Do not take this medicine with any of the following medications:

-desvenlafaxine
-duloxetine
-linezolid
-MAOIs like Carbex, Eldepryl, Marplan, Nardil, and Parnate
-methylene blue (injected into a vein)
-milnacipran
-venlafaxine

This medicine may also interact with the following medications:

-alcohol
-amphetamines
-aspirin and aspirin-like medicines
-certain medicines for depression, anxiety, or psychotic disturbances
-certain medicines for sleep
-certain medicines that treat or prevent blood clots like warfarin, enoxaparin, and dalteparin
-certain medicines for migraine headache like almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, zolmitriptan
-clarithromycin
-diuretics
-fentanyl
-furazolidone
-isoniazid
-ketoconazole
-lithium
-medicines for heart rhythm or blood pressure
-NSAIDS, medicines for pain and inflammation, like ibuprofen or naproxen
-procarbazine
-rasagiline
-ritonavir
-sibutramine
-St. John''s wort, Hypericum perforatum
-stimulant medicines for attention disorders, weight loss, or to stay awake
-tramadol
-tryptophan

They need to know if you have any of these conditions:
-bleeding disorders
-glaucoma
-heart disease
-high blood pressure
-history of irregular heartbeat
-if you drink alcohol
-kidney disease
-low levels of sodium in the blood
-mania or bipolar disorder
-seizures
-suicidal thoughts, plans, or attempt; a previous suicide attempt by you or a family member
-take MAOIs like Azilect, Carbex, Eldepryl, Marplan, Nardil, and Parnate
-take medicines that treat or prevent blood clots
-trouble passing urine
-an unusual or allergic reaction to levomilnacipran, milnacipran, other medicines, foods, or preservatives
-pregnant or trying to get pregnant
-breast-feeding

Tell your doctor if your symptoms do not get better or if they get worse. Visit your doctor or health care professional for regular checks on your progress. Because it may take several weeks to see the full effects of this medicine, it is important to continue your treatment as prescribed by your doctor. Do not stop taking except on your doctor''s advice. You may develop a severe reaction. Your doctor will tell you how much medicine to take.

Patients and their families should watch out for new or worsening thoughts of suicide or depression. Also watch out for sudden changes in feelings such as feeling anxious, agitated, panicky, irritable, hostile, aggressive, impulsive, severely restless, overly excited and hyperactive, or not being able to sleep. If this happens, especially at the beginning of treatment or after a change in dose, call your health care professional.

This medicine can cause an increase in blood pressure. Check with your doctor for instructions on monitoring your blood pressure while taking this medicine.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medicine affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Alcohol may interfere with the effect of this medicine. Avoid alcoholic drinks.

Your mouth may get dry. Chewing sugarless gum, sucking hard candy and drinking plenty of water will help. Contact your doctor if the problem does not go away or is severe.

Keep out of the reach of children.

Store at room temperature between 20 and 25 degrees C (68 and 77 degrees F). Throw away any unused medicine after the expiration date.