duloxetine vs levomilnacipran
PlainMeds reviewed this comparison against our methodology in August 2026. It places FDA and CMS record fields side by side, without recommending either medication.
Side-by-side comparison of duloxetine and levomilnacipran. Data from FDA drug databases (Orange Book, NDC Directory, recalls, shortages) covering 20,000+ approved drugs, plus CMS pricing; see our methodology.
Cymbalta
Fetzima
Duloxetine is a medicine that can help treat depression and anxiety. It can also help with certain types of pain.
Fetzima is a medicine used to treat major depressive disorder (MDD) in adults. It helps to improve your mood by affecting certain chemicals in the brain.
Duloxetine can treat major depressive disorder and generalized anxiety disorder in adults and children (7 years and older). It can also treat diabetic nerve pain, fibromyalgia, and chronic muscle or bone pain in adults. In children, it can treat fibromyalgia (13 years and older).
Fetzima is used to treat major depressive disorder (MDD) in adults. MDD can cause you to feel sad, lose interest in activities, and have trouble with daily life. Fetzima can help improve your mood and reduce these symptoms.
Duloxetine is a type of drug called an SNRI. It works by increasing the levels of serotonin and norepinephrine in your brain. These chemicals can help improve mood and reduce pain.
Fetzima is a type of drug called a serotonin-norepinephrine reuptake inhibitor (SNRI). It works by increasing the levels of serotonin and norepinephrine in your brain. These chemicals can help improve your mood and reduce symptoms of depression.
- • Nausea
- • Dry mouth
- • Sleepiness
- • Constipation
- • Decreased appetite
- • Nausea
- • Constipation
- • Increased sweating
- • Increased heart rate
- • Erectile dysfunction
- Fatigue 4,787
- Nausea 4,782
- Pain 3,697
- Headache 3,654
- Diarrhoea 3,262
- Pain 210
- Vomiting 208
- Memory Impairment 189
- Paraesthesia 179
- Hypoaesthesia 178
Antidepressants may increase the risk of suicidal thoughts and behaviors in children, teenagers, and young adults. Watch closely for worsening depression or suicidal thoughts. Tell your doctor right away if you notice any changes in mood or behavior.
Antidepressants may increase the risk of suicidal thoughts and behaviors in young adults. Your doctor should closely watch you for worsening depression or suicidal thoughts. Fetzima is not approved for use in children.
Using duloxetine in the last month of pregnancy may cause problems in the newborn. Talk to your doctor about the risks and benefits of taking duloxetine during pregnancy. Women who stop taking antidepressants during pregnancy are more likely to experience a relapse of depression.
Tell your doctor if you are pregnant or plan to become pregnant. Using Fetzima in the last months of pregnancy may cause problems in the newborn. There is a pregnancy registry for women who take antidepressants during pregnancy.
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How to Read This duloxetine vs levomilnacipran Comparison
duloxetine is classified in the Serotonin-Norepinephrine Reuptake Inhibitor (SNRI) drug class, while levomilnacipran sits within the Serotonin-Norepinephrine Reuptake Inhibitor (SNRI) class. Because both drugs share the same classification, they are often considered interchangeable in theory, but clinical outcomes rarely track that cleanly. Both drugs are prescription-only, so a licensed provider must authorize use.
Adverse event totals above are pulled from the FDA's Adverse Event Reporting System (FAERS). For these top-ranked reactions alone, duloxetine has 20,182 submissions while levomilnacipran has 964. Those figures reflect cumulative reporting volume, not per-patient risk, so older, widely dispensed drugs typically look worse on count alone. No direct interaction between these two drugs is listed in our FDA-derived dataset, though co-prescription still warrants pharmacist review. Serious warnings, pregnancy guidance, and contraindications can differ even when indications overlap.
A table cannot represent individual circumstances. Data here is sourced from FDA Structured Product Labels (SPL) and FAERS, both of which update as manufacturers and clinicians submit new information. This registry does not provide medical, treatment, substitution, or medication-change directions for duloxetine or levomilnacipran.
Registry boundary: This comparison displays source-record fields and does not provide individualized medical direction.