Medication Guide App

Savella Side Effects

Generic Name: milnacipran

Note: This page contains side effects data for the generic drug milnacipran. It is possible that some of the dosage forms included below may not apply to the brand name Savella.

It is possible that some side effects of Savella may not have been reported. These can be reported to the FDA here. Always consult a healthcare professional for medical advice.

For the Consumer

Applies to milnacipran: oral tablet

As well as its needed effects, milnacipran (the active ingredient contained in Savella) may cause unwanted side effects that require medical attention.

If any of the following side effects occur while taking milnacipran, check with your doctor immediately:

More common
  • Blurred vision
  • body aches or pain
  • chills
  • cough
  • difficulty with breathing
  • dizziness
  • ear congestion
  • fast, irregular, pounding, or racing heartbeat or pulse
  • fear or nervousness
  • fever
  • headache
  • increased sweating
  • loss of voice
  • nasal congestion
  • pounding in the ears
  • runny nose
  • slow or fast heartbeat
  • sneezing
  • sore throat
  • unusual tiredness or weakness
Less common
  • Back pain
  • burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • chest pain or discomfort
  • chills
  • decrease in frequency of urination
  • decrease in urine volume
  • difficult or painful urination
  • difficulty in passing urine (dribbling)
  • frequent urination
  • groin pain
  • muscle aches
  • pain or burning with urination
  • shakiness in the legs, arms, hands, or feet
  • swollen, tender prostate
  • tightness in the chest
  • Bladder pain
  • bloating or swelling of the face, arms, hands, lower legs, or feet
  • bloody or cloudy urine
  • bruise
  • discouragement
  • fall
  • feeling sad or empty
  • frequent urge to urinate
  • full or bloated feeling
  • heartburn
  • increased or decreased weight
  • irritability
  • lack of appetite
  • loss of interest or pleasure
  • lower back or side pain
  • pressure in the stomach
  • rapid weight gain
  • swelling of the abdominal or stomach area
  • tingling of the hands or feet
  • tiredness
  • trouble concentrating
  • trouble sleeping
  • unusual weight gain or loss
  • vomiting
Incidence not known
  • Agitation
  • black, tarry stools
  • bleeding gums
  • blistering, peeling, or loosening of the skin
  • blood in the urine or stools
  • coma
  • confusion as to time, place, or person
  • convulsions
  • dark-colored urine
  • decreased urine output
  • diarrhea
  • difficulty with swallowing
  • general tiredness and weakness
  • high fever
  • holding false beliefs that cannot be changed by fact
  • increased sweating
  • increased thirst
  • itching
  • joint or muscle pain
  • light-colored stools
  • loss of balance control
  • loss of consciousness
  • mask-like face
  • muscle cramps or spasms
  • muscle pain or stiffness
  • overactive reflexes
  • pinpoint red spots on the skin
  • poor coordination
  • red irritated eyes
  • red skin lesions, often with a purple center
  • restlessness
  • seeing, hearing, or feeling things that are not there
  • seizures
  • severe muscle stiffness
  • shuffling walk
  • slowed movements
  • slurred speech
  • sores, ulcers, or white spots on the lips or in the mouth
  • stiffness of the arms and legs
  • sweating
  • swelling of the face, ankles, fingers, or lower legs
  • swollen glands
  • talking or acting with excitement you cannot control
  • tic-like (jerky) movements of the head, face, mouth, and neck
  • tiredness
  • trembling and shaking of the fingers and hands
  • twitching
  • unusual bleeding or bruising
  • unusual excitement, nervousness, or restlessness
  • unusually pale skin
  • upper right abdominal or stomach pain
  • weight gain
  • yellow eyes and skin

Some milnacipran side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned about them:

More common
  • Feeling of warmth
  • headache, severe and throbbing
  • redness of the face, neck, arms, and occasionally, upper chest
  • sudden sweating
Less common
  • Abdominal or stomach pain
  • change or problem with discharge of semen
  • decreased appetite
  • decreased interest in sexual intercourse
  • inability to have or keep an erection
  • loss in sexual ability, desire, drive, or performance
  • not able to ejaculate semen
  • rash
  • swelling of the testes
  • Acid or sour stomach
  • belching
  • bloated
  • change in taste
  • excess air or gas in the stomach or intestines
  • full feeling
  • heartburn
  • indigestion
  • irritability
  • loss of taste
  • night sweats
  • passing gas
  • sleepiness or unusual drowsiness
  • stomach discomfort, upset, or pain
Incidence not known
  • Swelling of the breasts or unusual milk production
  • unexpected or excess milk flow from the breasts

For Healthcare Professionals

Applies to milnacipran: oral tablet


Very common (10% or more): Nausea (35%), constipation (16%),
Common (1% to 10%): Vomiting (6%), dry mouth (5%), abdominal pain (3%)
Uncommon (0.1% to 1%): Decreased appetite (1%)
Frequency not reported: Anorexia, diarrhea, dyspepsia, gastroesophageal reflux disease, flatulence, abdominal distension[Ref]

Nervous system

Very common (10% or more): Headache (19%), dizziness (11%)
Common (1% to 10%): Migraine (6%), paresthesia (2%), tremor (2%), tension headache (2%), hypoesthesia (1%)
Frequency not reported: Night sweats, somnolence, dysgeusia, fatigue, convulsions (including grand mal), loss of consciousness, neuroleptic malignant syndrome, Parkinsonism, serotonin syndrome[Ref]


Very common (10% or more): Insomnia (12%)
Common (1% to 10%): anxiety (5%)
Frequency not reported: Aggression, depression, stress, anger, delirium, hallucinations, homicidal ideation, irritability[Ref]


Common (1% to 10%): Palpitations (8%), hypertension (7%), increased heart rate (5%), increased blood pressure (3%), tachycardia (3%), chest pain (3%), chest discomfort (2%)
Postmarketing reports: Supraventricular tachycardia, hypertensive crisis[Ref]


Common (1% to 10%): Hyperhidrosis (8%), rash (3%), pruritus (3%)
Frequency not reported: Night sweats, erythema multiforme, Stevens Johnson syndrome[Ref]


Common (1% to 10%): Upper respiratory tract infection (7%), upper respiratory tract infection (6%), dyspnea (2%)[Ref]


Common (1% to 10%): Blurred vision (1%)
Frequency not reported: Accommodation disorder[Ref]


Common (1% to 10%): Reported in at least 2% of males: Dysuria, ejaculation disorder, erectile dysfunction, ejaculation failure, decreased libido, prostatitis, scrotal pain, testicular pain, testicular swelling, urinary hesitation, urinary retention, urethral pain, decreased urine flow, cystitis, galactorrhea
Frequency not reported: Urinary tract infection[Ref]


Frequency not reported: Contusion, fall, physical dependence[Ref]

Milnacipran produces physical dependence, including withdrawal symptoms following drug discontinuation, similar to other SNRIs and SSRIs. These withdrawal symptoms can be severe.[Ref]


Very common (10% or more): Hot flush (11%)
Common (1% to 10%): Flushing (2%), chills (1%)
Frequency not reported: Weight decreased or increased, hypercholesterolemia, hyponatremia, pyrexia, peripheral edema[Ref]


Frequency not reported: Urinary tract infection, cystitis, acute renal failure[Ref]


Frequency not reported: Leukopenia, neutropenia, thrombocytopenia[Ref]


Frequency not reported: Hyperprolactinemia, galactorrhea[Ref]


Frequency not reported: Hepatitis[Ref]


Frequency not reported: Rhabdomyolysis[Ref]


1. "Product Information. Savella (milnacipran)." Forest Pharmaceuticals, St. Louis, MO.

2. Arai M "Parkinsonism associated with a serotonin and noradrenaline reuptake inhibitor, milnacipran." J Neurol Neurosurg Psychiatry 74 (2003): 137-8

3. Yoshida K, Higuchi H, Takahashi H, Shimizu T "Elevation of blood pressure induced by high-dose milnacipran." Hum Psychopharmacol 17 (2002): 431

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