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Savella Coupon - Savella 50mg tablet

Savella

milnacipran
Used for Fibromyalgia
Used for Fibromyalgia

Savella (milnacipran) is FDA approved to manage fibromyalgia in adults. It belongs to the drug class called serotonin and norepinephrine reuptake inhibitors (SNRIs). Savella (milnacipran) is a tablet that's taken by mouth twice a day. You'll usually follow a dosing schedule for the first few days to reach the right dose for you. Side effects can include nausea, constipation, headache, and dizziness. As of January 2025, Savella (milnacipran) is only available as a brand-name medication. There's no generic version yet.

Reviewed by:
reviewer
Allison Gourley, PharmD
reviewer
Cydnee Ng, PharmD
Last reviewed on February 28, 2025
BasicsSide effectsPros & consPharmacist tipsFAQsWarningsDosageInteractionsCostContraindicationsAlternativesLatest newsImagesReferencesPricesMedicare
basics-icon

What is Savella (milnacipran)?

What is Savella (milnacipran) used for?

How Savella (milnacipran) works

Savella (milnacipran) is a serotonin and norepinephrine reuptake inhibitor (SNRI). It’s not clear how the medication helps with fibromyalgia. But it raises the amount of serotonin and norepinephrine in the brain. These chemicals play a role in regulating pain.

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

Drug Facts

Common BrandsSavella
Drug ClassSerotonin and norepinephrine reuptake inhibitor (SNRI)
Controlled Substance ClassificationNot a controlled medication
Generic StatusNo lower-cost generic available
AvailabilityPrescription only
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$587.46(save 24.86%)
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$441.42
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What are the side effects of Savella (milnacipran)?

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 (37%)
  • Headache (18%)
  • Constipation (16%)
  • Trouble falling and staying asleep (insomnia, 12%)
  • Sudden feeling of warmth (hot flush, 12%)
  • Dizziness (10%)

Other Side Effects

  • Vomiting
  • Dry mouth
  • Sweating a lot
  • Migraine
  • Upper respiratory infection
  • Racing heart or fast heart rate
  • High blood pressure
  • Sexual problems (a lower sex drive; problems with erections, ejaculations, or orgasms)

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
  • Liver damage: yellowing of your skin or eyes, pain in your upper stomach, dark urine
  • Low sodium levels: headache, difficulty concentrating, memory problems, confusion, weakness, unsteadiness, hallucinations, fainting, seizures
  • Bleeding or bruising: unusual bleeding or bruising, bleeding or bruising that doesn't go away, nosebleeds, blood in your urine or stool
  • Seizure

Source: DailyMed

More on Savella (milnacipran) side effects

Health: Savella: side effects milnacipran

10 Savella (Milnacipran) Side Effects You Should Know About

Written by Austin Ulrich, PharmD, BCACP

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

Blurred vision

body aches or pain

chills

cough

difficulty with breathing

dizziness

ear congestion

fast, irregular, pounding, or racing heartbeat or pulse

fear or nervousness

fever

headache

increased sweating

loss of voice

nasal congestion

pounding in the ears

runny nose

slow or fast heartbeat

sneezing

sore throat

unusual tiredness or weakness

Less common

Back pain

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

chest pain or discomfort

chills

decrease in frequency of urination

decrease in urine volume

difficult or painful urination

difficulty in passing urine (dribbling)

frequent urination

groin pain

muscle aches

pain or burning with urination

shakiness in the legs, arms, hands, or feet

swollen, tender prostate

tightness in the chest

Rare

Bladder pain

bloating or swelling of the face, arms, hands, lower legs, or feet

bloody or cloudy urine

bruise

discouragement

fall

feeling sad or empty

frequent urge to urinate

full or bloated feeling

heartburn

increased or decreased weight

irritability

lack of appetite

loss of interest or pleasure

lower back or side pain

pressure in the stomach

rapid weight gain

swelling of the abdominal or stomach area

tingling of the hands or feet

tiredness

trouble concentrating

trouble sleeping

unusual weight gain or loss

vomiting

Incidence not known

Agitation

black, tarry stools

bleeding gums

blistering, peeling, or loosening of the skin

blood in the urine or stools

coma

confusion as to time, place, or person

convulsions

dark-colored urine

decreased urine output

diarrhea

difficulty with swallowing

general tiredness and weakness

high fever

holding false beliefs that cannot be changed by fact

increased sweating

increased thirst

itching

joint or muscle pain

light-colored stools

loss of balance control

loss of consciousness

mask-like face

muscle cramps or spasms

muscle pain or stiffness

overactive reflexes

pinpoint red spots on the skin

poor coordination

red skin lesions, often with a purple center

red, irritated eyes

restlessness

seeing, hearing, or feeling things that are not there

seizures

severe muscle stiffness

shuffling walk

slowed movements

slurred speech

sores, ulcers, or white spots on the lips or in the mouth

stiffness of the arms and legs

sweating

swelling of the face, ankles, fingers, or lower legs

swollen glands

talking or acting with excitement you cannot control

tic-like (jerky) movements of the head, face, mouth, and neck

tiredness

trembling and shaking of the fingers and hands

twitching

unusual bleeding or bruising

unusual excitement, nervousness, or restlessness

unusually pale skin

upper right abdominal or stomach pain

weight gain

yellow eyes and skin

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

Feeling of warmth

headache, severe and throbbing

redness of the face, neck, arms, and occasionally, upper chest

sudden sweating

Less common

Abdominal or stomach pain

change or problem with discharge of semen

decreased appetite

decreased interest in sexual intercourse

inability to have or keep an erection

loss in sexual ability, desire, drive, or performance

not able to ejaculate semen

rash

swelling of the testes

Rare

Acid or sour stomach

belching

bloated

change in taste

excess air or gas in the stomach or intestines

full feeling

heartburn

indigestion

irritability

loss of taste

night sweats

passing gas

sleepiness or unusual drowsiness

stomach discomfort or upset

Incidence not known

Swelling of the breasts or unusual milk production

unexpected or excess milk flow from the breasts

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 Savella (milnacipran)

thumbs-up

Pros

One of few medications approved for fibromyalgia

Can take with or without food

thumbs-down

Cons

Taken every day to help with fibromyalgia pain over time, not just "as needed" for quick relief

Not approved for children

pharmacist-tips

Pharmacist tips for Savella (milnacipran)

pharmacist

  • You can take Savella (milnacipran) with or without food. Taking it with food might help with upset stomach, which is a common side effect of the medication.

    • Follow the instructions from your prescriber and pharmacist on how to take Savella (milnacipran). The dosing schedule helps you slowly raise your dose over a week to reach your maintenance dose.

      • Savella (milnacipran) can sometimes make you dizzy and affect how well you can focus. Don't drive or do anything that you need to pay attention for until you know how the medication affects you. Don't drink alcohol while you're taking Savella (milnacipran) because it can make these side effects more intense.

        • Don't lower your dose or stop taking Savella (milnacipran) without talking to your prescriber first. Lowering your dose or stopping the medication suddenly can cause withdrawal symptoms. They can include mood swings, headache, trouble sleeping, and in serious cases seizure. To prevent withdrawal symptoms, your prescriber will help you stop the medication slowly over time.

          • Continue to exercise regularly and get enough sleep while you're taking Savella (milnacipran). These lifestyle changes can help make your fibromyalgia more manageable. Ask your prescriber about other ways to help with your fibromyalgia.

            faqs

            Frequently asked questions about Savella (milnacipran)

            Can Savella (milnacipran) help with depression?
            Savella (milnacipran) is only approved to treat fibromyalgia. Researchers have studied its use for depression, but results have been mixed. One large study couldn't draw clear conclusions about how well it works or how safe it is for depression. But some studies found that milnacipran might work as well as tricyclic antidepressants (TCAs) like amitriptyline. Others also showed that milnacipran might work better than selective serotonin reuptake inhibitors (SSRIs) like sertraline (Zoloft). Keep in mind that taking Savella (milnacipran) for depression is off-label. Talk to your primary care provider or psychiatrist about treatment options for depression.
            Is Savella (milnacipran) a controlled substance?
            No, Savella (milnacipran) isn't a controlled substance. The medication isn't known to have a risk of physical and mental dependence.
            Does Savella (milnacipran) cause hair loss?
            Hair loss wasn't reported in clinical studies of Savella (milnacipran). But some common antidepressants in the same drug class (SNRIs) have been linked to hair loss. Talk to your prescriber if you notice hair thinning or hair loss while you're taking Savella (milnacipran). They can help you find ways to manage it.
            Does Savella (milnacipran) cause weight gain?
            No, Savella (milnacipran) doesn't tend to cause weight gain. In a clinical study, people taking the maintenance dose of the medication actually lost an average of 2 pounds over 3 months. Talk to your prescriber if you're worried about any changes in your weight while you're taking Savella (milnacipran).
            Can Savella (milnacipran) be cut in half?
            No. Savella (milnacipran) tablets aren't designed to be cut. There are many different tablet strengths available: 12.5 mg, 25 mg, 50 mg, and 100 mg. Talk to your prescriber if you think you need to change your dose. They can see if your prescription needs to be adjusted.
            How long does it take for Savella (milnacipran) to work?
            In clinical studies, some people reported that their pain was "much" or "very much" improved after just a week of taking Savella (milnacipran) at a stable dose. But it can take up to a few months for others to feel the full effects. Talk to your prescriber if you don't notice any relief from fibromyalgia pain after several weeks to months of taking the medication.
            Is Savella (milnacipran) safe during pregnancy?
            Talk to your prescriber or obstetrician-gynecologist (OB-GYN) about the risks and benefits of taking Savella (milnacipran) during pregnancy. It's not clear if it's safe to take while pregnant. But in some cases, people had more bleeding after childbirth when they took Savella (milnacipran) in the third trimester. Some newborns also had breathing or feeding problems. If you took the medication during pregnancy, you can join the Savella Pregnancy Registry. It helps researchers learn how the medication affects pregnancy and the baby's health after birth.
            What's the difference between Savella (milnacipran) and duloxetine (Cymbalta)?
            Savella (milnacipran) and duloxetine (Cymbalta) are both FDA-approved medications for treating fibromyalgia. But they have some key differences. Savella (milnacipran) is only for adults. But duloxetine (Cymbalta) is for people 13 years and older with fibromyalgia. Also, Savella (milnacipran) is taken twice a day while duloxetine (Cymbalta) is taken once a day. Duloxetine (Cymbalta) is also FDA approved for depression, anxiety, and certain other types of chronic pain. Talk to your prescriber about comparing the medications.
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            What are the risks and warnings for Savella (milnacipran)?

            Savella (milnacipran) 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 or suicidal behavior

              Savella (milnacipran) is similar to some antidepressants that can raise the risk of worsening depression and suicidal thoughts or behavior. The risk is higher in people younger than 24 and people with depression. Talk to your prescriber if you're worried about this risk.

              Watch for new or worsening signs of depression or suicidal thoughts or behavior. Be on the lookout especially when when the dose of Savella (milnacipran) changes and during the first few months of treatment. Tell your prescriber if you or your loved ones notice any unusual changes in your mood or behavior while you're 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 rare, Savella (milnacipran) can cause serotonin syndrome. This is a serious condition caused by too much serotonin in the brain. The risk is higher if you're taking another medication that affects serotonin levels. Examples include certain antidepressants, opioid medications, and triptans. It's important to tell your prescriber and pharmacist about all the medications you take so they can check your risk for serotonin syndrome.

                Symptoms of serotonin syndrome include fever, sweating, movement problems, distress, and hallucinations. Stop taking Savella (milnacipran) and get emergency medical help right away if you have any of these symptoms.

                risk-warning

                Higher blood pressure and faster heart rate

                • Risk factors: History of high blood pressure | History of problems with heart rate

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

                  Let your care team know if your blood pressure or heart rate stays high during treatment. You might need a lower dose of Savella (milnacipran) or might have to stop taking the medication.

                  risk-warning

                  Higher risk of bleeding

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

                    Savella (milnacipran) can raise your risk of bleeding or bruising. The risk is even higher if you also take blood thinners or nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil, Motrin). These medications can also make bleeding more likely.

                    Bleeding or bruising can be mild, like with nosebleeds, or more serious. Tell your prescriber if you have unusual bleeding or bruising or if it doesn't go away while taking Savella (milnacipran).

                    risk-warning

                    Urination problems

                    • Risk factors: Swollen or enlarged prostate | Inflamed prostate | History of other urinary problems

                      Some people taking Savella (milnacipran) have had issues with urination. This can include having pain when urinating or having trouble urinating. Let your prescriber know if you've had pain while urinating before, especially if you have an enlarged prostate or other urinary problems. Tell your prescriber if you notice any changes in urination while you're taking this medication.

                      risk-warning

                      Sexual problems

                      Savella (milnacipran) 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

                      Liver damage

                      • Risk factors: Chronic liver problems | Long-term or heavy drinking

                        Some people taking Savella (milnacipran) might have higher liver enzyme levels, which can be a sign of liver damage. Savella (milnacipran) is usually not recommended for people with a chronic liver condition. It's also not recommended for people who drink heavily since alcohol can already cause liver damage.

                        Tell your prescriber right away if you notice yellowing of your skin or eyes, pain in your upper stomach, or dark urine while taking Savella (milnacipran). These can be signs of liver damage. You might have to switch to a different medication.

                        risk-warning

                        Worsening of glaucoma in certain people

                        Savella (milnacipran) 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, headache, see halos around lights, or feel nauseous. These could be signs of an angle-closure attack that needs urgent care.

                        dosage

                        Savella (milnacipran) dosage forms

                        The average cost for 60 tablets of 50mg of Savella (milnacipran) is $475.36 with a free GoodRx coupon. This is 19.08% off the average retail price of $587.46.
                        tablet
                        Tablet
                        DosageQuantityPrice as low asPrice per unit
                        12.5mg60 tablets$482.75$8.05
                        25mg60 tablets$477.75$7.96
                        50mg60 tablets$475.36$7.92
                        100mg60 tablets$476.66$7.94
                        titration pack
                        Titration pack
                        DosageQuantityPrice as low asPrice per unit
                        4 weeks of 55 tablets1 titration pack$441.42$441.42

                        Typical dosing for Savella (milnacipran)

                        You'll usually start at a low dose of Savella (milnacipran). Then, your prescriber will raise your dose over a span of a week until you reach a maintenance dose.

                        • Day 1: Take 12.5 mg by mouth once daily.

                        • Days 2 to 3: Take 12.5 mg by mouth twice daily.

                        • Days 4 to 7: Take 25 mg by mouth twice daily.

                        • After Day 7 (maintenance dose): Take 50 mg by mouth twice daily.

                        If you need more pain relief, your prescriber might raise your maintenance dose to 100 mg twice daily.

                        Your maintenance dose might be different if you have severe kidney problems.

                        interactions

                        Interactions between Savella (milnacipran) and other drugs

                        Savella (milnacipran) 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 Savella (milnacipran). 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.

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                        contraindications-icon

                        Savella (milnacipran) 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 Savella (milnacipran) will not be safe for you to take.

                        • Take a monoamine oxidase inhibitor (MAOI) currently or within the last 14 days

                        alternatives

                        What are alternatives to Savella (milnacipran)?

                        There are a number of medications that your doctor can prescribe in place of Savella (milnacipran). Compare a few possible alternatives below.
                        Savella (milnacipran)
                        Used for:
                        $441.42 Lowest GoodRx priceView Prices
                        Duloxetine (Cymbalta)
                        Used for:
                        $10.20 Lowest GoodRx priceView Prices
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                        Savella (milnacipran) images

                        White Oval Fl And 50 - Savella 50mg Tablet
                        This medicine is White, Oval Tablet Imprinted With "50" And "Fl".White Oval Fl And 50 - Savella 50mg Tablet

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                        References

                        Best studies we found

                        Allergan, Inc. (2024). Savella- milnacipran hydrochloride tablet, film coated; Savella- milnacipran hydrochloride kit [package insert]. DailyMed.

                        Amneal Pharmaceuticals LLC. (2024). Milnacipran HCl- milnacipran hcl tablet [package insert]. DailyMed.

                        English, C., et al. (2010). Milnacipran (Savella), a treatment option for fibromyalgia. Pharmacy and Therapeutics.

                        View All References (4)

                        Khazaeni, B., et al. (2023). Acute angle-closure glaucoma. StatPearls.

                        Marks, D. M., et al. (2009). Serotonin-norepinephrine reuptake inhibitors for pain control: Premise and promise. Current Neuropharmacology.

                        Nakagawa, A., et al. (2009). Milnacipran versus other antidepressive agents for depression. The Cochrane Database of Systematic Reviews.

                        Porter, D. (2020). Narrow angles. American Academy of Ophthalmology.

                        GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
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