Skip to main content

Levomilnacipran Side Effects

Medically reviewed by Last updated on Oct 23, 2022.


Commonly reported side effects of levomilnacipran 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. Continue reading for a comprehensive list of adverse effects.

Applies to levomilnacipran: oral capsule extended release.


Oral route (Capsule, Extended Release)

Antidepressants increased the risk of suicidal thoughts and behaviors in pediatric and young adult patients in short-term studies. Closely monitor all antidepressant-treated patients for clinical worsening, and for emergence of suicidal thoughts and behaviors. Not approved for use in pediatric patients.

Serious side effects of Levomilnacipran

Along with its needed effects, levomilnacipran 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

  • Decreased interest in sexual intercourse
  • difficult urination
  • fast, pounding, or irregular heartbeat or pulse
  • inability to have or keep an erection
  • loss in sexual ability, desire, drive, or performance

Less common

  • Anxiety
  • arm, back, or jaw pain
  • blurred vision
  • burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • chest pain, discomfort, heaviness, or tightness
  • 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
  • shuffling walk
  • slow heartbeat
  • stiffness of the limbs
  • sweating
  • trouble breathing
  • trouble sleeping
  • twisting movements of the body
  • uncontrolled movements, especially of the face, neck, and back
  • unusual tiredness or weakness

Incidence not known

  • Delayed or inability to have an orgasm

Other side effects of Levomilnacipran

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
  • vomiting

Less common

  • 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
  • stomach pain
  • sudden sweating
  • thirst
  • yawning

For Healthcare Professionals

Applies to levomilnacipran: oral capsule extended release.


The most commonly reported side effects included nausea, erectile dysfunction, constipation, and hyperhidrosis.[Ref]


Very common (10% or more): Nausea (up to 17%)

Common (1% to 10%): Constipation, vomiting

Frequency not reported: Abdominal pain, flatulence[Ref]


Common (1% to 10%): Hot flush, hypertension, hypotension, increased blood pressure, increased heart rate, palpitations, tachycardia

Frequency not reported: Angina pectoris, chest pain, increased diastolic blood pressure, increased orthostatic blood pressure, increased orthostatic heart rate response, increased systolic blood pressure, labile hypertension, orthostatic hypotension, postural orthostatic tachycardia syndrome, sinus tachycardia, supraventricular extrasystoles, ventricular extrasystoles

Postmarketing reports: Takotsubo cardiomyopathy[Ref]


Erectile dysfunction and urinary hesitation occurred as dose-related events.[Ref]

Common (1% to 10%): Ejaculation disorder, erectile dysfunction, testicular pain, urinary hesitation

Frequency not reported: Ejaculation delayed, ejaculation failure, epididymitis, hematuria, organic erectile dysfunction, pollakiuria, proteinuria, seminal vesiculitis, urinary hesitation, urinary retention[Ref]


Common (1% to 10%): Hyperhidrosis, rash

Frequency not reported: Dry skin, erythematous rash, generalized rash, macular rash, maculopapular rash, pruritus, urticaria[Ref]


Common (1% to 10%): Decreased appetite

Frequency not reported: Hyponatremia, increased blood cholesterol, thirst[Ref]


Frequency not reported: Aggression, agitation, anger, bruxism, hypomania activation, mania activation, panic attack, premature ejaculation, psychogenic erectile dysfunction, suicidal behaviors, suicidal thoughts, tension[Ref]

Suicidal thoughts and behaviors more commonly occurred in adolescent and young adults 24 years and younger.[Ref]

Nervous system

Frequency not reported: Extrapyramidal disorder, migraine, paresthesia, postural dizziness, seizure, serotonin syndrome, syncope[Ref]


Frequency not reported: Angle closure glaucoma, blurred vision, conjunctival hemorrhage, dry eye[Ref]


Frequency not reported: Discontinuation syndrome[Ref]


Frequency not reported: Hypersensitivity[Ref]


Frequency not reported: Increased bleeding risk[Ref]


Frequency not reported: Abnormal liver function tests[Ref]


Frequency not reported: Yawning[Ref]

Frequently asked questions


1. "Product Information. Fetzima (levomilnacipran)." Forest Pharmaceuticals (2013):

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.