Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Fetzima (Levomilnacipran).
Abnormal bleeding: Fetzima (Levomilnacipran), like other similar medications, may cause abnormal bleeding, including bleeding in the stomach or intestines. If you have or have had a history of bleeding disorders, discuss with your doctor how Fetzima (Levomilnacipran) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Fetzima (Levomilnacipran), and whether any special monitoring is needed.
Report any unusual bruising or bleeding to your doctor, especially if you are taking other medications that affect blood clotting. These medications include acetylsalicylic acid (Asa), Clopidogrel, Dipyridamole, nonsteroidal anti-inflammatory drugs (NSAIDs; e.g., Ibuprofen or Naproxen), other anticoagulant medications (e.g., Warfarin), and certain antipsychotic medications.
Blood pressure: Fetzima (Levomilnacipran) may cause an increase in blood pressure or make existing high blood pressure worse. If you have high blood pressure or have any medical conditions that would be affected by increased blood pressure, discuss with your doctor how Fetzima (Levomilnacipran) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Fetzima (Levomilnacipran), and whether any special monitoring is needed.
Bone fracture: Other medications similar to Fetzima (Levomilnacipran) have been linked to an increased risk of bone fractures (breaks). There may be similar risks when taking Fetzima (Levomilnacipran). If you are at risk for developing Osteoporosis, or have osteoporosis or any other illness that increases your risk for breaking bones, discuss with your doctor how Fetzima (Levomilnacipran) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Fetzima (Levomilnacipran), and whether any special monitoring is needed.
Diabetes: How Fetzima (Levomilnacipran) affects a person with diabetes has not been studied. It is possible that Fetzima (Levomilnacipran) may cause a change in glucose tolerance. If you have diabetes or are at risk for developing diabetes, discuss with your doctor how Fetzima (Levomilnacipran) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Fetzima (Levomilnacipran), and whether any special monitoring is needed.
Glaucoma: Fetzima (Levomilnacipran) can cause an increase in the pressure in the eye, making symptoms of glaucoma worse. If you have narrow-angle glaucoma, discuss with your doctor how Fetzima (Levomilnacipran) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Fetzima (Levomilnacipran), and whether any special monitoring is needed.
Kidney function: Kidney Disease or reduced kidney function may cause Fetzima (Levomilnacipran) to build up in the body, causing side effects. If you have reduced kidney function or kidney disease, discuss with your doctor how Fetzima (Levomilnacipran) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Fetzima (Levomilnacipran), and whether any special monitoring is needed.
Heart problems: Fetzima (Levomilnacipran) can cause an increased heart rate and high blood pressure. Together, these side effects can cause congestive heart failure and Angina symptoms to become worse. If you have heart disease such as angina, congestive heart failure, or arrhythmia, discuss with your doctor how Fetzima (Levomilnacipran) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Fetzima (Levomilnacipran), and whether any special monitoring is needed. Contact your doctor as soon as possible if you develop symptoms of heart problems such as shortness of breath, chest pain, rapid heartbeat, or swollen ankles.
Mania: Fetzima (Levomilnacipran) may cause symptoms of mania to worsen or return. If you have a history of mania or bipolar disorder, discuss with your doctor how Fetzima (Levomilnacipran) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Fetzima (Levomilnacipran), and whether any special monitoring is needed.
Seizures: The effect of Fetzima (Levomilnacipran) on a person who has a history of seizures has not been thoroughly studied. If you have a seizure disorder, discuss with your doctor how Fetzima (Levomilnacipran) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Fetzima (Levomilnacipran), and whether any special monitoring is needed.
Serotonin syndrome: Severe reactions are possible when Fetzima (Levomilnacipran) is combined with other medications that act on serotonin, such as tricyclic antidepressants, "triptan" medications for migraine, and some medications to treat nausea due to chemotherapy. These combinations should be avoided. Symptoms of a reaction may include muscle rigidity and spasms, difficulty moving, and changes in mental state including delirium and agitation. Coma and death are possible.
Stopping the medication: Stopping Fetzima (Levomilnacipran) suddenly may lead to side effects such as dizziness, abnormal dreams, numbness or tingling sensations, agitation, anxiety, nausea, vomiting, sweating, or other symptoms. If you are thinking of stopping the medication, check with your doctor first. Your doctor may want you to decrease the dose of the medication gradually when it is time to stop taking Fetzima (Levomilnacipran).
Suicidal or agitated behaviour: People taking Fetzima (Levomilnacipran) may feel agitated (restless, anxious, aggressive, emotional, and feeling not like themselves), or they may want to hurt themselves or others. These behavioural changes may be more likely to occur in children and adolescents, however they are possible for all age groups that use Fetzima (Levomilnacipran). These symptoms may occur within several weeks after starting Fetzima (Levomilnacipran). If you experience these side effects or notice them in a family member who is taking Fetzima (Levomilnacipran), contact your doctor immediately. You should be closely monitored by your doctor for emotional and behavioural changes while taking Fetzima (Levomilnacipran).
Urinary problems: Fetzima (Levomilnacipran) can affect urinary tract function. It may cause difficulty starting urine flow, completely emptying the bladder or contribute to incontinence (urine leakage). If you have a history of urinary retention or benign prostatic hypertrophy, or other prostate problems, discuss with your doctor how Fetzima (Levomilnacipran) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Fetzima (Levomilnacipran), and whether any special monitoring is needed.
Pregnancy: Fetzima (Levomilnacipran) should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Fetzima (Levomilnacipran), contact your doctor immediately.
Breast-feeding: It is not known if Fetzima (Levomilnacipran) passes into breast milk. If you are a breast-feeding mother and are taking Fetzima (Levomilnacipran), it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children and adolescents: The safety and effectiveness of Fetzima (Levomilnacipran) for people under 18 years of age have not been established. The use of Fetzima (Levomilnacipran) by children and adolescents less than 18 years old may cause behavioural and emotional changes, such as suicidal thoughts and behaviour.
Seniors: Seniors may need lower doses of Fetzima (Levomilnacipran) and should be closely monitored by their doctor when taking Fetzima (Levomilnacipran).
