Ixel® [Milnacipran]
Pierre Fabre Medicament
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Clinical Pharmacology
Ixel is an antidepressant with an activating effect. Inhibits reuptake of norepinephrine and serotonin. Has no affinity for m-cholinergic receptors, a1-adrenoreceptors, histamine H1- receptors, as well as dopamine, benzodiazepine and opioid receptors.
Indications
Depressive disorders of varying severity.
Composition
1 caps contains milnacipran hydrochloride 50 mg
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Dosage and Administration
The average daily dose is 100 mg; The drug should be taken in 2 divided doses in the morning. Depending on the severity of symptoms, the dose of the drug can be increased to 250 mg.
The drug is preferably taken with meals.
The duration of therapy is set individually.
In patients with renal insufficiency, a dose reduction is necessary depending on the values of creatinine clearance.
Adverse reactions
From the side of the central nervous system: anxiety, dizziness; rarely - tremor.
From the digestive system: rarely, dry mouth, nausea, vomiting, constipation; in isolated cases - a moderate increase in transaminase activity.
Other: rarely - palpitations, increased sweating, hot flashes, difficulty urinating; in rare cases - serotonergic syndrome.
Side effects are rare, mainly during the first 2 weeks of therapy, usually self-suppressed as the regression of depressive symptoms and do not require discontinuation of the drug.
Contraindications
Absolute
- children's and teenage age up to 15 years;
- hypersensitivity to the drug;
- simultaneous use of non-selective and selective MAO type B inhibitors;
- simultaneous reception of selective serotonin reuptake inhibitors (sumatriptan).
Relative
- simultaneous reception with adrenaline, norepinephrine, clonidine and its derivatives;
- benign prostatic hyperplasia and obstruction of the urinary tract of another genesis;
- pregnancy;
- lactation (breastfeeding).
Drug interactions
With simultaneous use of Ixel with MAO inhibitors, sumatriptan, lithium preparations, there is a risk of developing serotonergic syndrome.
Simultaneous use of Ixel with adrenaline and noradrenaline can provoke the development of hypertensive crisis and heart rhythm disorders.
When taken simultaneously with digoxin (especially when administered parenterally), there is a risk of potentiation of hemodynamic disorders.
With the simultaneous use of Ixel inhibits the hypotensive effect of clonidine and its derivatives.
Special instructions
With caution, the drug is prescribed to patients with convulsive seizures in history, with arterial hypertension, cardiomyopathy.
Ixel can be prescribed no earlier than 14 days after discontinuation of MAO inhibitors. In addition, from the moment of discontinuation of the drug Ixel before the start of therapy with MAO inhibitors should take at least 7 days.
To reduce the severity of side effects, a gradual increase in the dose of the drug is recommended.
When carrying out local anesthesia with drugs containing adrenaline or norepinephrine during therapy with Ixel, the dose of anesthetics should not exceed 0.1 mg per 10 minutes and 0.3 mg per hour.
During the period of treatment Ixel should not drink alcohol.
Influence on ability to driving and management of mechanisms
During the period of use of the drug should refrain from engaging in potentially hazardous activities that require increased attention and quick psychomotor reactions.
Overdosage
Symptoms: with an accidental increase in dose - nausea, vomiting, sweating, constipation. When taking the drug in a dose exceeding 800-1000 mg - vomiting, difficulty breathing, tachycardia. After taking in an excessively high dose (1900-2800 mg of milnacipran) in combination with other psychotropic drugs (most often benzodiazepines), drowsiness, hypercapnia, and impaired consciousness are added to the above symptoms.
Treatment: gastric lavage, symptomatic therapy. Recommended medical monitoring of the patient for at least a day. There is no specific antidote.
- Brand name: Ixel
- Active ingredient: Milnacipran
- Dosage form: Capsules
- Manufacturer: Pierre Fabre Medicament
- Country of Origin: France
Studies and clinical trials of Milnacipran (Click to expand)
- Open channel block of NMDA receptors by conformationally restricted analogs of milnacipran and their protective effect against NMDA-induced neurotoxicity
- The Place of Milnacipran in the Treatment of Depression
- Milnacipran: an antidepressant with dual selectivity of action on noradrenaline and serotonin uptake
- A New Enantioselective Synthesis of Milnacipran and an Analogue by Catalytic Asymmetric Cyclopropanation
- Efficacy and safety of milnacipran 100 mg/day in patients with fibromyalgia: Results of a randomized, double-blind, placebo-controlled trial
- ChemInform Abstract: Synthesis and Biological Activity of Conformationally Restricted Analogues of Milnacipran: (1S,2R)-1-Phenyl-2- [(R)-1-amino-2-propynyl]-N,N-diethylcyclopropanecarboxamide Is a Novel Class of NMDA Receptor Channel Blocker.
- ChemInform Abstract: A New Enantioselective Synthesis of Milnacipran and an Analogue by Catalytic Asymmetric Cyclopropanation.
- Synthesis of Enantiomerically Pure Milnacipran Analogues and Inhibition of Dopamine, Serotonin, and Norepinephrine Transporters.
- ChemInform Abstract: Studies on a Series of Milnacipran Analogues Containing a Heteroaromatic Group as Potent Norepinephrine and Serotonin Transporter Inhibitors.
- ChemInform Abstract: Advances in Development of Methods for the Synthesis of Dual Selective Serotonin and Norepinephrine Reuptake Inhibitors (SSNRIs) [Venlafaxine Hydrochloride (Effexor), Milnacipran Hydrochloride (Ixel, Dalcipran) and Duloxetine Hydrochloride (Cymbalta)]
- Chiral HPLC analysis of milnacipran and its FMOC-derivative on cellulose-based stationary phases
- Effects of the novel antidepressant milnacipran in a chronic mild stress model of depression
- Functional magnetic resonance imagery (fMRI) in fibromyalgia and the response to milnacipran
- Olanzapine augmentation of milnacipran for stage 2 treatment-resistant major depression: an open study
- Remarkable effect of milnacipran in the treatment of Japanese major depressive patients
- Elevation of blood pressure induced by high-dose milnacipran
- Controlled comparison of milnacipran (F2207) 200 mg and amitriptyline in endogenous depressive inpatients
- Milnacipran plasma levels and antidepressant response in Japanese major depressive patients
- Differential period of onset of action of fluvoxamine, paroxetine and milnacipran for depression
- Milnacipran for the treatment of chronic pain
- Effect of pindolol and milnacipran versus milnacipran and placebo on plasma prolactin and adrenocorticotrophic hormone in depressed subjects
- Milnacipran and pindolol: a randomized trial of reduction of antidepressant latency
- Double-blind comparative study of the action of repeated administration of milnacipran versus placebo on cognitive functions in healthy volunteers
- A case of temporo-mandibular disorder with fibromyalgia treated with the antidepressant, milnacipran
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