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Fetzima Side Effects

Generic Name: levomilnacipran

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

In Summary

Common side effects of Fetzima include: erectile dysfunction, nausea, and orthostatic hypotension. Other side effects include: constipation, ejaculatory disorder, epididymitis, increased heart rate, palpitations, premature ejaculation, sinus tachycardia, tachycardia, testicular pain, urinary hesitancy, vomiting, delayed ejaculation, ejaculation failure, and hyperhidrosis. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to levomilnacipran: oral capsule extended release

Along with its needed effects, levomilnacipran (the active ingredient contained in Fetzima) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while 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 side effects of levomilnacipran may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

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


The most commonly reported side effects were nausea, constipation, hyperhidrosis, increased heart rate, erectile dysfunction, tachycardia, vomiting, and palpitations.[Ref]


Frequency not reported: Hypersensitivity


Frequency not reported: Agitation, anger, bruxism, panic attack, tension, aggression, activation of mania/hypomania, discontinuation syndrome, suicidal thought and behaviors in adolescents and young adults[Ref]

Nervous system

Frequency not reported: Seizure, serotonin syndrome, migraine, paresthesia, syncope, extrapyramidal disorder[Ref]


Common (1% to 10%): Tachycardia, increased heart rate, palpitations, hypertension, hypotension, hot flush
Frequency not reported: Angina pectoris, supraventricular and ventricular extra systoles, chest pain[Ref]


Common (1% to 10%): Decreased appetite
Frequency not reported: Thirst, increased blood cholesterol, hyponatremia[Ref]


Frequency not reported: Dry eye, blurred vision, conjunctival hemorrhage, angle closure glaucoma[Ref]


Very common (10% or more): Nausea (17%)
Common (1% to 10%): Constipation, vomiting
Frequency not reported: Abdominal pain, flatulence[Ref]


Common (1% to 10%): Hyperhidrosis, rash
Frequency not reported: Dry skin, pruritus, urticaria[Ref]


Common (1% to 10%): Erectile dysfunction, ejaculation disorder, testicular pain, urinary hesitation
Frequency not reported: Pollakiuria, hematuria, proteinuria[Ref]


Frequency not reported: Abnormal bleeding[Ref]


Frequency not reported: Abnormal liver function test[Ref]


Frequency not reported: Yawning[Ref]


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

Some side effects of Fetzima may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.