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Fetzima Coupon - Fetzima 40mg capsule

Fetzima

levomilnacipran
Used for Depression
Used for Depression

Fetzima, the brand name for levomilnacipran, is used to treat depression in adults. This antidepressant belongs to the drug class called serotonin and norepinephrine reuptake inhibitors (SNRIs). It comes as an extended-release capsule that you take by mouth once a day. You can take this medication at any time of the day, but make sure you take it about the same time each day. Side effects include nausea, constipation, and sweating.

Last reviewed on May 5, 2025
basics-icon

What is Fetzima (levomilnacipran)?

What is Fetzima (levomilnacipran) used for?

How Fetzima (levomilnacipran) works

Fetzima (levomilnacipran) is a serotonin and norepinephrine reuptake inhibitor (SNRI). It works by raising the amount of serotonin and norepinephrine in the brain. These chemicals play a role in regulating mood.

Are you looking for information on Savella (milnacipran) or dapagliflozin (Farxiga) instead?
When does Fetzima (levomilnacipran) start working?
Time passed since treatment started:
HOURS
DAYS
WEEKS
MONTHS
Initial effect
Full effect

Drug Facts

Common BrandsFetzima
Drug ClassSNRI
Controlled Substance ClassificationNot a controlled medication
Generic StatusNo lower-cost generic available
AvailabilityPrescription only

More on Fetzima (levomilnacipran) essentials

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Avg retail price
$637.79(save 22.68%)
GoodRx discount
$493.12
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What are the side effects of Fetzima (levomilnacipran)?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

  • Nausea (17%)
  • Constipation (9%)
  • Sweating (9%)
  • Fast heart rate (6%)
  • Erectile dysfunction (6%)
  • Vomiting (5%)

Other Side Effects

  • Stomach pain
  • Gas
  • Lower appetite
  • Migraine
  • Numbness or tingling
  • Dry eye
  • Dry skin
  • Itching
  • Rash
  • Hot flash
  • Problems with urination (e.g., trouble urinating)
  • Changes in behavior
  • Higher blood pressure

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.
  • Suicidal thoughts or behaviors
  • Serotonin syndrome: fever, sweating, movement problems, distress, hallucinations
  • Bleeding or bruising: unusual bleeding or bruising, bleeding or bruising that doesn't go away, nosebleeds, blood in your urine or stool
  • Low sodium levels: headache, trouble concentrating, memory problems, confusion, weakness, unsteadiness, hallucinations, fainting
  • Seizure
When do Fetzima (levomilnacipran) possible side effects begin and end?
Time passed since treatment started:
MINUTES
HOURS
DAYS
WEEKS
MONTHS
Nausea
Fast heart rate
Constipation
Sexual problems
Risk of suicidal thoughts or behaviors
Seek immediate medical care if you experience this side effect.
If a line continues to the right, you'll likely keep experiencing this side effect once it starts.

Source: DailyMed

The following side effects have also been reported

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

Difficult urination

fast, pounding, or irregular heartbeat or pulse

Less common

Anxiety

arm, back, or jaw pain

blurred vision

burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings

chest pain or discomfort

chest tightness or heaviness

cloudy urine

confusion

decrease in the frequency of urination

difficulty in passing urine (dribbling)

difficulty with speaking

dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position

drooling

dry mouth

fainting

headache

irritability

loss of balance control

muscle trembling, jerking, or stiffness

nausea

painful urination

pounding in the ears

rapid or irregular heartbeat

restlessness

shaking

shuffling walk

slow heartbeat

stiffness of the limbs

sweating

trouble breathing

trouble sleeping

twisting movements of the body

uncontrolled movements, especially of the face, neck, and back

unusual tiredness or weakness

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Difficulty having a bowel movement (stool)

increased sweating

loss in sexual ability, desire, drive, or performance

vomiting

Less common

Abdominal or stomach pain

bloated or full feeling

decreased appetite

dry eyes

dry skin

feeling of warmth

headache, severe and throbbing

hives or welts, itching, or rash

passing gas

red eye

red face, neck, arms, and occasionally, upper chest

sudden sweating

thirst

yawning

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

pros-and-cons

Pros and cons of Fetzima (levomilnacipran)

thumbs-up

Pros

A first-choice option for depression

Taken by mouth once a day

Low risk of weight gain

thumbs-down

Cons

Can make your heart race and raise your blood pressure

Can cause sexual side effects (e.g., low sex drive, erectile dysfunction)

Can have uncomfortable side effects if you stop the medication too suddenly

pharmacist-tips

Pharmacist tips for Fetzima (levomilnacipran)

pharmacist
  • You can take Fetzima (levomilnacipran) at any time of day that's convenient for you. Be sure to try to stick with around the same time each day. This helps make it part of your daily routine to help you remember to take your medication.

    • Swallow Fetzima (levomilnacipran) capsules whole. Don't open, crush, or chew the capsules. If you have trouble swallowing it whole, let your prescriber know. They might switch you to a different antidepressant that might be easier for you to take.

      • You can take Fetzima (levomilnacipran) with or without food. Taking it with food might help lessen stomach upset and nausea, which are common side effects.

        • Nausea and constipation are common side effects of Fetzima (levomilnacipran). Eating smaller meals can help with nausea. Drink plenty of water and eat more fiber to ease constipation. Tell your care team know if these side effects get uncomfortable or don't get better. They can help you manage them.

          • Your prescriber might ask you to check your blood pressure and heart rate at home. Fetzima (levomilnacipran) can make your blood pressure go up and your heart beat faster. Tell your care team if they stay higher than usual while you're taking this medication.

            • Don't lower your dose or suddenly stop taking Fetzima (levomilnacipran) without talking to your prescriber first. Otherwise, you might have withdrawal symptoms like nausea, headache, and sleep problems. Follow your prescriber's instructions to lower your dose slowly over time to stop the medication safely.

              • Make sure to tell your healthcare team and pharmacist about all the medications you take. Fetzima (levomilnacipran) interacts with some medications, such as other antidepressants, blood thinners, and blood pressure medications. Your care team can check that your medications are safe to take together.

                More on Fetzima (levomilnacipran) tips

                faqs

                Frequently asked questions about Fetzima (levomilnacipran)

                Should I take Fetzima (levomilnacipran) in the morning or night?
                You can take Fetzima (levomilnacipran) at any time of day. What's most important is to take it at the same time every day. Choose a time that's most convenient for you. This can also help you remember to take the medication each day. If you're not sure when to take Fetzima (levomilnacipran), or if you want to change when you take it, ask your prescriber or pharmacist for help.
                Does Fetzima (levomilnacipran) work?
                Studies show that Fetzima (levomilnacipran) works well to improve depression in adults. In the studies, these people took the medication for at least 2 months. In fact, clinical guidelines list SNRIs like Fetzima (levomilnacipran) as one of the top choices for depression. Talk to your prescriber about how well this medication might work for you.
                How long does Fetzima (levomilnacipran) take to work?
                Studies show that Fetzima (levomilnacipran) can start to improve mood within 2 weeks for some people. But it can take up to 2 months to get the full benefits from the medication. You might have side effects like nausea and constipation before your mood gets better. Don't get discouraged — keep taking Fetzima (levomilnacipran) as prescribed. Also note that everyone's experience with treatment is different. So, talk to your prescriber if you're not sure Fetzima (levomilnacipran) is working for you.
                Does Fetzima (levomilnacipran) help with anxiety?
                Fetzima (levomilnacipran) isn't FDA approved for treating anxiety. It's not clear if the medication helps with anxiety because there aren't many studies on it for that use. But there are other similar antidepressants that are known to work well for generalized anxiety. If you have anxiety, talk to your prescriber about the best options for you.
                Does Fetzima (levomilnacipran) cause hair loss?
                No, hair loss wasn't a side effect that people reported while taking Fetzima (levomilnacipran) in clinical trials. Talk to your primary care provider if you notice hair loss during treatment. They can examine you to see what might be causing any hair loss.
                Does Fetzima (levomilnacipran) cause weight gain?
                It's possible to experience weight gain while taking antidepressants. But the risk is lower with Fetzima (levomilnacipran) than with some other antidepressants. In one study, people who took Fetzima (levomilnacipran) for almost a year had very little change in weight. On average, they lost about 1 pound. Talk to prescriber or primary care provider if you notice unexpected weight changes after starting this medication.
                Does Fetzima (levomilnacipran) make you sleepy?
                Sleepiness is a possible side effect of SNRIs like Fetzima (levomilnacipran). But it doesn't seem to be common. It's a good idea not to drive or do anything that needs a lot of focus until you know how the medication affects you. Talk to your prescriber if Fetzima (levomilnacipran) makes you too sleepy during the day. They might lower your dose or switch you to a different medication.
                Can you take Fetzima (levomilnacipran) while pregnant?
                Tell your prescriber if you're pregnant or thinking of becoming pregnant. They can help you understand the benefits and risks of taking Fetzima (levomilnacipran) while pregnant. Taking SNRIs like Fetzima (levomilnacipran) late in pregnancy might raise the risk of adaptation syndrome in your baby. This condition is similar to withdrawal. Your newborn could be jittery, cry a lot, or have trouble with feeding. But these problems are usually mild and temporary. Not treating depression during pregnancy can also be harmful for you and your baby. Your prescriber can help choose the safest plan for you.
                Can you breastfeed while taking Fetzima (levomilnacipran)?
                Let your prescriber know if you're breastfeeding or are thinking about breastfeeding. They can discuss the risks and benefits of breastfeeding while taking Fetzima (levomilnacipran). This medication can pass into breast milk. It might make your baby fussy, sleepy or have trouble with feeding. Your prescriber can help you decide what's the safest option for you and your baby. If you choose to breastfeed while taking Fetzima (levomilnacipran), tell your healthcare team if your baby has any side effects.
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                What are the risks and warnings for Fetzima (levomilnacipran)?

                Fetzima (levomilnacipran) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

                risk-warning

                Suicidal thoughts and behavior

                • 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-warning

                  Serotonin syndrome

                  • 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-warning

                    Higher blood pressure and faster heart rate

                    • 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-warning

                      Higher risk of bleeding

                      • 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).

                        risk-warning

                        Worsening of glaucoma in certain people

                        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.

                        risk-warning

                        Sexual problems

                        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-warning

                        Low sodium levels

                        • 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-warning

                          Mania

                          • 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).

                            dosage

                            Fetzima (levomilnacipran) dosage forms

                            The average cost for 30 capsules of 40mg of Fetzima (levomilnacipran) is $523.01 with a free GoodRx coupon. This is 18% off the average retail price of $637.79.
                            capsule
                            Capsule
                            DosageQuantityPrice as low asPrice per unit
                            20mg30 capsules$522.96$17.43
                            40mg30 capsules$523.01$17.43
                            80mg30 capsules$522.58$17.42
                            120mg30 capsules$522.32$17.41
                            dose pack
                            Dose pack
                            DosageQuantityPrice as low asPrice per unit
                            28 capsules of 20mg and 40mg1 dose pack$493.12$493.12

                            Typical dosing for Fetzima (levomilnacipran)

                            The typical starting dose is 20 mg by mouth once a day for 2 days. Then, your prescriber will raise your dose to 40 mg by mouth once a day.

                            As you keep taking the medication, your prescriber will adjust your dose based on how well it works for you and if you have any side effects.

                            The maximum dose is 120 mg per day. The maximum dose differs if you have kidney problems or if you take certain medications.

                            interactions

                            Interactions between Fetzima (levomilnacipran) and other drugs

                            Fetzima (levomilnacipran) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Fetzima (levomilnacipran). Please note that only the generic name of each medication is listed below.

                            Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

                            Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

                            drug-cost

                            How much does Fetzima (levomilnacipran) cost?

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                            contraindications-icon

                            Fetzima (levomilnacipran) contraindications

                            Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Fetzima (levomilnacipran) will not be safe for you to take.
                            • Allergic reaction to Fetzima (levomilnacipran) or Savella (milnacipran)

                            • Currently take or have taken a monoamine oxidase inhibitor (MAOI) within the last 14 days

                            alternatives

                            What are alternatives to Fetzima (levomilnacipran)?

                            There are a number of medications that your doctor can prescribe in place of Fetzima (levomilnacipran). Compare a few possible alternatives below.
                            Fetzima (levomilnacipran)
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                            images

                            Fetzima (levomilnacipran) images

                            Yellow Fl 40 - Fetzima 40mg Extended-Release Capsule
                            This medicine is Yellow Capsule Imprinted With "Fl 40".Yellow Fl 40 - Fetzima 40mg Extended-Release Capsule

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