Brand & Generic Names; Drug Classes
|US brand name: Fetzima|
|Generic name: levomilnacipran extended-release|
|Primary drug class: Antidepressants|
|Additional drug class(es): Serotonin and Norepinephrine Reuptake Inhibitors|
Approved & Off-Label Uses (Indications)
Fetzima’s US FDA Approved Treatment(s)
short-term (8 weeks) treatment of Major Depressive Disorder (MDD).
Uses Approved Overseas but not in the US
Off-Label Uses of Fetzima
I have never seen this before:
Limitation of Use: FETZIMA is not approved for the management of fibromyalgia. The efficacy and safety of FETZIMA for the management of fibromyalgia have not been established. --the Fetzima PI sheet
Forest is specifically telling doctors and consumers to not use a med for an off-label purpose. While Forest has a vested interest in making sure people still buy Savella, based upon how Fetzima works, they do have a point. Fetzima isn’t going to make you puke like Savella, and it’s easier to take, but it won’t work as well for fibromyalgia or other forms of chronic pain than Savella will. BUT, a med you can tolerate that does a half-assed job is better than a med you literally can’t stomach. So if Savella works better for you than Cymbalta, but you can’t deal with the side effects, you may as well give Fetzima a shot. Just make sure the side effects weren’t from SSRI/SNRI discontinuation syndrome. If you were taking 60mg (or more) a day of Cymbalta and your doctor had you stop taking it all at once when starting you at 12.5 mg of Savella, find another doctor! Then consider giving Savella another chance.
When & If Fetzima Will Work
Fetzima’s Usual Onset of Action (when it starts working)
Like any SNRI, expect Fetzima to start working in 2 to 4 weeks.
Likelihood of Working
Fetzima doesn’t seem to be much better than most antidepressants in the short-run. When it comes to long-term (maintenance) use,Fetzima is only so-so when it comes to keeping depression away.
Taking and Discontinuing
How to Take Fetzima
Forest Laboratories recommends:
The recommended dose range for FETZIMA is 40 mg to 120 mg once daily, with or without food. FETZIMA should be initiated at 20 mg once daily for 2 days and then increased to 40 mg once daily. Based on efficacy and tolerability, FETZIMA may then be increased in increments of 40 mg at intervals of 2 or more days. The maximum recommended dose is 120 mg once daily.
FETZIMA should be taken at approximately the same time each day. FETZIMA should be swallowed whole. Do not open, chew or crush the capsule.
How to Stop Taking Fetzima (discontinuation / withdrawal)
It’s an SNRI, so you had better do it as slowly and carefully as possible.