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Why is Ella prescribed?

Ella (Milnacipran) is used to treat fibromyalgia, a condition that causes muscle pain and stiffness. It is part of a class of medications called selective serotonin and norepinephrine reuptake inhibitors (SSNRIs).

What does it do?

It works by enhancing the activity of certain chemicals in the brain, specifically Serotonin and Norepinephrine.

How should I take it?

Take this medication orally, it can be taken with or without food. If it causes an upset stomach, take it with food. Follow your doctor advise and do not take the medication more frequently than prescribed.

What if I missed a dose?

If you miss a dose, skip it and take your next dose at the usual time. Do not double dose.

What are the special precautions before taking Ella?

It’s important to inform your healthcare provider if you have any of the following conditions:

• Bleeding disorders
• Mania or bipolar disorder
• Frequent alcohol consumption
• Glaucoma
• Kidney disease
• Liver disease
• Prostate issues
• Seizures
• Taken MAOIs within the past 14 days

This medication may raise your blood pressure, so it's important to monitor it regularly. Consult your healthcare team for guidance on how to do so.

It can also impact your coordination, reaction time, and judgment. Avoid driving or operating machinery until you understand how it affects you. To reduce the risk of dizziness or fainting, rise slowly from sitting or lying down. Avoid alcohol, as it can increase these side effects.

Does it have any side effects?

Common side effects may include:
• Changes in sex drive or performance
• Nausea
• Constipation
• Dizziness
• Dry mouth
• Excessive sweating
• Vomiting

This side effects may not need medical attention but should be reported if bothersome.

Serious side effects may include:
• Bleeding symptoms, such as bloody or black, tar-like stools
• Increased blood pressure
• Heart palpitations, including rapid or irregular heartbeat
• Signs of serotonin syndrome, including irritability, vomiting, and diarrhea
• Difficulty passing urine
• Liver injury symptoms, such as pain in the upper right abdomen
• Low sodium levels, including muscle weakness, fatigue, or confusion
• Sudden eye pain or changes in vision, such as blurry vision
• Seizures
• Thoughts of suicide or self-harm or increased feelings of depression

This list may not cover all possible side effects. Contact your doctor for advice regarding any side effects you experience.

Is it safe to take it with another drug?

Some drug interactions may cause serious or life-threatening reactions when administered together. Immediately inform your doctor if you are taking Ella with any of the following medications:

• Duloxetine
• Linezolid
• Desvenlafaxine
• Methylene blue (injected into a vein)
• Levomilnacipran
• MAOIs such as Carbex
• Venlafaxine

Ella may also interact with the following:

• Aspirin and aspirin-like medications
• Clonidine
• Digoxin
• Amphetamines
• Blood pressure medications
• Procarbazine
• Rasagiline
• Migraine medications such as Almotriptan

This list may not cover all possible interactions. Provide your healthcare provider with a list of all medications you are using.

How should I store it?

Store at room temperature, between 15 and 30°C (59 and 86°F).

What action should I take in case of overdose?

In the event of an overdose, contact your doctor or go to the nearest hospital immediately.

Is it safe for pregnant or breastfeeding women?

Taking Milnacipran during later stages of pregnancy may increase the risk of certain complications for both you and your unborn baby. Inform your healthcare provider if you are pregnant or planning to become pregnant.

Milnacipran is passed into breast milk. Consult your doctor whether it’s safe to take Milnacipran while nursing. If you are breastfeeding and notice your baby becoming irritable or having trouble feeding, contact your healthcare provider immediately.

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