Milnacipran
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Universal Activity Number: 407-000-10-053-H01-T
CEUs 1.0
Audience: Pharmacy Technicians
Activity Type: Knowledge-based
Issued date: 05/01/2010
Expiration date: 05/01/2013
Submit your answers by clicking here
completed purchase is required to receive the corresponding CEUs.
CEUs 1.0
Audience: Pharmacy Technicians
Activity Type: Knowledge-based
Issued date: 05/01/2010
Expiration date: 05/01/2013
Submit your answers by clicking here
completed purchase is required to receive the corresponding CEUs.
Article title:
Milnacipran: A New Treatment for Fibromyalgia Syndrome
Goal
The pharmacology, efficacy, and tolerability of milnacipran in the treatment of symptoms of fibromyalgia syndrome and associated fibromyalgia pain are presented. The practicing pharmacist and technician are given the current rationale for the use of milnacipran that will aid in the proper care and treatment of the patient with fibromyalgia.
Objectives
Upon completion of this CE article, the reader will be able to:
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Describe the symptoms and potential pathogenesis of fibromyalgia.
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Describe the most important adverse events and other risks of milnacipran.
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State the important considerations regarding dosing and administration of milnacipran.
- Discuss the role of milnacipran in the treatment of fibromyalgia syndrome and fibromyalgia pain.
Abstract
Objective: To review the pharmacology, efficacy, and tolerability of milnacipran, a dual serotonin-norepinephrine reuptake inhibitor (SNRI), in the treatment of symptoms of fibromyalgia syndrome and associated fibromyalgia pain.
Data Sources: English-language articles were obtained via searches of MEDLINE (1950–January 2010), EMBASE (1980–January 2010), and International Pharmaceutical Abstracts (1970–January 2010), using the key words milnacipran, fibromyalgia, serotonin-norepinephrine reuptake inhibitors, F 2207, and pain management. Bibliographies of selected articles were used to identify additional sources.
Study Selection and Data Extraction: Available published articles reporting the results of human studies of milnacipran were reviewed for inclusion in this article. Additional information regarding pharmacology, adverse events, contraindications, and
precautions was obtained from the manufacturer’s prescribing information.
precautions was obtained from the manufacturer’s prescribing information.
Data Synthesis: Milnacipran is a dual SNRI approved for the treatment of fibromyalgia symptoms and pain. Milnacipran is well absorbed upon oral administration, has limited first-pass elimination, has a short half-life, and is not metabolized by the cytochrome P450 enzyme group. Phase 3 clinical trials evaluating the efficacy of milnacipran demonstrated a 10–20% higher composite response rate compared with placebo in the treatment of fibromyalgia symptoms and associated pain when milnacipran was given in doses of 100–200 mg/day. Significant improvements in physical functioning, fatigue, cognition, and mental health were also noted. Milnacipran appears to have fewer anticholinergic, sedative, and cardiovascular adverse effects compared with other pharmacologic treatments of fibromyalgia. Nausea was the most commonly reported adverse event.
Conclusions: Milnacipran is an effective treatment for the symptoms of fibromyalgia syndrome and associated pain. Additional studies are needed to assess comparative effectiveness with that of other pharmacologic treatments of fibromyalgia syndrome, long-term efficacy, and safety.
J Pharm Technol 2010;26:129-35.