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Levomilnacipran Side Effects

In Summary

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. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to levomilnacipran: oral capsule extended release

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

Major Side Effects

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

Minor Side Effects

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


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.

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

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