don't worry. Skip the missed dose and take the medicine as usual when it is due. Never take two doses at the same time. If this happens, consult your doctor.
What if I take too much medicine?
If you think you have taken too much medicine, go to the nearest hospital Emergency Department (ETU) immediately. Or call the National Poisons Information Centre at the Colombo National Hospital for advice.
Also remember, this medicine has been prescribed for you only. Do not give this medicine to someone else, even if their symptoms are the same as yours. It can be dangerous.
Other medications that may interact with this medicine (Interactions)
Milnacipran is a medication that can interact with other medications, so it is very important to tell your doctor about all the medications you are taking (including vitamins, herbal remedies, and supplements).
Do not take Milnacipran with this medicine.
You should definitely not use Milnacipran if you are taking any of the following medications: It can cause serious, even life-threatening, reactions.
- MAOI medications (e.g. Marplan, Nardil)
- Linezolid
- Methylene blue (intravenous)
- Other SNRIs such as Duloxetine, Desvenlafaxine, Venlafaxine, Levomilnacipran
Problems can also occur with this medication.
The following medications may also interact with Milnacipran. Therefore, be sure to inform your doctor about these as well.
- Aspirin and similar painkillers
- NSAIDS-type painkillers (e.g. Ibuprofen, Naproxen)
- Medicines that prevent blood clotting (e.g. Warfarin, Enoxaparin)
- Some migraine medications (Triptans)
- Other medications for mental illness
- Tramadol, Lithium, Tryptophan
- The herbal supplement St. John's Wort
This list is not complete, so tell your doctor about everything you take.
Things to be careful about when taking medicine
Pay special attention: When you first start using this medicine or when you change the dose, watch carefully for new or worsening mood swings, suicidal thoughts, agitation, or anxiety in yourself or your family. If this happens , call your doctor right away. This is very important.
- Blood pressure: This medication may increase blood pressure. Your doctor may ask you to have your blood pressure checked regularly.
- Dizziness: This medicine may affect your ability to concentrate and react quickly. Therefore, avoid driving or operating machinery until you know how this medicine affects you. To reduce dizziness and lightheadedness, get up slowly from a sitting position or from bed. This condition can be made worse by drinking alcohol.
- Dry mouth: Dry mouth is a common side effect. This can be managed by chewing sugar-free gum and drinking plenty of water.
What are the possible side effects of the medicine?
Like any medicine, Milnacipran can cause side effects. Not everyone gets them. Some are serious, while others are mild.
| Serious side effects that should be reported to the doctor immediately | |
|---|---|
| Allergic reactions | Skin rash, itching, swelling of the face, lips, tongue, difficulty breathing. |
| Abnormal bleeding | Black stools that look like coffee grounds or are bloody, vomiting blood, dark red/brown urine, and small red/purple spots on the skin. |
| Changes in heart rate | Feeling like your heart is beating fast, chest tightness. |
| Serotonin Syndrome | Restlessness, confusion, excessive sweating, fever, muscle stiffness or twitching, vomiting, diarrhea. |
| Symptoms of liver damage | Pain in the upper right side of the stomach, loss of appetite, yellowing of the eyes or skin, dark yellow/brown urine. |
| Symptoms of low sodium in the body | Muscle weakness, extreme fatigue, headaches, confusion. |
| Other serious symptoms | Seizures, sudden eye pain, blurred vision, suicidal thoughts, difficulty urinating. |
Side effects that are usually not serious
These usually go away in a few days. But if they persist, or if they bother you a lot, tell your doctor.
- Nausea, vomiting
- Constipation
- Dry mouth
- Dizziness
- Excessive sweating
- Changes in sexual desire or function
Take-Home Message
- Milnacipran is a special medication used to treat fibromyalgia .
- Before starting this medication, tell your doctor about all other medications you are taking and any medical conditions you have .
- Never stop taking medication suddenly without medical advice.
- Be very careful about mood changes, agitation, or suicidal thoughts during the initial stages of taking the medication. If you experience any of these, tell your doctor immediately.
- This medicine is for you only. Do not share it with anyone else.
- Store the medicine at room temperature , out of the reach of children .
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