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milnacipran 🐶 Veterinary Use | Indications/Contra | FAERs-F | FAERs-M | Orange Bk | BioActivity |

Stem definition	Drug id	CAS RN
	1808	92623-85-3

Description:

Molecule	Description
Molfile Inchi Smiles Synonyms: milnacipran midalcipran (+/-)-Milnacipran milnacipran hydrochloride milnacipran HCl	A cyclopropanecarboxamide serotonin and norepinephrine reuptake inhibitor (SNRI) that is used in the treatment of FIBROMYALGIA. Molecular weight: 246.35 Formula: C15H22N2O CLOGP: 1.91 LIPINSKI: 0 HAC: 3 HDO: 1 TPSA: 46.33 ALOGS: -2.30 ROTB: 5 Status: OFP Legend: OFP - off patent OFM - off market ONP - on patent

Molecule

Description

Molfile Inchi Smiles

Synonyms:

milnacipran
midalcipran
(+/-)-Milnacipran
milnacipran hydrochloride
milnacipran HCl

A cyclopropanecarboxamide serotonin and norepinephrine reuptake inhibitor (SNRI) that is used in the treatment of FIBROMYALGIA.

Molecular weight: 246.35
Formula: C15H22N2O
CLOGP: 1.91
LIPINSKI: 0
HAC: 3
HDO: 1
TPSA: 46.33
ALOGS: -2.30
ROTB: 5

Status: OFP

Legend:
OFP - off patent
OFM - off market
ONP - on patent

Drug dosage:

Dose	Unit	Route
0.10	g	O

ADMET properties:

Property	Value	Reference
BDDCS (Biopharmaceutical Drug Disposition Classification System)	3	Benet LZ, Broccatelli F, Oprea TI
EoM (Fraction excreted unchanged in urine)	55 %	Benet LZ, Broccatelli F, Oprea TI
MRTD (Maximum Recommended Therapeutic Daily Dose)	11.60 µM/kg/day	Contrera JF, Matthews EJ, Kruhlak NL, Benz RD
BA (Bioavailability)	84 %	Kim MT, Sedykh A, Chakravarti SK, Saiakhov RD, Zhu H
Vd (Volume of distribution)	4.51 L/kg	Lombardo F, Berellini G, Obach RS
CL (Clearance)	8.17 mL/min/kg	Lombardo F, Berellini G, Obach RS
fu (Fraction unbound in plasma)	0.87 %	Lombardo F, Berellini G, Obach RS
t_half (Half-life)	6.48 hours	Lombardo F, Berellini G, Obach RS

Approvals:

Date	Agency	Company	Orphan
Jan. 14, 2009	FDA	CYPRESS BIOSCIENCE

FDA Adverse Event Reporting System (Female)

MedDRA adverse event term	Likelihood ratio	Likelihood ratio threshold	Patients taking drug having adverse event	Patients taking drug not having adverse event	Patients not taking drug having adverse event	Patients not taking drug not having adverse event
Suicidal ideation	136.71	17.75	86	7075	62335	63419526
Drug hypersensitivity	98.26	17.75	146	7015	310541	63171320
Serotonin syndrome	93.04	17.75	51	7110	28631	63453230
Somatic delusion	77.26	17.75	17	7144	575	63481286
Hyperhidrosis	72.05	17.75	74	7087	107762	63374099
Nausea	65.94	17.75	228	6933	854243	62627618
Migraine	60.29	17.75	66	7095	103280	63378581
Hot flush	55.38	17.75	46	7115	51113	63430748
Blepharospasm	55.32	17.75	22	7139	5974	63475887
Headache	50.42	17.75	171	6990	633070	62848791
Urine odour abnormal	43.91	17.75	19	7142	6370	63475491
Heart rate increased	42.91	17.75	53	7108	94185	63387676
Persistent genital arousal disorder	41.72	17.75	9	7152	277	63481584
Gastrointestinal motility disorder	41.10	17.75	17	7144	5102	63476759
Abnormal faeces	39.98	17.75	17	7144	5463	63476398
Depression	38.79	17.75	75	7086	196417	63285444
Blood thyroid stimulating hormone normal	36.58	17.75	7	7154	116	63481745
Insomnia	36.35	17.75	77	7084	215175	63266686
Taste disorder	35.42	17.75	21	7140	13641	63468220
Anger	34.54	17.75	20	7141	12436	63469425
Oral discomfort	34.42	17.75	18	7143	9183	63472678
Memory impairment	32.79	17.75	49	7112	104209	63377652
Chromaturia	31.53	17.75	21	7140	16696	63465165
Blood pressure increased	30.92	17.75	61	7100	162001	63319860
Tremor	27.95	17.75	52	7109	132187	63349674
Musculoskeletal discomfort	27.84	17.75	20	7141	17947	63463914
Lip swelling	27.66	17.75	25	7136	31038	63450823
Crying	27.36	17.75	22	7139	23321	63458540
Aphasia	26.37	17.75	25	7136	32975	63448886
Flushing	26.08	17.75	37	7124	75050	63406811
Homicidal ideation	25.57	17.75	9	7152	1743	63480118
Palpitations	24.65	17.75	45	7116	112725	63369136
Epilepsy	24.53	17.75	22	7139	27043	63454818
Vomiting	24.50	17.75	126	7035	559491	62922370
Paraesthesia	21.81	17.75	52	7109	156914	63324947
Irritability	21.58	17.75	22	7139	31672	63450189
Disturbance in attention	21.56	17.75	24	7137	38165	63443696
Drug withdrawal syndrome	20.59	17.75	20	7141	27174	63454687
Withdrawal syndrome	19.61	17.75	17	7144	19980	63461881
Feeling abnormal	19.38	17.75	48	7113	148344	63333517
Hypoaesthesia	18.44	17.75	51	7110	168342	63313519
Ear infection	18.19	17.75	22	7139	38191	63443670
Swollen tongue	18.17	17.75	21	7140	34779	63447082
Blood catecholamines increased	18.04	17.75	3	7158	21	63481840
Panic attack	17.99	17.75	17	7144	22314	63459547

FDA Adverse Event Reporting System (Male)

MedDRA adverse event term	Likelihood ratio	Likelihood ratio threshold	Patients taking drug having adverse event	Patients taking drug not having adverse event	Patients not taking drug having adverse event	Patients not taking drug not having adverse event
Urinary retention	48.56	26.18	23	1022	36265	34919621
Suicidal ideation	46.22	26.18	23	1022	40365	34915521
Agoraphobia	40.87	26.18	7	1038	245	34955641
Bicytopenia	34.66	26.18	9	1036	2375	34953511
Dysuria	32.62	26.18	16	1029	27136	34928750
Neurosis	29.69	26.18	5	1040	158	34955728
Urinary hesitation	28.59	26.18	8	1037	2794	34953092

FDA Adverse Event Reporting System (Geriatric)

MedDRA adverse event term	Likelihood ratio	Likelihood ratio threshold	Patients taking drug having adverse event	Patients taking drug not having adverse event	Patients not taking drug having adverse event	Patients not taking drug not having adverse event
Suicidal ideation	129.32	18.90	78	6118	76262	79661930
Drug hypersensitivity	109.45	18.90	125	6071	298791	79439401
Somatic delusion	80.31	18.90	17	6179	701	79737491
Serotonin syndrome	68.51	18.90	43	6153	44984	79693208
Migraine	64.89	18.90	54	6142	87439	79650753
Blepharospasm	63.84	18.90	22	6174	5829	79732363
Headache	52.36	18.90	139	6057	653633	79084559
Gastrointestinal motility disorder	47.90	18.90	18	6178	6104	79732088
Persistent genital arousal disorder	45.22	18.90	9	6187	272	79737920
Urine odour abnormal	43.89	18.90	17	6179	6256	79731936
Hyperhidrosis	43.28	18.90	56	6140	151436	79586756
Nausea	41.53	18.90	165	6031	957031	78781161
Heart rate increased	41.52	18.90	49	6147	120675	79617517
Hot flush	40.93	18.90	34	6162	54843	79683349
Abnormal faeces	40.80	18.90	17	6179	7554	79730638
Oral discomfort	39.79	18.90	18	6178	9742	79728450
Blood thyroid stimulating hormone normal	39.08	18.90	7	6189	118	79738074
Memory impairment	37.83	18.90	45	6151	111689	79626503
Taste disorder	37.04	18.90	20	6176	15803	79722389
Urinary hesitation	31.41	18.90	12	6184	4254	79733938
Anger	30.20	18.90	18	6178	17144	79721048
Lip swelling	29.78	18.90	25	6171	40886	79697306
Depression	29.46	18.90	57	6139	216733	79521459
Hypoaesthesia	29.21	18.90	51	6145	179301	79558891
Chromaturia	28.07	18.90	20	6176	25726	79712466
Musculoskeletal discomfort	27.80	18.90	18	6178	19817	79718375
Crying	27.69	18.90	19	6177	23024	79715168
Aphasia	26.90	18.90	25	6171	46707	79691485
Flushing	25.76	18.90	33	6163	88235	79649957
Withdrawal syndrome	25.08	18.90	19	6177	26835	79711357
Anxiety	24.13	18.90	57	6139	248455	79489737
Insomnia	23.55	18.90	56	6140	245114	79493078
Agoraphobia	23.42	18.90	6	6190	572	79737620
Pain	23.25	18.90	112	6084	703690	79034502
Ear infection	22.93	18.90	20	6176	34412	79703780
Drug withdrawal syndrome	22.79	18.90	20	6176	34698	79703494
Paraesthesia	22.30	18.90	45	6151	176278	79561914
Blood pressure increased	22.18	18.90	50	6146	211310	79526882
Epilepsy	21.88	18.90	21	6175	40839	79697353
Disturbance in attention	21.51	18.90	23	6173	50778	79687414
Bicytopenia	20.27	18.90	9	6187	4661	79733531
Panic attack	20.15	18.90	16	6180	24200	79713992
Palpitations	19.31	18.90	35	6161	126575	79611617

FDA Adverse Event Reporting System (Pediatric)

None

Pharmacologic Action:

Source	Code	Description
ATC	N06AX17	NERVOUS SYSTEM PSYCHOANALEPTICS ANTIDEPRESSANTS Other antidepressants
FDA MoA	N0000000102	Norepinephrine Uptake Inhibitors
FDA MoA	N0000000109	Serotonin Uptake Inhibitors
MeSH PA	D000700	Analgesics
MeSH PA	D018712	Analgesics, Non-Narcotic
MeSH PA	D002491	Central Nervous System Agents
MeSH PA	D049990	Membrane Transport Modulators
MeSH PA	D018377	Neurotransmitter Agents
MeSH PA	D014179	Neurotransmitter Uptake Inhibitors
MeSH PA	D018373	Peripheral Nervous System Agents
MeSH PA	D018689	Sensory System Agents
MeSH PA	D000068760	Serotonin and Noradrenaline Reuptake Inhibitors
FDA EPC	N0000175749	Serotonin and Norepinephrine Reuptake Inhibitor

Drug Use | Suggest Off label Use Form| |View source of the data|

Disease	Relation	SNOMED_ID	DOID
Fibromyalgia	indication	203082005	DOID:631
Tachyarrhythmia	contraindication	6285003
Urinary tract obstruction	contraindication	7163005	DOID:5200
Alcoholism	contraindication	7200002
Hypertensive disorder	contraindication	38341003	DOID:10763
Disorder of cardiovascular system	contraindication	49601007	DOID:1287
Syndrome of inappropriate vasopressin secretion	contraindication	55004003	DOID:3401
Acute nephropathy	contraindication	58574008
Blood coagulation disorder	contraindication	64779008	DOID:1247
Hyponatremia	contraindication	89627008
Seizure disorder	contraindication	128613002
Liver function tests abnormal	contraindication	166603001
Mania	contraindication	231494001
Hypomania	contraindication	231496004
Disease of liver	contraindication	235856003	DOID:409
Suicidal	contraindication	267073005
Serotonin syndrome	contraindication	371089000
Angle-closure glaucoma	contraindication	392291006	DOID:13550

🐶 Veterinary Drug Use

None

🐶 Veterinary products

None

Acid dissociation constants calculated using MoKa v3.0.0

Dissociation level	Dissociation constant	Type (acidic/basic)
pKa1	10.64	Basic

Orange Book patent data (new drug applications)

Formulation strength	Trade name	Applicant	Application number	Approval date	Type	Dose form	Route	Patent number	Patent expiration date	Patent use
100MG	SAVELLA	ABBVIE	N022256	Jan. 14, 2009	RX	TABLET	ORAL	6602911	Jan. 14, 2023	MANAGEMENT OF FIBROMYALGIA (FM)
12.5MG	SAVELLA	ABBVIE	N022256	Jan. 14, 2009	RX	TABLET	ORAL	6602911	Jan. 14, 2023	MANAGEMENT OF FIBROMYALGIA (FM)
25MG	SAVELLA	ABBVIE	N022256	Jan. 14, 2009	RX	TABLET	ORAL	6602911	Jan. 14, 2023	MANAGEMENT OF FIBROMYALGIA (FM)
50MG	SAVELLA	ABBVIE	N022256	Jan. 14, 2009	RX	TABLET	ORAL	6602911	Jan. 14, 2023	MANAGEMENT OF FIBROMYALGIA (FM)
100MG	SAVELLA	ABBVIE	N022256	Jan. 14, 2009	RX	TABLET	ORAL	7994220	Sept. 19, 2029	MANAGEMENT OF FIBROMYALGIA
12.5MG	SAVELLA	ABBVIE	N022256	Jan. 14, 2009	RX	TABLET	ORAL	7994220	Sept. 19, 2029	MANAGEMENT OF FIBROMYALGIA
25MG	SAVELLA	ABBVIE	N022256	Jan. 14, 2009	RX	TABLET	ORAL	7994220	Sept. 19, 2029	MANAGEMENT OF FIBROMYALGIA
50MG	SAVELLA	ABBVIE	N022256	Jan. 14, 2009	RX	TABLET	ORAL	7994220	Sept. 19, 2029	MANAGEMENT OF FIBROMYALGIA

Orange Book exclusivity data (new drug applications)

None

Bioactivity Summary:

Target	Class	Pharos	UniProt	Action	Type	Activity value (-log[M])	Bioact source	MoA source
Sodium-dependent serotonin transporter	Transporter	P31645	SC6A4_HUMAN	INHIBITOR	Ki	7.29	WOMBAT-PK	CHEMBL
Sodium-dependent noradrenaline transporter	Transporter	P23975	SC6A2_HUMAN	INHIBITOR	Ki	7.60	WOMBAT-PK	CHEMBL
Sodium-dependent dopamine transporter	Transporter	Q01959	SC6A3_HUMAN		IC50	5.21	CHEMBL
Glutamate receptor ionotropic, NMDA 2A	Ion channel	Q12879	NMDE1_HUMAN		IC50	5.20	WOMBAT-PK
Sodium-dependent serotonin transporter	Transporter		SC6A4_RAT		IC50	7.33	CHEMBL
Sodium-dependent dopamine transporter	Transporter		SC6A3_RAT		IC50	4.43	CHEMBL
Transporter	Transporter		Q63380_RAT		IC50	7.52	CHEMBL

External reference:

ID	Source
4025253	VUID
N0000179785	NUI
D01107	KEGG_DRUG
101152-94-7	SECONDARY_CAS_RN
4025253	VANDF
4028372	VANDF
C1533126	UMLSCUI
CHEBI:135005	CHEBI
CHEMBL252923	ChEMBL_ID
CHEMBL259209	ChEMBL_ID
DB04896	DRUGBANK_ID
CHEMBL4297064	ChEMBL_ID
D000078764	MESH_DESCRIPTOR_UI
65833	PUBCHEM_CID
7436	IUPHAR_LIGAND_ID
5701	INN_ID
G56VK1HF36	UNII
30003	RXNORM
26139	MMSL
d06635	MMSL
008263	NDDF
008264	NDDF
441641002	SNOMEDCT_US
442542004	SNOMEDCT_US
442642007	SNOMEDCT_US
CHEMBL1237129	ChEMBL_ID

Pharmaceutical products:

Product	Category	Ingredients	NDC	Form	Quantity	Route	Marketing	Label
Savella	HUMAN PRESCRIPTION DRUG LABEL	1	0456-1510	TABLET, FILM COATED	100 mg	ORAL	NDA	38 sections
Savella	HUMAN PRESCRIPTION DRUG LABEL	1	0456-1510	TABLET, FILM COATED	100 mg	ORAL	NDA	38 sections
Savella	HUMAN PRESCRIPTION DRUG LABEL	1	0456-1512	TABLET, FILM COATED	12.50 mg	ORAL	NDA	38 sections
Savella	HUMAN PRESCRIPTION DRUG LABEL	1	0456-1512	TABLET, FILM COATED	12.50 mg	ORAL	NDA	38 sections
Savella	HUMAN PRESCRIPTION DRUG LABEL	1	0456-1525	TABLET, FILM COATED	25 mg	ORAL	NDA	38 sections
Savella	HUMAN PRESCRIPTION DRUG LABEL	1	0456-1525	TABLET, FILM COATED	25 mg	ORAL	NDA	38 sections
Savella	HUMAN PRESCRIPTION DRUG LABEL	1	0456-1550	TABLET, FILM COATED	50 mg	ORAL	NDA	38 sections
Savella	HUMAN PRESCRIPTION DRUG LABEL	1	0456-1550	TABLET, FILM COATED	50 mg	ORAL	NDA	38 sections
SAVELLA	HUMAN PRESCRIPTION DRUG LABEL	1	16590-845	TABLET, FILM COATED	25 mg	ORAL	NDA	35 sections
SAVELLA	HUMAN PRESCRIPTION DRUG LABEL	1	16590-846	TABLET, FILM COATED	50 mg	ORAL	NDA	35 sections
SAVELLA	HUMAN PRESCRIPTION DRUG LABEL	1	16590-847	TABLET, FILM COATED	100 mg	ORAL	NDA	35 sections
Savella	HUMAN PRESCRIPTION DRUG LABEL	1	21695-650	TABLET, FILM COATED	25 mg	ORAL	NDA	34 sections
Savella	HUMAN PRESCRIPTION DRUG LABEL	1	21695-651	TABLET, FILM COATED	50 mg	ORAL	NDA	34 sections
Savella	HUMAN PRESCRIPTION DRUG LABEL	1	35356-545	TABLET, FILM COATED	50 mg	ORAL	NDA	33 sections
Savella	HUMAN PRESCRIPTION DRUG LABEL	1	50436-9993	TABLET, FILM COATED	25 mg	ORAL	NDA	33 sections
Savella	HUMAN PRESCRIPTION DRUG LABEL	1	54868-6024	TABLET, FILM COATED	100 mg	ORAL	NDA	33 sections
Savella	HUMAN PRESCRIPTION DRUG LABEL	1	54868-6043	TABLET, FILM COATED	50 mg	ORAL	NDA	33 sections
Savella	HUMAN PRESCRIPTION DRUG LABEL	1	55154-4626	TABLET, FILM COATED	50 mg	ORAL	NDA	36 sections
Savella	HUMAN PRESCRIPTION DRUG LABEL	1	55154-4626	TABLET, FILM COATED	50 mg	ORAL	NDA	36 sections
Milnacipran HCl	HUMAN PRESCRIPTION DRUG LABEL	1	65162-091	TABLET	12.50 mg	ORAL	ANDA	21 sections
Milnacipran HCl	HUMAN PRESCRIPTION DRUG LABEL	1	65162-091	TABLET	12.50 mg	ORAL	ANDA	21 sections
Milnacipran HCl	HUMAN PRESCRIPTION DRUG LABEL	1	65162-091	TABLET	12.50 mg	ORAL	ANDA	21 sections
Milnacipran HCl	HUMAN PRESCRIPTION DRUG LABEL	1	65162-092	TABLET	25 mg	ORAL	ANDA	21 sections
Milnacipran HCl	HUMAN PRESCRIPTION DRUG LABEL	1	65162-092	TABLET	25 mg	ORAL	ANDA	21 sections
Milnacipran HCl	HUMAN PRESCRIPTION DRUG LABEL	1	65162-092	TABLET	25 mg	ORAL	ANDA	21 sections
Milnacipran HCl	HUMAN PRESCRIPTION DRUG LABEL	1	65162-093	TABLET	50 mg	ORAL	ANDA	21 sections
Milnacipran HCl	HUMAN PRESCRIPTION DRUG LABEL	1	65162-093	TABLET	50 mg	ORAL	ANDA	21 sections
Milnacipran HCl	HUMAN PRESCRIPTION DRUG LABEL	1	65162-093	TABLET	50 mg	ORAL	ANDA	21 sections
Milnacipran HCl	HUMAN PRESCRIPTION DRUG LABEL	1	65162-094	TABLET	100 mg	ORAL	ANDA	21 sections
Milnacipran HCl	HUMAN PRESCRIPTION DRUG LABEL	1	65162-094	TABLET	100 mg	ORAL	ANDA	21 sections