Last update June 29, 2022

Milnacipran Hydrochloride

Limited compatibility

Unsafe. Moderate/severe adverse effects. Compatible under certain circumstances. Follow-up recommended. Use safer alternative or discontinue breastfeeding from 5 to 7 T ½ . Read Commentary.

Serotonin and Norepinephrine selective re-uptake inhibitor. Used in the treatment of depression. Authorized for treatment of Fibromyalgia in some countries. Oral administration in two daily doses.

Latest update failed to find relevant data on breastfeeding.

According to the manufacturer, it is excreted in breast milk in small amounts. (FDA 2012)

Pharmacokinetic data (low serum protein binding and high bioavailability) indicates that drug excretion into breast milk in significant amount is highly probable. Absorption by the infant is likely to be high as well.

At usual dose it does not induce galactorrhea. (Trenque 2011)

Frequent and potential severe side effects have been found.

Until more published data is known about this drug in relation to breastfeeding, known safer alternatives are preferable, especially during the neonatal period and in the event of prematurity.


See below the information of this related product:

  • Maternal Depression (Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.)

Alternatives

  • Duloxetine (Safe substance and/or breastfeeding is the best option.)
  • Paroxetine (Safe substance and/or breastfeeding is the best option.)
  • Pregabalin (Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.)
  • Sertraline Hydrochloride (Safe substance and/or breastfeeding is the best option.)

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

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Other names

Milnacipran Hydrochloride is also known as


Milnacipran Hydrochloride in other languages or writings:

Groups

Milnacipran Hydrochloride belongs to these groups or families:

Tradenames

Main tradenames from several countries containing Milnacipran Hydrochloride in its composition:

List of 10 tradenames

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 85 - 90 %
Molecular weight 283 daltons
Protein Binding 13 %
VD 5.5 - 6.8 l/Kg
pKa 9.8 -
Tmax 2 - 4 hours
T½ 6 - 8 hours
Theoretical Dose 0.02 - 0.04 mg/Kg/d
Relative Dose 2.8 %

References

  1. FDA. MIlnacipran (Savella). Drug Summary. 2012 Full text (in our servers)
  2. Trenque T, Herlem E, Auriche P, Dramé M. Serotonin reuptake inhibitors and hyperprolactinaemia: a case/non-case study in the French pharmacovigilance database. Drug Saf. 2011 Abstract
  3. EMeA Questions and answers on the recommendation for the refusal of the marketing authorisation for Milnacipran EMA 2009 Full text (in our servers)
  4. EMeA Preguntas y respuestas sobre la recomendación de denegar la autorización de comercialización de \ Milnacipran EMA 2009
  5. Puozzo C, Panconi E, Deprez D. Pharmacology and pharmacokinetics of milnacipran. Int Clin Psychopharmacol. 2002 Abstract

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