Highlighting side effects, warnings, interactions, and more


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US brand name: Savella
Generic name: milnacipran

Savella’s Potential Side Effects

Potential Side Effects All Crazy Meds Have

No matter which neurological and/or psychiatric drug you take, you’ll probably get one or more of these side effects. These will usually be gone, or at least will diminish to the point where you barely notice it most of the time, within a week or two.

  • Headache
  • Drowsiness / fatigue - even when taking stimulants in some circumstances.
  • Insomnia, instead of or alternating with the drowsiness.
  • Nausea
  • Assorted other minor GI complaints (constipation, diarrhea, etc.)
  • Generally feeling spacey / out of it
    • Which can all add up to the ever-helpful “flu-like symptoms” listed as an adverse event on the PI sheet of practically every medication on the planet used to treat almost any condition humans and other animals could have.1
  • All crazy meds can, and probably will affect your dreams as well. There is no way of telling if that will be good or bad, let alone if this side effect is permanent or temporary.
  • Any of the above side effects you see listed again below means they’re even more likely to happen and/or stick around longer and/or are worse than most other meds.

Typical Potential Side Effects

The usual for SNRIs: headache, nausea, dry mouth, sweating, urinary hesitancy, constipation, dizziness, and insomnia . Because Savella / Ixel works on norepinephrine much more than serotonin, popular TCA side effects are much more common than with other SNRIs. These include flushing / hot flashes, high blood pressure (hypertension), heart palpitations / irregular heartbeat (tachycardia), and increased heartbeat. And like every crazy med on the planet, Savella / Ixel will affect your dreams.

Uncommon Potential Side Effects

Weight loss (not all side effects are bad, unless you can’t afford to lose weight), itchy skin with no rash (pruritus), migraine, making symptoms worse .

Freaky Rare Side Effects

Savella has The. Best. Freakiest. Rarest. Side Effect. EVER!!! That should be Toledomin has it, because this happened in Japan and the guy was taking it as an antidepressant. Nothing comes close to this one:

Ejaculation After Defecation Without Orgasm Induced by Milnacipran

One of the things that makes this the best freaky rare side effect in the history of medication is the way the report is written. It’s not entirely clear what changed and what problem the guy had with it. Did he normally have anorgasmia and Toledomin made him need to take a dump? Did he normally jack-off when the was on the toilet and Toledomin caused anorgasmia? Whatever it was, it sucked less than depression, because this went on for over a year and he refused to stop taking the milnacipran.

Since it happened in Japan, I wouldn’t be surprised if there’s now some kind of anorgasmic scat fetish underground.

Not all side effects have been listed here, just the most likely and most interesting. For all reported side effects, see Savella’s PI Sheet.

What You Really Need to be Careful About

Your liver could implode. It’s unlikely to happen if you’re taking only Savella / Ixel, you don’t drink and you don’t smoke. You should still get regular blood tests.

Pregnancy Category

C-Use with caution

Savella’s Noted Drug-Drug, Drug-Food & Drug-Supplement Interactions

Don’t drink alcohol when you take Savella / Ixel. This has nothing to do with operating heavy machinery, but has everything to do with your liver. Unless you have the same pull as David Crosby2 with the organ donor registry, you’ll want to avoid alcohol, nicotine, and charbroiled meat (no, really) as much as you can. You sure as hell don’t want to be taking Savella / Ixel and Depakote together. NSAIDs, including Tylenol (acetaminophen), were used along with Savella in some of the clinical trials. I’d be leery of mixing acetaminophen with milnacipran.

Check for Other Drug-Drug, Drug-Food & Drug-Supplement Interactions Savella may have at

Drugs.com’s drug-drug and drug-food interaction checker

It’s always a good idea to check for drug-drug interactions yourself. Just because most people in the crazy meds business know about really important interactions (e.g. MAOIs and a lot of stuff, warfarin and everything on the planet) doesn’t mean the person who prescribed your meds told you about them, or the pharmacist has all the meds you take at their fingertips like they’re supposed to. Or they have the time to do their jobs properly when not dealing with complete idiots or playing Angry Farmers on teh Faecesbooks.
Learn more about drug-everything interactions on our page of tips about taking crazy meds.

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1 As well as being an indication of half of said conditions.

2 He drank his liver into a rock-solid mass of uselessness, got a transplant for being a self-medicating, raging alcoholic asshole, did the same thing in a shorter period of time, then got another transplant! What do you call someone with bipolar disorder who took their Depakote as directed, didn't self-medicate, and ended up needing a transplant because their doctor never ordered a liver function test? Dead, that's what you call them, because we get sent to the bottom of the list for being suicide risks. No matter how badly we want to stay alive.

Last modified on Wed, 04 May, 2016 at 17:17:56 by JerodPoorePage Author Date created Saturday, 04 October 2014 at 17:55:01
“Savella (milnacipran) Pharmacology” by Jerod Poore is copyright © 2014 Jerod Poore Published online 2014/10/05

Savella, and all other drug names on this page and used throughout the site, are the trademarks of someone else. Savella’s PI Sheet will probably have the name of the manufacturer and trademark owner (they’re not always the same company) at or near the very bottom. Or ask Google who the owner is. The way pharmaceutical companies buy each other and swap products like Monopoly™ real estate, the ownership of the trademark may have changed without my noticing. It may of changed hands by the time you finished reading this article.

Page design and explanatory material by Jerod Poore, copyright © 2003 - 2016. All rights reserved. See the full copyright notice for full copyright details.
Don’t automatically believe everything you read on teh Intergoogles. No warranty is expressed or implied in this information. Consult one or more doctors and/or pharmacists before taking, or changing how you take any neurological and/or psychiatric medication. Your mileage may vary. What happened to us won’t necessarily happen to you. For more details see the Crazymeds big-ass disclaimer.

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