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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	132.43	18.39	85	6499	55300	50543240
Drug hypersensitivity	100.28	18.39	142	6442	250868	50347672
Serotonin syndrome	90.59	18.39	50	6534	24663	50573877
Hyperhidrosis	72.98	18.39	73	6511	89353	50509187
Somatic delusion	70.19	18.39	16	6568	550	50597990
Nausea	65.39	18.39	220	6364	705178	49893362
Hot flush	55.55	18.39	46	6538	44123	50554417
Headache	52.16	18.39	164	6420	506371	50092169
Heart rate increased	43.65	18.39	52	6532	77198	50521342
Persistent genital arousal disorder	41.57	18.39	9	6575	243	50598297
Migraine	41.43	18.39	50	6534	75230	50523310
Urine odour abnormal	41.19	18.39	18	6566	5355	50593185
Insomnia	39.85	18.39	77	6507	174788	50423752
Abnormal faeces	38.61	18.39	16	6568	4180	50594360
Gastrointestinal motility disorder	37.50	18.39	16	6568	4493	50594047
Blood thyroid stimulating hormone normal	35.59	18.39	7	6577	116	50598424
Depression	34.26	18.39	70	6514	165353	50433187
Anger	33.65	18.39	20	6564	11313	50587227
Blood pressure increased	32.01	18.39	60	6524	133072	50465468
Chromaturia	29.02	18.39	20	6564	14570	50583970
Oral discomfort	28.75	18.39	16	6568	8001	50590539
Lip swelling	27.47	18.39	24	6560	24712	50573828
Crying	27.20	18.39	22	6562	20394	50578146
Tremor	26.63	18.39	51	6533	114852	50483688
Musculoskeletal discomfort	26.33	18.39	19	6565	14879	50583661
Palpitations	25.76	18.39	45	6539	94461	50504079
Homicidal ideation	24.57	18.39	9	6575	1693	50596847
Aphasia	24.57	18.39	24	6560	28470	50570070
Flushing	23.82	18.39	36	6548	66979	50531561
Irritability	20.95	18.39	22	6562	28404	50570136
Feeling abnormal	20.17	18.39	48	6536	125444	50473096
Blepharospasm	19.79	18.39	9	6575	2939	50595601
Drug withdrawal syndrome	19.55	18.39	20	6564	25061	50573479
Withdrawal syndrome	19.40	18.39	17	6567	17573	50580967
Memory impairment	19.34	18.39	36	6548	79324	50519216
Ear infection	18.96	18.39	20	6564	25950	50572590

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	49.77	27.43	23	930	31875	29541699
Suicidal ideation	47.91	27.43	23	930	34693	29538881
Agoraphobia	40.63	27.43	7	946	235	29573339
Dysuria	34.40	27.43	16	937	22424	29551150
Urinary hesitation	29.87	27.43	8	945	2205	29571369
Neurosis	29.79	27.43	5	948	143	29573431

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	130.31	19.45	78	5596	66464	64426594
Drug hypersensitivity	118.53	19.45	124	5550	237691	64255367
Somatic delusion	73.27	19.45	16	5658	674	64492384
Serotonin syndrome	69.01	19.45	43	5631	39239	64453819
Headache	54.86	19.45	134	5540	529333	63963725
Persistent genital arousal disorder	45.34	19.45	9	5665	236	64492822
Gastrointestinal motility disorder	45.01	19.45	17	5657	5162	64487896
Migraine	44.88	19.45	40	5634	62637	64430421
Hyperhidrosis	44.73	19.45	55	5619	124865	64368193
Nausea	43.29	19.45	159	5515	785641	63707417
Heart rate increased	42.90	19.45	48	5626	98627	64394431
Hot flush	42.34	19.45	34	5640	46201	64446857
Urine odour abnormal	41.55	19.45	16	5658	5120	64487938
Abnormal faeces	39.50	19.45	16	5658	5843	64487215
Blood thyroid stimulating hormone normal	38.21	19.45	7	5667	118	64492940
Oral discomfort	33.95	19.45	16	5658	8390	64484668
Lip swelling	30.35	19.45	24	5650	31883	64461175
Anger	29.58	19.45	18	5656	15723	64477335
Depression	28.74	19.45	55	5619	183236	64309822
Crying	27.92	19.45	19	5655	20071	64472987
Insomnia	26.98	19.45	56	5618	197780	64295278
Musculoskeletal discomfort	26.52	19.45	17	5657	16260	64476798
Chromaturia	25.89	19.45	19	5655	22592	64470466
Ear infection	25.31	19.45	19	5655	23385	64469673
Withdrawal syndrome	25.24	19.45	19	5655	23473	64469585
Aphasia	25.18	19.45	24	5650	40882	64452176
Anxiety	24.91	19.45	55	5619	202594	64290464
Flushing	23.98	19.45	32	5642	78616	64414442
Blood pressure increased	23.70	19.45	49	5625	172503	64320555
Agoraphobia	23.01	19.45	6	5668	541	64492517
Drug withdrawal syndrome	22.44	19.45	20	5654	31271	64461787
Blepharospasm	22.01	19.45	9	5665	3366	64489692
Memory impairment	21.86	19.45	32	5642	85650	64407408
Palpitations	21.05	19.45	35	5639	104453	64388605
Panic attack	20.44	19.45	16	5658	20937	64472121

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	ALLERGAN	N022256	Jan. 14, 2009	RX	TABLET	ORAL	6602911	Jan. 14, 2023	MANAGEMENT OF FIBROMYALGIA (FM)
12.5MG	SAVELLA	ALLERGAN	N022256	Jan. 14, 2009	RX	TABLET	ORAL	6602911	Jan. 14, 2023	MANAGEMENT OF FIBROMYALGIA (FM)
25MG	SAVELLA	ALLERGAN	N022256	Jan. 14, 2009	RX	TABLET	ORAL	6602911	Jan. 14, 2023	MANAGEMENT OF FIBROMYALGIA (FM)
50MG	SAVELLA	ALLERGAN	N022256	Jan. 14, 2009	RX	TABLET	ORAL	6602911	Jan. 14, 2023	MANAGEMENT OF FIBROMYALGIA (FM)
100MG	SAVELLA	ALLERGAN	N022256	Jan. 14, 2009	RX	TABLET	ORAL	7994220	Sept. 19, 2029	MANAGEMENT OF FIBROMYALGIA
12.5MG	SAVELLA	ALLERGAN	N022256	Jan. 14, 2009	RX	TABLET	ORAL	7994220	Sept. 19, 2029	MANAGEMENT OF FIBROMYALGIA
25MG	SAVELLA	ALLERGAN	N022256	Jan. 14, 2009	RX	TABLET	ORAL	7994220	Sept. 19, 2029	MANAGEMENT OF FIBROMYALGIA
50MG	SAVELLA	ALLERGAN	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	37 sections
Savella	HUMAN PRESCRIPTION DRUG LABEL	1	0456-1512	TABLET, FILM COATED	12.50 mg	ORAL	NDA	37 sections
Savella	HUMAN PRESCRIPTION DRUG LABEL	1	0456-1525	TABLET, FILM COATED	25 mg	ORAL	NDA	37 sections
Savella	HUMAN PRESCRIPTION DRUG LABEL	1	0456-1550	TABLET, FILM COATED	50 mg	ORAL	NDA	37 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	33 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	65162-093	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