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Updated on August 19, 2010


Savella (milnacipran) is a prescription medication manufactured by Cypress Bioscience (San Diego, CA) for the treatment of fibromyalgia pain in adults. Savella is not a cure for fibromyalgia, but is designed to treat the symptoms by reducing pain and improving physical function.

Savella is a tablet, and comes in 4 different strengths:

  • 12.5mg tablet
  • 25mg tablet
  • 50mg tablet
  • 100mg tablet

Savella is generally taken twice daily, with or without food, and the dose is slowly tapered up to 50mg twice daily for most patients.

In this article I want to provide you with some information on

  1. A Brief Review of Fibromyalgia
  2. How Savella Works
  3. Common Side Effects with Savella
  4. Other Information about Savella

This information is intended to be brief and simple. I want to just give you the most critical information with respect to taking Savella.

1. A Brief Review of FIBROMYALGIA

Unfortunately, fibromyalgia is still not very well understood. It is a condition sometimes defined by a "lowered pain threshold." It is frequently distinguished from other chronic pain conditions by several characteristic "tender points" as seen in the diagram at the right. Fibromyalgia is 9 times more common in women than in men, effecting 1% to 2% of the general population, and most frequently seen between the ages of 30 to 50 years old. The cause of fibromyalgia is unknown.

Diagnosis is difficult, and primarily involves ruling out other conditions, since there is no blood test or other objective method of making this diagnosis. The American College of Rheumatology offers the following for making a Fibromyalgia Diagnosis:

  1. History of widespread pain
  2. Pain in 11 of 18 selected tender spots on digital palpation (mainly in the spine, elbows, and knees)



Savella actually belongs to a family of medications known as "selective serotonin norepinephrine reuptake inhibitors." Don't let that scare you. It is just a big long fancy way of talking about a group of drugs for depression. Savella, however, is not an antidepressant and is only approved for the treatment of fibromyagia. Other drugs in this family, approved only for depression, include Pristiq and Effexor.  Cymbalta belongs to this family and is also approved for fibromyalgia pain.

It is not entirely clear (and that is probably an understatement!) how Savella (and other similar medications) works to relieve pain associated with fibromyalgia. The theory that seems popular at the moment suggests that it is related to the fact that Savella interferes with the neurotransmitters known as norepinephrine and serotonin.

However, regardless of exactly how Savella works, numerous studies have documented patient improvement (as compared to placebo) in the following three areas:

  1. Pain Reduction
  2. Improvement in patient overall assessment of fibromyalgia
  3. Improvement in physical function



Side effects which occur more frequently than 5% include:

  • Nausea
  • Headache
  • Constipation
  • Dizziness
  • Insomnia
  • Vomiting
  • Excessive thirst/Dry Mouth
  • Palpitations
  • Increases in blood pressure

Now, this may seem pretty disappointing, but remember you may not experience any of these side effects at all.  Also, as with all drugs in this or similar classes sometimes used for depression, there have been concerns about an increase in suicidal thoughts.  This was only in younger patients.  Older patients actually had decreases in the frequency of suicidal thoughts.  Savella is not approved to be used in pediatric patients or for the treatment of depression.



Savella should not be taken by anyone being treated with, or only recently discontinued, a MAO Inhibitor.  If you do not know what an MAO Inhibitor is, you can read an article about them HERE.

Savella should not be taken by anyone with uncontrolled narrow angle glaucoma (a specific type of eye disease).

Savella is a BRAND NAME medication, and there are no generics currently available.

I have collected and rounded up for you several other websites with valuable information if you would like to continue your research on Savella for Fibromyalgia:

Savella Manufacturer website is loaded with lots of good information about Fibromyalgia and about treatment with Savella

A brief review of 2 major studies on Savella and the outcomes is provided: Click Here!

For information on how to save money on your prescriptions Click Here!


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