GlobalRPh Renal Dosing Masterv7.4
Renal Dosing Master: fast drug lookup
GlobalRPh source record

Milnacipran (Savella)

Read renal action and limits
Local official-label summarySource retrieved 2026-09-05See the evidence for this drug3 sources available - open source summaries, references and comparisons
READ THE SOURCE-SPECIFIC ANSWER

Renal guidance at a glance

Cautions / source differences (1)
Review first - source-specific qualification

SAVELLA: source applicability and renal evidence limits

Use the intact renal-dosing section, not the malformed moderate-renal PK range in the mirror. Reduced maintenance and initial titration are separate instructions.

Before applying: Do not skip titration or abruptly stop extended treatment.

Evidence for this qualification

Selected-source comparison; independent clinician adjudication pending.

Use the renal measure and units named by this source. Confirm product, indication, age, stable versus changing kidney function, and exact dialysis modality. The selected summary is not a complete prescribing monograph. Renal method and dosing checklist

Choose a source to read (3)

Display order is not a clinical ranking. Date of retrieval is not the label revision date. Sources are never merged into one regimen. Other sources and conflicts remain below.

Official source

SAVELLA: selected primary-label renal guidance and limits

This source only - not a merged recommendation

What matters first

Product: Adult oral SAVELLA for fibromyalgia; not levomilnacipran extended-release.

Renal action / finding
CrCl 5-29: maintenance 25 mg twice daily; response-dependent increase to 50 mg twice daily.
Evidence or dialysis limit
ESRD: not recommended. Mild: no adjustment; moderate: caution.
Monitoring / application
Do not skip titration or abruptly stop extended treatment.

Selected-section summary, not a complete monograph. Independent clinician review remains pending. Read the exact renal measure, dates and full source below.

Product / population
Adult oral SAVELLA for fibromyalgia; not levomilnacipran extended-release.
Renal measure
Estimated CrCl, mL/min; severe 5-29
Source revision
Revision date not captured in selected review; retrieval date is not revision date.
Retrieved
2026-11-07 (not the revision date)
Dose or interval guidance. Use only the product, indication, renal metric and population described in this source.
Before using this finding

ESRD: not recommended. Mild: no adjustment; moderate: caution.

Selected renal section, not a complete prescribing monograph. A label and its mirror are not independent evidence.

Section 2.2; discontinuation context

Mild impairment requires no adjustment; use caution in moderate impairment. At CrCl 5-29 mL/min, reduce maintenance to 25 mg twice daily; depending on response it may increase to 50 mg twice daily. ESRD use is not recommended. This is maintenance guidance, not an instruction to skip initial titration. Monitor tolerability and taper after extended use.

Source revision: Revision date not captured in selected review; retrieval date is not revision date. | Retrieved: 2026-11-07. Retrieval date is not the revision date.

Source: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=8b720a1e-034b-4583-b80d-105a794cce74

Scope: Selected sections checked against the identified source; not a complete monograph or independent clinician approval. GlobalRPh v7.4.

Full source card / provenance

All sources, comparison tools and evidence navigation
Source-specific interpretation

What the dialysis evidence actually supports

Removal information alone does not define a maintenance dose, supplemental dose or dialysis schedule. A reported regimen still requires its product, indication, renal measure and dialysis assumptions to match the patient.

SAVELLA: selected primary-label renal guidance and limits

Source retrieved 2026-11-07 - confirm current applicability

No dialysis regimen established in selected content

Read the source and its limits

SAVELLA: selected RX renal passage

Source retrieved 2026-11-07 - confirm current applicability

No dialysis regimen established in selected content

Read the source and its limits

These manual classifications apply only to the identified selected sections, not every retained source or the entire prescribing information. They are not dosing clearance.

Source-first renal review

Evidence sources and renal implications

Choose a source to jump directly to its locally stored result. Qualitative precautions and evidence gaps remain visible even when no numerical clearance schedule is supplied.

Read 1 source difference / applicability notes

Official product label

SAVELLA: selected primary-label renal guidance and limits

Dose or interval guidance. Use only the product, indication, renal metric and population described in this source.
Before using this finding

ESRD: not recommended. Mild: no adjustment; moderate: caution.

Dialysis evidence: No dialysis regimen established in selected content

Adult oral SAVELLA for fibromyalgia; not levomilnacipran extended-release.

Renal method: Estimated CrCl, mL/min; severe 5-29
Retrieved: 2026-11-07

Read local renal resultOpen this source quick answerOpen original reference
GlobalRPh RX List

SAVELLA: selected RX renal passage

Dose or interval guidance. Use only the product, indication, renal metric and population described in this source.
Before using this finding

ESRD: not recommended. Mild: no adjustment; moderate: caution.

Dialysis evidence: No dialysis regimen established in selected content

Adult oral SAVELLA for fibromyalgia; not levomilnacipran extended-release.

Renal method: Estimated CrCl, mL/min; severe 5-29
Retrieved: 2026-11-07

Read local renal resultOpen this source quick answerOpen original reference

Source presence is not independent validation. A label mirror is not a second independent source; review the original reference and exact formulation.

Product / population check

Confirm the exact formulation before using a renal source

These links compare product identities, not interchangeable doses. A selected summary is not a complete prescribing monograph.

Source-specific review points

SAVELLA: source applicability and renal evidence limits

Read the attributed comparison notes and source cards below. No conflict has been silently adjudicated.

Source-quality holds
Find text within this drug
Find a term without leaving this drug

Search the stored clinical text

Locate a word or phrase within this drug's source summaries. Choose all sources or one source to focus the search. The selection never hides warnings or source text, changes a dose, or proves that a renal finding is absent.

Find:

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All source summaries, original wording and provenance
Before applying a renal protocol

Check the setting. Compare whole sources.

No patient-specific dose is calculated. Context choices only display reminders; they do not validate, hide or change any regimen.

Share a reproducible source review

Choose sources below, then open a print-ready comparison with product scope, renal method, dates and cautions. Links can pin the exact local cards; they never contain patient values or choose a dose.

Open / share selected sources
Jump to renal guidanceRead 1 difference / caution notesClinician guide

Select two distinct source versions. The complete stored summaries will appear below.

Build a source-review outline for documentation

This creates a blank decision outline with the source identities you select, not a dose recommendation or completed clinical assessment. No patient fields are collected, saved or sent. Complete the clinical decisions in your approved documentation system.

Choose one or two sources above or use the source checkboxes below.

Renal-context checklist: population, kidney trend and dialysis

These prompts are a reading aid, not a prescription checklist or proof that all requirements have been met. No selections are stored or sent to a server.

Read the exact source scope, renal metric and date before selecting a row. No applicability assessment has been performed.

See source-specific renal methods and the clinical interpretation guide for the supporting context.

Read before choosing a regimen

Source differences and product cautions

Search differences across all drugs

These are specific issues found during source review, not an automated judgment that one source is universally correct. A label mirror and its original label are not independent evidence.

Source scope / renal recommendation differences

SAVELLA: source applicability and renal evidence limits

Use the intact renal-dosing section, not the malformed moderate-renal PK range in the mirror. Reduced maintenance and initial titration are separate instructions.

How to use this: Do not skip titration or abruptly stop extended treatment.

SAVELLA: selected primary-label renal guidance and limitsSAVELLA: selected RX renal passage

Selected-source comparison; independent clinician adjudication pending.

Go directly to the relevant source section

Renal dosing and precautions

Choose a source, then jump to its renal or dialysis section. These links locate stored text; they do not merge regimens or certify that sources agree.

Independent clinical review is pending. These selected summaries are not an approved institutional dosing protocol. Confirm the exact product, the complete current source and local policy before use.
Official source

SAVELLA: selected primary-label renal guidance and limits

Adult oral SAVELLA for fibromyalgia; not levomilnacipran extended-release.

Method: Estimated CrCl, mL/min; severe 5-29

Read this complete source summary
Rxlist source

SAVELLA: selected RX renal passage

Adult oral SAVELLA for fibromyalgia; not levomilnacipran extended-release.

Method: Estimated CrCl, mL/min; severe 5-29

Read this complete source summary

No dialysis or renal heading shown? Read the complete source summary. Absence of a heading is not evidence that dose adjustment is unnecessary.

Compare or copy source versions

All content below is stored locally. Read a whole source version; do not combine its dose with another source's interval, renal metric or dialysis assumptions.

Original content / product scopeSAVELLA: selected primary-label renal guidance and limitsSAVELLA: selected RX renal passage
Choose two source checkboxes below.
Historical source content is not a current prescription. Original GlobalRPh recommendations are preserved, not automatically certified as current. Product-label and professional additions below are separately attributed. Confirm indication, population, kidney-function method, monitoring and the full prescribing information before applying a regimen.
Locally stored source content

Original GlobalRPh protocol

Clinical facts and comments transcribed into a structured reading format. Read the original source for its complete context: https://globalrph.com/renal/milnacipran/

Usual Dosing (Adults)

Fibromyalgia; the source states not approved for pediatric use. Take orally with or without food; food may improve tolerability. Day 1: 12.5 mg once. Days 2-3: 12.5 mg twice daily. Days 4-7: 25 mg twice daily. After day 7: 50 mg twice daily (recommended 100 mg/day). Depending on response, increase to 100 mg twice daily; doses above 200 mg/day were not studied. Taper rather than abruptly stopping after extended treatment.

GRPH-milnacipran-01 · Source section: Usual Dosing (Adults)Renal section finder

Renal Dosing

Mild impairment: no adjustment. Moderate impairment: caution. Severe impairment, estimated CrCl 5-29 mL/min: reduce maintenance by 50% to 25 mg twice daily; may increase to 50 mg twice daily according to response.

GRPH-milnacipran-02 · Source section: Renal DosingRenal section finder

Hemodialysis

Not recommended in end-stage renal disease.

GRPH-milnacipran-03 · Source section: HemodialysisRenal section finder
Separate U.S. product-label layer

FDA / DailyMed dosing and renal information

Official

SAVELLA: selected primary-label renal guidance and limits

Open original reference

Open / share this exact local source

DailyMed / product prescribing information · Adult oral SAVELLA for fibromyalgia; not levomilnacipran extended-release.

Renal method: Estimated CrCl, mL/min; severe 5-29
Source date: Revision date not captured in selected review; retrieval date is not revision date.
Retrieved: 2026-11-07

Dose or interval guidance. Use only the product, indication, renal metric and population described in this source.
Before using this finding

ESRD: not recommended. Mild: no adjustment; moderate: caution.

Dialysis evidence: No dialysis regimen established in selected content

Selected sections checked against the identified source; not a complete monograph or independent clinician approval.

Section 2.2; discontinuation context

Mild impairment requires no adjustment; use caution in moderate impairment. At CrCl 5-29 mL/min, reduce maintenance to 25 mg twice daily; depending on response it may increase to 50 mg twice daily. ESRD use is not recommended. This is maintenance guidance, not an instruction to skip initial titration. Monitor tolerability and taper after extended use.

RDM72-milnacipran-label-1 · Source locator: Section 2.2; discontinuation context

Source-specific limits

Selected renal section, not a complete prescribing monograph. A label and its mirror are not independent evidence.

Source identity and provenance
Source family
product_label
Source
https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=8b720a1e-034b-4583-b80d-105a794cce74
Retrieved
2026-11-07
Renal-function method
Estimated CrCl, mL/min; severe 5-29
Source date/version
Revision date not captured in selected review; retrieval date is not revision date.
Hash meaning
Locally authored summary text; not original source HTML, XML or PDF bytes
Local summary SHA-256
bf4fc8357b293137e7fe416a6a7801240435b9ee81ecd4af8a1b3dd195dc2174
Locally imported selected renal sections

GlobalRPh RX List renal information

Rxlist

SAVELLA: selected RX renal passage

Open original reference

Open / share this exact local source

GlobalRPh RX List / label mirror · Adult oral SAVELLA for fibromyalgia; not levomilnacipran extended-release.

Renal method: Estimated CrCl, mL/min; severe 5-29
Source date: Revision date not established in reviewed mirror passage.
Retrieved: 2026-11-07

Label mirror, not independent corroboration. This is selected locally stored RX List content. Full monograph import and current official-label review are not implied.
Dose or interval guidance. Use only the product, indication, renal metric and population described in this source.
Before using this finding

ESRD: not recommended. Mild: no adjustment; moderate: caution.

Dialysis evidence: No dialysis regimen established in selected content

Selected sections checked against the identified source; not a complete monograph or independent clinician approval.

Section 2.2; discontinuation context

The intact renal dosing section reports reduced maintenance at CrCl 5-29, a response-dependent increase, and ESRD avoidance. A malformed moderate-renal range in the PK paragraph was excluded from numerical interpretation.

RDM72-milnacipran-rx-1 · Source locator: Section 2.2; discontinuation context

Source-specific limits

Selected renal section, not a complete prescribing monograph. A label and its mirror are not independent evidence.

Source identity and provenance
Source family
product_label_mirror
Source
https://globalrph.com/rx-list/savella-drug/
Retrieved
2026-11-07
Renal-function method
Estimated CrCl, mL/min; severe 5-29
Source date/version
Revision date not established in reviewed mirror passage.
Hash meaning
Locally authored summary text; not original source HTML, XML or PDF bytes
Local summary SHA-256
f2b2215e6e47a3139e35523748a160615f89a04b37d15ff31f1e9b0bbb79368a

Provenance and preservation

Additional summaries stored on this page: 1 official-label, 1 RX List, 0 professional, 0 handbook. Empty additional-source groups are not shown. A missing layer is not a no-adjustment recommendation.

Original source
https://globalrph.com/renal/milnacipran/
Source retrieval
2026-09-05. This is not the source publication or label revision date.
Original source type
globalrph individual
Local text SHA-256
93ef7a166b193b38f5f954c5a77f5a5e73a34ba12f1c98c93d765b9736587a19
Import versus clinical validation
Source-section locators identify where retained content came from. A source-section identifier does not assert that every numeric statement has been independently corroborated. The local text hash is not a hash of original HTML, an FDA PDF or SPL XML.

The original individual GlobalRPh pages commonly cite NIH/NLM DailyMed and instruct readers to review the applicable package insert for updates. That historical reference is preserved as context; it is not counted as an independently retrieved current label.

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