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Fetzima Side Effects

Generic Name: levomilnacipran

Note: This page contains information about the side effects of levomilnacipran. Some of the dosage forms included on this document may not apply to the brand name Fetzima.

Not all side effects for Fetzima may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

For the Consumer

Applies to levomilnacipran: oral capsule extended release

In addition to its needed effects, some unwanted effects may be caused by levomilnacipran (the active ingredient contained in Fetzima). In the event that any of these side effects do occur, they may require medical attention.

You should check with your doctor immediately if any of these side effects occur when taking levomilnacipran:

More common
  • Difficult urination
  • fast, pounding, or irregular heartbeat or pulse
Less common
  • Anxiety
  • arm, back, or jaw pain
  • blurred vision
  • burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • chest pain or discomfort
  • chest tightness or heaviness
  • cloudy urine
  • confusion
  • decrease in the frequency of urination
  • difficulty in passing urine (dribbling)
  • difficulty with speaking
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • drooling
  • dry mouth
  • fainting
  • headache
  • irritability
  • loss of balance control
  • muscle trembling, jerking, or stiffness
  • nausea
  • painful urination
  • pounding in the ears
  • rapid or irregular heartbeat
  • restlessness
  • shaking
  • shortness of breath
  • shuffling walk
  • slow heartbeat
  • stiffness of the limbs
  • sweating
  • trouble sleeping
  • twisting movements of the body
  • uncontrolled movements, especially of the face, neck, and back
  • unusual tiredness or weakness

Some of the side effects that can occur with levomilnacipran may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

More common
  • Difficulty having a bowel movement (stool)
  • increased sweating
  • loss in sexual ability, desire, drive, or performance
  • vomiting
Less common
  • Abdominal or stomach pain
  • bloated or full feeling
  • decreased appetite
  • dry eyes
  • dry skin
  • feeling of warmth
  • headache, severe and throbbing
  • hives or welts, itching, or rash
  • passing gas
  • red eye
  • red face, neck, arms, and occasionally, upper chest
  • sudden sweating
  • thirst
  • yawning

For Healthcare Professionals

Applies to levomilnacipran: oral capsule extended release


Very common (10% or more): Tachycardia (17%)
Common (1% to 10%): Heart rate increased (6%), palpitations (5%), hypertension (3%), hypotension (3%)
Less than 2%: Angina pectoris, supraventricular and ventricular extra systoles, chest pain[Ref]


Common (1% to 10%): Hyperhidrosis (9%), rash (2%)
Less than 2%: Dry skin, pruritus, urticaria[Ref]


Very common (10% or more): Nausea (17%)
Common (1% to 10%): Constipation (9%), vomiting (5%)
Less than 2%: Abdominal pain, flatulence[Ref]


Common (1% to 10%): Erectile dysfunction (6%), ejaculation disorder (5%), testicular pain (4%), urinary hesitation (4%)
Less than 2%: Pollakiuria, hematuria, proteinuria
Frequency not reported: Urinary hesitation or retention[Ref]


Less than 2%: blood cholesterol increased
Frequency not reported: Abnormal bleeding, hyponatremia[Ref]


Less than 2%: Abnormal liver function test[Ref]


Frequency not reported: Hypersensitivity[Ref]


Common (1% to 10%): Decreased appetite (3%)
Less than 2%: Thirst[Ref]

Nervous system

Common (1% to 10%): Hot flush (3%)
Less than 2%: Migraine, paresthesia, syncope, extrapyramidal disorder
Frequency not reported: Seizure, discontinuation syndrome, suicidal thoughts and behaviors in adolescents and young adults, serotonin syndrome[Ref]


Less than 2%: Dry eye, blurred vision, conjunctival hemorrhage
Frequency not reported: Narrow-angle glaucoma[Ref]


Less than 2%: Agitation, anger, bruxism, panic attack, tension, aggression
Frequency not reported: Activation of mania/hypomania[Ref]


Less than 2%: Yawning[Ref]


1. "Product Information. Fetzima (levomilnacipran)." Forest Pharmaceuticals, St. Louis, MO.

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