Arthritis Today



Drug Class:

Antidepressants (Serotonin-norepinephrine re-uptake inhibitor (SNRI))

Brand Names




30 to 120 mg twice a day.

Potential Side Effects


Anxiety; changes in appetite or weight; constipation; diarrhea; drowsiness; fatigue; high blood pressure; nausea; restlessness; sexual difficulties; rash; sweating; trembling; trouble sleeping; weakness.

Special Instructions

  • Do not drive or perform other potentially dangerous activities until you know whether the medication will impair your ability to do them safely.
  • Take with food.
  • Talk to your doctor before stopping the drug. Your dose may need to be slowly reduced.

Be Aware

  • This drug can increase the risk of bleeding and bruising, especially if taken with aspirin or other blood thinners or NSAIDs.
  • Combining any of these drugs with alcohol or other depressants (including antihistamines, narcotics and some dental anesthetics) can make side effects more severe. Also, many of the medicines used to treat fibromyalgia work by boosting the amount of serotonin in your body. Taking two or more of these drugs together could lead to a potentially life-threatening condition called serotonin syndrome. Symptoms usually begin within hours of combining the drugs and include confusion, agitation, irregular heartbeat, unstable blood pressure, tremors, muscle rigidity, nausea and vomiting. If you have these symptoms, stop taking your medication and seek immediate medical help.

The Arthritis Today Drug Guide is meant for education – not self-medicating. Arthritis Today, the Arthritis Foundation and the Drug Guide Medical Review Panel do not endorse any products mentioned in this guide. While we endeavor to keep the information up to date, we make no representations or warranties about the completeness of the information provided.

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