Milran 50 Tablet

Generic Name: Milnacipran Hydrochloride

Strength: 50mg

Indications:

Milran is indicated for the management of fibromyalgia. It is not approved for use in pediatric patients.

Pharmacology:

Milnacipran is a potent inhibitor of neuronal norepinephrine and serotonin reuptake, with approximately a 1:3 ratio, respectively. This action helps to treat both depression and fibromyalgia and improves multiple fibromyalgia symptoms such as peripheral and central pain, depressiveness, sleep, and quality of life.

Dosage & Administration:

The recommended dose of Milnacipran HCl is 100 mg/day (50 mg twice daily).

The dosing may be titrated based on efficacy and tolerability, according to the following schedule:

• Day 1: 12.5 mg once

• Days 2-3: 25 mg/day (12.5 mg twice daily)

• Days 4-7: 50 mg/day (25 mg twice daily)

• After Day 7: 100 mg/day (50 mg twice daily)

Based on individual patient response, the dose may be increased to 200 mg/day (100 mg twice daily). Doses above 200 mg/day have not been studied. It should be taken with food, preferably during meals.

Interaction:

• Increased risk of bleeding with aspirin, NSAIDs, warfarin, and other drugs that affect coagulation.

• Increased CNS effects with centrally-acting drugs (e.g., clomipramine).

• Increased risk of serotonin syndrome and NMS-like reactions with serotonergic drugs (e.g., tramadol), SSRIs, other selective serotonin-norepinephrine reuptake inhibitors, 5-HT1 receptor agonists (e.g., sumatriptan),