levomilnacipran
Brand names: Fetzima
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.
Drug Pricing (NADAC)
Brand Price
$16.13/unit
Generic Available
No
ABBVIE
Pricing data from NADAC (CMS), effective January 2, 2024. Compare all drug costs →
What it does
Fetzima is used to treat major depressive disorder (MDD) in adults.
Common side effects
Nausea, Constipation, Increased sweating
Key warnings
Antidepressants may increase the risk of suicidal thoughts and behaviors in young adults.
How It Works
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.
How to Take It
Take Fetzima exactly as your doctor tells you to. The usual dose is between 40 mg and 120 mg once a day. You can take it with or without food. Swallow the capsule whole; do not crush, chew, or open it.
Pregnancy & Breastfeeding
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.
Missed Dose
If you miss a dose, take it as soon as you remember. If it is close to your next dose, skip the missed dose and continue with your regular schedule.
Storage
Store Fetzima at room temperature, away from moisture and heat.
Side Effects (from patient reports)
Based on 2,050 FDA adverse event reports.
FDA Adverse Event Report Analysis
Detailed analysis of 1,858 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2013–2025.
Total Reports
1,858
Death-Related Reports
154
Hospitalization Reports
283
Top Indication
Product Used For Unknown Indication
Gender Distribution
Age Distribution
Most Reported Adverse Reactions (FAERS)
| # | Reaction | Reports |
|---|---|---|
| 1 | OFF LABEL USE | 327 |
| 2 | DRUG INEFFECTIVE | 246 |
| 3 | PAIN | 210 |
| 4 | VOMITING | 208 |
| 5 | MEMORY IMPAIRMENT | 189 |
| 6 | PARAESTHESIA | 179 |
| 7 | HYPOAESTHESIA | 178 |
| 8 | ABDOMINAL PAIN UPPER | 175 |
| 9 | MIGRAINE | 170 |
| 10 | GASTROOESOPHAGEAL REFLUX DISEASE | 168 |
| 11 | DRUG INTOLERANCE | 162 |
| 12 | TASTE DISORDER | 157 |
| 13 | EPILEPSY | 155 |
| 14 | BLEPHAROSPASM | 152 |
| 15 | NAUSEA | 143 |
Reactions in Death Reports
Reactions in Hospitalization Reports
Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation
Serious Warnings
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.
Known Drug Interactions
Within 14 days of stopping an MAOI intended to treat psychiatric disorders In a patient who is being treated with linezolid or intravenous methylene blue [see Dosage and Administration ( 2.5 , 2.6 ), Contraindications ( 4 ), and Warnings and Precautions ( 5.2 )] . Examples: selegiline, tranylcypromine, isocarboxazid, phenelzine, linezolid, methylene blue Other Serotonergic Drugs Clinical Impact: Concomitant use of FETZIMA with other serotonergic drugs increases the risk of serotonin syndrome.
Mechanism: Both of these medications increase the levels of a brain chemical called serotonin. If levels get too high, it can lead to a serious and potentially life-threatening reaction.
What to do: Do not take these two medicines together. Your doctor will typically wait at least two weeks after stopping one before starting the other.
Examples: selegiline, tranylcypromine, isocarboxazid, phenelzine, linezolid, methylene blue Other Serotonergic Drugs Clinical Impact: Concomitant use of FETZIMA with other serotonergic drugs increases the risk of serotonin syndrome.
Mechanism: Both drugs increase serotonin levels in the brain, which can lead to a dangerous buildup called serotonin syndrome.
What to do: Do not take these medicines together because the combination can cause serious side effects.
Examples: selegiline, tranylcypromine, isocarboxazid, phenelzine, linezolid, methylene blue Other Serotonergic Drugs Clinical Impact: Concomitant use of FETZIMA with other serotonergic drugs increases the risk of serotonin syndrome.
Mechanism: These drugs both raise serotonin levels, and using them at the same time can cause too much serotonin to build up in your body.
What to do: Avoid using these two drugs together to prevent a potentially dangerous reaction.
Examples: selegiline, tranylcypromine, isocarboxazid, phenelzine, linezolid, methylene blue Other Serotonergic Drugs Clinical Impact: Concomitant use of FETZIMA with other serotonergic drugs increases the risk of serotonin syndrome.
Mechanism: Taking these medications together can cause serotonin levels to become dangerously high, leading to a condition called serotonin syndrome.
What to do: Talk to your doctor before using these together, as this combination is generally avoided.
Examples: other SNRIs, SSRIs, triptans, tricyclic antidepressants, opioids, lithium, buspirone, amphetamines, tryptophan, and St.
Mechanism: Both of these medicines increase the levels of a brain chemical called serotonin. Taking them together can cause serotonin levels to become dangerously high.
What to do: Your doctor should monitor you closely for signs of too much serotonin, such as shivering, sweating, or confusion. Tell your provider immediately if you feel unusual.
Common Questions
What should I do if I feel worse after starting Fetzima?
Can I drink alcohol while taking Fetzima?
What if I have kidney problems?
Can I stop taking Fetzima suddenly?
Will Fetzima affect my other medications?
How long does it take for Fetzima to start working?
What if I have bipolar disorder?
Can Fetzima cause sexual side effects?
What if I need surgery?
Is there a generic version of Fetzima?
What are the common side effects of levomilnacipran?
Does levomilnacipran interact with other medications?
What drug class is levomilnacipran?
Is levomilnacipran safe during pregnancy?
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What the FDA Data Shows for levomilnacipran
The FDA label for levomilnacipran (sold under brand names such as Fetzima) classifies it as a prescription-only medication in the Serotonin-Norepinephrine Reuptake Inhibitor (SNRI) class. Fetzima is used to treat major depressive disorder (MDD) in adults. Official labeling lists 9 commonly reported side effects, including Nausea, Constipation, Increased sweating.
Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 2,050 voluntary reports. The database also lists 11 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated moderate severity. NADAC pricing from CMS.
Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history, and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.
Data Sources
Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).
FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.
Last updated: April 30, 2024
Read our methodology — how this data is sourced, computed, and verified.
All federal data sources used on this page
- FDA Orange Book — approved drug products with therapeutic equivalence. accessdata.fda.gov/cder/ob
- FDA DailyMed — NIH-hosted drug labeling for FDA-approved meds. dailymed.nlm.nih.gov
- FDA Adverse Event Reporting System (FAERS) — post-marketing safety surveillance. fda.gov/drugs/faers
- NLM RxNorm — standardized clinical drug nomenclature. nlm.nih.gov/research/umls/rxnorm
- CMS Medicare Part B Drug Average Sales Price Files — federal drug pricing data. cms.gov/medicare/part-b-drugs/asp
- FDA Drug Shortages Database — current and resolved drug shortage tracking. accessdata.fda.gov/drugshortages