levomilnacipran

• Risk factors: Age under 24 years old | History of depression

Antidepressants like Fetzima (levomilnacipran) can raise the risk of worsening depression. They can also raise the risk of suicidal thoughts or behavior. The risk is higher in people younger than 24 and in people with depression. Talk to your prescriber if you're worried about this risk.

Watch for signs of depression and suicidal thoughts or behavior. This is important to do during the first few months of treatment and when your dose changes. Tell your prescriber if you or your loved ones notice any unusual changes in your mood or behavior while taking this medication. Call 911 if you have suicidal thoughts or behavior.

• Risk factors: Taking other medications that can raise serotonin in the brain

Although it's rare, Fetzima (levomilnacipran) can cause a serious condition called serotonin syndrome. This happens when there's too much serotonin in the brain. The risk is higher if you take other medications that also raise serotonin. Examples include other antidepressants, some opioids, and triptans for migraine. Tell your prescriber and pharmacist about all the medications you take. They can check your risk for serotonin syndrome.

Stop taking Fetzima (levomilnacipran) and get medical help right away if you have any symptoms of serotonin syndrome. This can look like fever, sweating, trouble moving or walking, distress, or hallucinations.

• Risk factors: History of high blood pressure | History of heart problems | History of having problems with blood flow to the brain | History of problems with heart rate

Some people taking Fetzima (levomilnacipran) have had higher blood pressure or a faster heart rate. If you have high blood pressure or take medication for your heart, talk to your prescriber before starting Fetzima (levomilnacipran). They can check if it's safe for you.

Your care team will check your blood pressure and heart rate before you start Fetzima (levomilnacipran). They'll also check at follow-up visits during treatment. They might also ask you to check at home.

Let your care team know if your blood pressure or heart rate stays high while taking Fetzima (levomilnacipran). Your care team can help you manage these side effects. You might need a lower dose or you might have to stop the medication.

• Risk factors: Taking other medications that can make bleeding more likely (e.g., blood thinners, NSAIDs)

Fetzima (levomilnacipran) can make you more likely to bleed or bruise. This risk is higher if you also take blood thinners or nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil). These medications can also raise the risk of bleeding.

Some bleeding or bruising can be mild, like with nosebleeds. But it can also be more serious. Tell your prescriber if you have any unusual bleeding or bruising or if it doesn't go away while taking Fetzima (levomilnacipran).

Antidepressants like Fetzima (levomilnacipran) can make glaucoma worse in some people. Tell your prescriber if you have narrow-angle eyes or angle-closure glaucoma and haven't had laser surgery. Call your eye specialist right away if you have sudden blurry vision, severe eye pain, or see halos around lights. These could be signs of an angle-closure attack, a serious eye condition that needs urgent care.

Fetzima (levomilnacipran) can cause sexual problems as a side effect. They can include a lower sex drive, trouble getting or keeping an erection, problems ejaculating, and trouble having an orgasm. Tell your prescriber if you notice any changes in your sex life and when they started. They can check if something else is causing the problem and help you find ways to manage this side effect.

• Risk factors: Older adults | Taking diuretics (water pills) | Dehydration

Antidepressants like Fetzima (levomilnacipran) can cause low sodium levels in your body. Tell your prescriber if you feel weak, confused, or unsteady. These symptoms can raise your risk of falling. Also tell them if you have trouble thinking clearly, headaches, memory problems, or hallucinations. They can all be signs of low sodium, which should be treated right away.

• Risk factors: Personal or family history of bipolar disorder or mania

Before starting Fetzima (levomilnacipran), tell your prescriber if you or someone in your family has bipolar disorder. They can help decide if this medication is right for you.

Treating someone with bipolar disorder with an antidepressant alone can cause them to have a manic episode. This can look like being overly excited, being very active, talking a lot, or having delusions. Although rare, some people who took Fetzima (levomilnacipran) had symptoms of mania.

Call your prescriber right away if you or someone close to you notices unusual changes in your behavior after you take Fetzima (levomilnacipran).