Posology : מינונים

4.2 Posology and method of administration

Oral use.

Adults
Recommended daily dose is 100 mg divided into two 50 mg doses, 1 capsule in the morning and 1 capsule in the evening, preferably during meals.
In this case, use 50 mg capsules.

Special populations
Elderly: dosage adjustment is not necessary as long as renal function is normal (see section 5.2).
Patients with renal insufficiency: dosage adjustment is necessary. It is recommended to reduce the dose to 50 or 25 mg depending on the degree of alteration in renal function (see section 5.2). In this case, use 25 mg capsules.
The following dose adjustment is recommended:


Creatinine clearance (CrCl) (ml/min)                        Posology / 24 h 
CrCl > 60                                         50 mg x 2
60 > CrCl ≥ 30                                      25 mg x 2
30 > CrCl ≥ 10                                       25 mg

Duration of treatment
Treatment with antidepressants is symptomatic.
As with any antidepressants, the efficacy of milnacipran only becomes apparent after a certain delay which can vary from 1 to 3 weeks.
For one episode treatment should last for several months (usually about 6 months) in order to prevent relapses.
Treatment with Milnacipran should be discontinued gradually.

Associated psychotropic treatments
Concomitant prescription of a sedative or anxiolytic treatment can be useful at the start of treatment to prevent occurrence or worsening of manifestations of anxiety.
But anxiolytics do not necessarily protect the patient from suicide attempts.