Fetzima (levomilnacipran) is a brand-name, extended-release oral capsule that’s prescribed for depression in adults. As with other drugs, Fetzima can cause side effects, such as nausea or heart palpitations.

Fetzima can cause certain side effects, some of which are more common than others. These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

These are just a few of the more common side effects reported by people who took Fetzima in clinical trials:

* For more information about this side effect, see “Side effect specifics” below.

Mild side effects can occur with Fetzima use. This list doesn’t include all possible mild side effects of the drug. For more information, you can refer to Fetzima’s prescribing information.

Mild side effects that have been reported with Fetzima include:

These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. If you develop a side effect while taking Fetzima and want to tell the FDA about it, visit MedWatch.

* For more information about this side effect, see “Side effect specifics” below.
† An allergic reaction is possible after using Fetzima. However, it’s not clear whether this side effect occurred in clinical trials. To learn more, see the “Side effect specifics” section below.

Fetzima may cause serious side effects. However, serious side effects from this medication aren’t common. The list below may not include all possible serious side effects of the drug. For more information, you can refer to Fetzima’s prescribing information.

If you develop serious side effects while taking Fetzima, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Serious side effects that have been reported and their symptoms include:

* Fetzima has a boxed warning for this side effect. This is the most serious warning from the FDA. To learn more, see the “Side effect specifics” section below.
† An allergic reaction is possible after using Fetzima. However, it’s not clear whether this side effect occurred in clinical trials. To learn more, see the “Side effect specifics” section below.

Fetzima may cause several side effects. Here are some frequently asked questions about the drug’s side effects and their answers.

How do side effects of Fetzima compare with those seen with Pristiq?

Fetzima and Pristiq (desvenlafaxine) are both medications that may be prescribed to treat depression. In addition, they both belong to the same drug class: serotonin-norepinephrine reuptake inhibitors (SNRIs). However, these drugs have different active ingredients. For this reason, Fetzima and Pristiq may have some side effects that are similar and others that are different.

For example, both Fetzima and Pristiq can cause nausea, constipation, and sexual side effects. Both drugs can also cause more serious side effects, such as bleeding, glaucoma, or seizure.

However, some side effects of the drugs are different. For example, Pristiq can cause interstitial lung disease or eosinophilic pneumonia. Fetzima isn’t known to cause these side effects.

Before starting treatment with Fetzima, talk with your doctor about the best treatment plan for you. They can recommend the best plan to fit your needs.

Is withdrawal possible with Fetzima?

Yes, withdrawal symptoms are possible with Fetzima. Withdrawal can occur when you suddenly stop taking a medication that you’re dependent on. With dependence, your body needs medication to function as it usually does. When withdrawal symptoms occur due to suddenly stopping antidepressants, it’s called discontinuation syndrome.

Suddenly stopping treatment with Fetzima may cause side effects that include:

To help prevent withdrawal symptoms, it’s important that you talk with your doctor before you stop taking Fetzima. They will likely do a dosage taper. This is when they slowly lower your dose of Fetzima over time until you can stop taking it. In addition, your doctor can also closely monitor your condition for withdrawal symptoms when you stop treatment.

Does Fetzima cause long-term side effects?

Yes, it’s possible for Fetzima to cause long-term side effects. However, they’re not common. Examples of long-term side effects reported with Fetzima include:

  • angle-closure glaucoma
  • high blood pressure
  • urinary retention

If you have concerns about long-term side effects with Fetzima, talk with your doctor or pharmacist.

Learn more about some of the side effects that Fetzima may cause, including its boxed warning. To find out how often side effects occurred in clinical trials, see the prescribing information for Fetzima.

Risk of suicidal thoughts and behaviors

Fetzima has a boxed warning for the increased risk of suicidal thoughts and behaviors. A boxed warning is the most serious warning from the FDA. Its purpose is to alert patients and prescribers about the risks of taking a medication.

Taking an antidepressant, such as Fetzima, may raise the risk of suicidal thoughts and behaviors. In clinical trials of other antidepressants, this risk was highest in children and adults ages 24 years and younger. This side effect may be more common at the start of treatment and after a dose increase.

Because it works in a similar manner to other antidepressants, it’s possible that Fetzima may also carry these risks. However, it’s important to note that Fetzima is not approved for use in children.

What you can do

When you first start taking Fetzima, be sure to discuss your mood with your doctor, family, and friends. Throughout treatment and especially after any dosage changes, your doctor will monitor you for mood changes.

If your depression begins to worsen or you have thoughts of harming yourself, talk with your doctor as soon as possible. If you and your doctor determine that Fetzima isn’t right for you, they can slowly taper you off of the drug. Then, they can recommend another treatment option for your depression.

Constipation

It’s possible for Fetzima to cause constipation. In the drug’s clinical trials, this was one of the more common side effects reported.

With constipation, you have difficulty passing stool. Symptoms can include:

In most cases, constipation is mild. However, without treatment, constipation can become serious.

What you can do

If you develop constipation during your treatment with Fetzima, talk with your doctor. They may suggest certain dietary changes, such as drinking more water or eating a high fiber diet. Or they may recommend taking an over-the-counter medication, such as MiraLAX (polyethylene glycol 3350), to help manage this side effect.

For more information about laxatives for constipation, see this article.

Allergic reaction

As with most drugs, Fetzima can cause an allergic reaction in some people. However, it’s not clear whether this side effect occurred in clinical trials.

Symptoms can be mild or serious and can include:

  • skin rash
  • itching
  • flushing
  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

What you can do

For mild symptoms of an allergic reaction, call your doctor right away. They may recommend ways to ease your symptoms and determine whether you should keep taking Fetzima. However, if your symptoms are serious and you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.

Find more links and local resources.

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Before starting treatment with Fetzima, be sure to tell your doctor about your medical history as well as any medications that you take. They can help determine whether Fetzima may be a safe treatment for you.

Boxed warning: Risk of suicidal thoughts and behaviors

This drug has a boxed warning for the risk of suicidal thoughts and behaviors. A boxed warning is the most serious warning from the FDA. For details, see the “Side effect specifics” section above.

Other precautions

Be sure to talk with your doctor about your health history before you take Fetzima. This drug may not be the right treatment for you if you have certain medical conditions or other factors that affect your health. These are considered drug-condition or drug-factor interactions. The conditions and factors to consider include:

High blood pressure or heart problems: Tell your doctor if you have a heart problem or any risk factors for one, such as high blood pressure. Fetzima can raise your blood pressure and heart rate. If you already have one of these conditions, taking this drug may worsen it. In turn, this could increase your risk of serious heart problems, such as heart attack or stroke.

Before you start treatment with Fetzima, talk with your doctor about any heart problems or risk factors you may have. If your heart condition is well-managed, they may prescribe Fetzima and monitor your symptoms more closely during treatment. However, in some cases, they may recommend a different treatment option for your depression.

Angle-closure glaucoma: Before you start treatment with Fetzima, tell your doctor if you have angle-closure glaucoma. If you do, taking this drug may cause a serious condition called an angle closure attack. Symptoms of this complication can include having sudden blurry vision, experiencing severe eye pain, and seeing rainbow-colored rings around bright lights. Without treatment, an angle closure attack can lead to permanent blindness. Due to this risk, your doctor may not prescribe Fetzima if you have this type of glaucoma.

Bleeding conditions: If you have a condition that affects blood clotting, such as hemophilia, talk with your doctor. This medication can increase the risk of bleeding and bruising. If you already bruise or bleed more easily, taking Fetzima may further increase your risk. In this case, talk with your doctor about the best treatment plan for you.

Urinary problems: Fetzima may cause urinary retention. If you already have a urinary tract problem or difficulty emptying your bladder, taking Fetzima may make your condition worse. In this case, your doctor can recommend the best treatment plan for you.

Seizure: It’s possible for Fetzima to cause a seizure. If you have a seizure disorder or a history of seizures, you may have a higher risk of this side effect while taking this drug. Your doctor will determine whether Fetzima is safe for you to take with your condition.

Low sodium levels: Fetzima can cause low sodium levels in your blood. If you already have this condition, taking Fetzima may make it worse. Extremely low sodium levels can become serious or even life threatening. If you have a higher risk of this condition, your doctor will likely monitor your sodium levels during treatment. In some cases, they may recommend a different treatment option for you.

Kidney problems: Your kidneys help remove Fetzima from your body. If you have a condition that affects your kidney function, this drug may build up in your body. In turn, this may raise your risk of side effects. Before starting treatment, talk with your doctor about any kidney problems you may have. Due to this risk, they may prescribe a lower dose of Fetzima for you.

Bipolar disorder: If you have bipolar disorder, including mania or hypomania, be sure to tell your doctor before you start taking Fetzima. This medication can cause mood changes, such as an increased risk of suicidal thoughts or behaviors. As such, it may also worsen symptoms of bipolar disorder. Your doctor will help determine whether Fetzima is safe for you and your mental health.

Allergic reaction: If you’ve had an allergic reaction to Fetzima or any of its ingredients, your doctor will likely not prescribe Fetzima. This includes milnacipran, which is a different form of the active drug in Fetzima (levomilnacipran). Ask your doctor what other medications may be better options for you.

Pregnancy or breastfeeding: If you’re pregnant or breastfeeding your child, talk with your doctor. It’s not clear whether Fetzima is safe for you to take.

There are no clinical trials to determine how this drug may affect a developing baby or a child who’s breastfed. However, similar antidepressants have been shown to pass into breast milk. In some cases, these drugs have caused irritability, agitation, poor feeding, and poor weight gain in children who are breastfed.

If you become pregnant during treatment with Fetzima, talk with your doctor right away. If you and your doctor decide that the treatment benefits outweigh the potential risks, consider signing up for the National Pregnancy Registry for Antidepressants.

The purpose of a pregnancy registry is to collect data to determine the effects that a drug may have on a pregnancy. You can sign up by calling 844-405-6185 or visiting the program website.

Alcohol consumption: If you drink alcohol, Fetzima may not be safe for you to take. Alcohol can cause Fetzima to be released too quickly into your body. Fetzima is an extended-release drug, which means it should be released slowly over time. Receiving too much of the drug at once can increase your risk of side effects.

Your doctor can advise how much alcohol, if any, is safe for you to drink with Fetzima.

If you’d like to learn more about Fetzima, talk with your doctor or pharmacist. They can help answer any questions you have about side effects from taking the drug.

Besides talking with your doctor, you can do some research on your own. These articles might help:

  • More information about Fetzima: For details about other aspects of Fetzima, refer to this article.
  • A look at your condition: For details about depression, see our hubs on depression and mental health.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.