Generally, we all want our medicines to be as effective as possible, and that requires effort on our part. It may be necessary to avoid taking pills with certain foods or drinks and to check that medications won’t interfere with each other.
And in some cases, it may be important to take a drug at a particular time of day. This approach, known as chronotherapy, is gaining attention as research suggests a relationship between when we take medications and how well they work.
What is Fetzima?
Fetzima is a brand of levomilnacipran a medication used to treat depression. Levomilnacipran is in a class of medications called selective serotonin and norepinephrine reuptake inhibitors (SNRIs). It works by increasing the amount of serotonin and norepinephrine, natural substances in the brain that help maintain mental balance.
The National Institute of Mental Health (NIMH) estimates that 19.4 million adults, or 7.8 percent of all adults in the United States, had at least one episode of major depression in 2019.
Episodes of major depression were more common among:
- women (9.6 percent, compared to 6 percent in men)
- people between the ages of 18 and 25 (15.2 percent)
- people who describe themselves as being of two or more races or ethnicities (13.7 percent)
How should Fetzima be used?
Levomilnacipran comes as an extended-release (long-acting) capsule to take by mouth. It is usually taken once daily with or without food. Take levomilnacipran at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take levomilnacipran exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Swallow the capsules whole; do not open, chew, or crush them.
Your doctor may start you on a low dose of levomilnacipran and gradually increase your dose, not more than once every 2 days.
Fetzima (Levomilnacipran) controls depression but does not cure it. It may take several weeks or longer before you feel the full benefit of levomilnacipran. Continue to take levomilnacipran even if you feel well. Do not stop taking levomilnacipran without talking to your doctor. Your doctor will probably decrease your dose gradually. If you suddenly stop taking levomilnacipran, you may experience withdrawal symptoms such as mood changes, agitation, irritability, dizziness, ringing in the ears, shock-like sensations, anxiety, confusion, tiredness, difficulty falling asleep or staying asleep, numbness or tingling in the arms, legs, hands, or feet, headache, increased sweating, seizures, or nausea. Tell your doctor if you experience any of these symptoms when your dose of levomilnacipran is decreased.
What is the best time to take Fetzima morning or night?
The best time to take Fetzima is at night just before you go to bed. This is because Fetzima can cause drowsiness or sleepiness and may affect your ability to make decisions, think clearly, or react quickly if you take it during the morning or during day time.
You should also remember that combining Fetzima with stimulants whether during the day or night can also increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking and blurred vision.
What are the other side effects of Fetzima?
Get emergency medical help if you have signs of an allergic reaction: skin rash or hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Report any new or worsening symptoms to your doctor, such as mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.
Call your doctor at once if you have:
• blurred vision, tunnel vision, eye pain or swelling, eye redness;
• painful or difficult urination;
• easy bruising, unusual bleeding, purple or red spots under your skin;
• pounding heartbeats or fluttering in your chest;
• seizure (convulsions);
• manic episodes–racing thoughts, increased energy, decreased need for sleep, risk-taking behavior, being agitated or talkative; or
• low sodium level–headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady.
Serious side effects may be more likely in older adults.
Seek medical attention right away if you have symptoms of serotonin syndrome, such as agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.
Common side effects may include:
• nausea, vomiting, constipation;
• irregular heartbeats;
• sweating; or
• decreased sex drive, impotence, or difficulty having an orgasm.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
