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Statements

Subject Item
n2:DB04896
rdf:type
n5:Drug
n5:description
Milnacipran is an antidepressant of the serotonin-norepinephrine reuptake inhibitor class. It more potently inhibits norepinephrine uptake than serotonin. It is provided as a racemic mixture. FDA approved in January 2009.
n5:dosage
n19:271B5DF2-363D-11E5-9242-09173F13E4C5 n19:271B5DEE-363D-11E5-9242-09173F13E4C5 n19:271B5DEF-363D-11E5-9242-09173F13E4C5 n19:271B5DF0-363D-11E5-9242-09173F13E4C5 n19:271B5DF1-363D-11E5-9242-09173F13E4C5
n5:generalReferences
# Leo RJ, Brooks VL: Clinical potential of milnacipran, a serotonin and norepinephrine reuptake inhibitor, in pain. Curr Opin Investig Drugs. 2006 Jul;7(7):637-42. "Pubmed":http://www.ncbi.nlm.nih.gov/pubmed/16869117 # Sato S, Yamakawa Y, Terashima Y, Ohta H, Asada T: Efficacy of milnacipran on cognitive dysfunction with post-stroke depression: preliminary open-label study. Psychiatry Clin Neurosci. 2006 Oct;60(5):584-9. "Pubmed":http://www.ncbi.nlm.nih.gov/pubmed/16958942 # Simon LS: Is milnacipran effective in treating pain in patients with fibromyalgia? Nat Clin Pract Rheumatol. 2006 Mar;2(3):126-7. "Pubmed":http://www.ncbi.nlm.nih.gov/pubmed/16932669 # Soya A, Terao T, Nakajima M, Kojima H, Okamoto T, Inoue Y, Iwakawa M, Shinkai K, Yoshimura R, Ueta Y, Nakamura J: Effects of repeated milnacipran administration on brain serotonergic and noradrenergic functions in healthy volunteers. Psychopharmacology (Berl). 2006 Sep;187(4):526-7. Epub 2006 Jul 8. "Pubmed":http://www.ncbi.nlm.nih.gov/pubmed/16830129 # King T, Rao S, Vanderah T, Chen Q, Vardanyan A, Porreca F: Differential blockade of nerve injury-induced shift in weight bearing and thermal and tactile hypersensitivity by milnacipran. J Pain. 2006 Jul;7(7):513-20. "Pubmed":http://www.ncbi.nlm.nih.gov/pubmed/16814690 # Moojen VK, Martins MR, Reinke A, Feier G, Agostinho FR, Cechin EM, Quevedo J: Effects of milnacipran in animal models of anxiety and memory. Neurochem Res. 2006 Apr;31(4):571-7. Epub 2006 May 9. "Pubmed":http://www.ncbi.nlm.nih.gov/pubmed/16758367 # Moret C, Charveron M, Finberg JP, Couzinier JP, Briley M: Biochemical profile of midalcipran (F 2207), 1-phenyl-1-diethyl-aminocarbonyl-2-aminomethyl-cyclopropane (Z) hydrochloride, a potential fourth generation antidepressant drug. Neuropharmacology. 1985 Dec;24(12):1211-9. "Pubmed":http://www.ncbi.nlm.nih.gov/pubmed/3005901 # Briley M, Prost JF, Moret C: Preclinical pharmacology of milnacipran. Int Clin Psychopharmacol. 1996 Sep;11 Suppl 4:9-14. "Pubmed":http://www.ncbi.nlm.nih.gov/pubmed/8923122 # Puozzo C, Panconi E, Deprez D: Pharmacology and pharmacokinetics of milnacipran. Int Clin Psychopharmacol. 2002 Jun;17 Suppl 1:S25-35. "Pubmed":http://www.ncbi.nlm.nih.gov/pubmed/12369608 # Leinonen E, Lepola U, Koponen H, Mehtonen OP, Rimon R: Long-term efficacy and safety of milnacipran compared to clomipramine in patients with major depression. Acta Psychiatr Scand. 1997 Dec;96(6):497-504. "Pubmed":http://www.ncbi.nlm.nih.gov/pubmed/9421348 # Papakostas GI, Fava M: A meta-analysis of clinical trials comparing milnacipran, a serotonin--norepinephrine reuptake inhibitor, with a selective serotonin reuptake inhibitor for the treatment of major depressive disorder. Eur Neuropsychopharmacol. 2007 Jan;17(1):32-6. Epub 2006 Jun 8. "Pubmed":http://www.ncbi.nlm.nih.gov/pubmed/16762534 # Kako Y, Niwa Y, Toyomaki A, Yamanaka H, Kitagawa N, Denda K, Koyama T: A case of adult attention-deficit/hyperactivity disorder alleviated by milnacipran. Prog Neuropsychopharmacol Biol Psychiatry. 2007 Apr 13;31(3):772-5. Epub 2007 Jan 12. "Pubmed":http://www.ncbi.nlm.nih.gov/pubmed/17300859 # Bernstein CD, Albrecht KL, Marcus DA: Milnacipran for fibromyalgia: a useful addition to the treatment armamentarium. Expert Opin Pharmacother. 2013 Mar 19. "Pubmed":http://www.ncbi.nlm.nih.gov/pubmed/23506481
n5:group
approved
n5:halfLife
The terminal elimination half-life, when given to healthy subjects is 6-8 hours. When given to severe renal impairment patients is 7 - 10 hours. The active enantiomer, d-milnacipran, has a longer elimination half-life (8-10 hours) than the l-enantiomer (4-6 hours).
n5:indication
Milnacipran is used to treat moderate to severe clinical depression but this indication is not yet FDA-approved in the USA. Milnacipran is labelled for the treatment of fibromyalgia pain.
owl:sameAs
n4:DB04896 n15:DB04896
dcterms:title
Milnacipran
adms:identifier
n7:0456-1512-60 n8:65833 n9:59245 n12:DB04896 n14:46506141 n18:50239538 n20:PA164752812 n21:Milnacipran n22:D08222
n5:mechanismOfAction
Milnacipran inhibits norepinephrine and serotonin reuptake in a 3:1 ratio, in practical use this means a balanced (equal) action upon both transmitters. The serotonin reuptake inhibition is likely to improve depression, while the norepinephrine reuptake inihibition probably improves chronic pain. Milnacipran exerts no significant actions on postynaptic H1, alpha-1, D1, D2, and muscarinic receptors, as well as on benzodiazepine/opiate binding sites. [Wikipedia]
n5:packager
n29:271B5DE9-363D-11E5-9242-09173F13E4C5 n29:271B5DE7-363D-11E5-9242-09173F13E4C5 n29:271B5DE8-363D-11E5-9242-09173F13E4C5
n5:patent
n16:6602911
n5:routeOfElimination
It is excreted predominantly unchanged in urine (50%- 60%, 24% as l-milnacipran and 31% as d-milnacipran). The l-milnacipran carbamoyl-O-glucuronide was the major metabolite excreted in urine and accounted for approximately 17% of the dose; approximately 2% of the dose was excreted in urine as d-milnacipran carbamoyl-O-glucuronide. Approximately 8% of the dose was excreted in urine as the N-desethyl milnacipran metabolite.
n5:synonym
Milnacipran Midalcipran (-)-milnacipran Milnacipranum
n5:toxicity
LD50, oral, rat: 213 mg/kg. The most frequently occurring adverse reactions (≥ 5% and greater than placebo) were nausea, headache, constipation, dizziness, insomnia, hot flush, hyperhidrosis, vomiting, palpitations, heart rate increased, dry mouth, and hypertension.
n5:volumeOfDistribution
400 L, following a single IV dose to a healthy subject.
n27:hasAHFSCode
n28:28-16-04-16 n28:28-40%20
n5:proteinBinding
Plasma protein binding is 13%.
n5:salt
n5:synthesisReference
Jean Deregnaucourt, "Use of the (1S,2R) enantiomer of milnacipran for the preparation of a drug." U.S. Patent US20040259953, issued December 23, 2004.
n25:hasConcept
n26:M0138607
foaf:page
n11:milnacipran.html n17:savella-drug.htm
n5:IUPAC-Name
n13:271B5DF7-363D-11E5-9242-09173F13E4C5
n5:InChI
n13:271B5DFD-363D-11E5-9242-09173F13E4C5
n5:Molecular-Formula
n13:271B5DFC-363D-11E5-9242-09173F13E4C5
n5:Molecular-Weight
n13:271B5DF9-363D-11E5-9242-09173F13E4C5
n5:Monoisotopic-Weight
n13:271B5DFA-363D-11E5-9242-09173F13E4C5
n5:SMILES
n13:271B5DFB-363D-11E5-9242-09173F13E4C5
n5:Water-Solubility
n13:271B5DF5-363D-11E5-9242-09173F13E4C5 n13:271B5E0C-363D-11E5-9242-09173F13E4C5
n5:logP
n13:271B5DF6-363D-11E5-9242-09173F13E4C5 n13:271B5DF3-363D-11E5-9242-09173F13E4C5
n5:logS
n13:271B5DF4-363D-11E5-9242-09173F13E4C5
n27:hasATCCode
n30:N06AX17
n5:H-Bond-Acceptor-Count
n13:271B5E03-363D-11E5-9242-09173F13E4C5
n5:H-Bond-Donor-Count
n13:271B5E04-363D-11E5-9242-09173F13E4C5
n5:InChIKey
n13:271B5DFE-363D-11E5-9242-09173F13E4C5
n5:Polar-Surface-Area--PSA-
n13:271B5DFF-363D-11E5-9242-09173F13E4C5
n5:Polarizability
n13:271B5E01-363D-11E5-9242-09173F13E4C5
n5:Refractivity
n13:271B5E00-363D-11E5-9242-09173F13E4C5
n5:Rotatable-Bond-Count
n13:271B5E02-363D-11E5-9242-09173F13E4C5
n5:absorption
Milnacipran is well absorbed following oral administration with an absolute bioavailability of 85-90%. Meals have no effect on absorption. Peak concentrations occur 2 -4 hours post-administration and is delayed in elderly patients. Time to steady state = 36 - 48 hours;
n5:affectedOrganism
Humans and other mammals
n5:casRegistryNumber
92623-85-3
n5:category
n5:containedIn
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n5:Bioavailability
n13:271B5E08-363D-11E5-9242-09173F13E4C5
n5:Ghose-Filter
n13:271B5E0A-363D-11E5-9242-09173F13E4C5
n5:MDDR-Like-Rule
n13:271B5E0B-363D-11E5-9242-09173F13E4C5
n5:Melting-Point
n13:271B5E0D-363D-11E5-9242-09173F13E4C5
n5:Number-of-Rings
n13:271B5E07-363D-11E5-9242-09173F13E4C5
n5:Physiological-Charge
n13:271B5E06-363D-11E5-9242-09173F13E4C5
n5:Rule-of-Five
n13:271B5E09-363D-11E5-9242-09173F13E4C5
n5:Traditional-IUPAC-Name
n13:271B5DF8-363D-11E5-9242-09173F13E4C5
n5:pKa--strongest-basic-
n13:271B5E05-363D-11E5-9242-09173F13E4C5