くすりのしおり

Internal
Revised: 3/2017

The information on this sheet is based on approvals granted by the Japanese regulatory authority. Approval details may vary by country. Medicines have adverse reactions (risks) as well as efficacies (benefits). It is important to minimize adverse reactions and maximize efficacy. To obtain a better therapeutic response, patients should understand their medication and cooperate with the treatment.
Brand name :
Toledomin Tablets 15mg
 Active ingredient:
Milnacipran hydrochloride
 Dosage form:
pale yellow tablet, diameter: 6.1 mm, thickness: 2.5 mm
 Print on wrapping:
(front, edge)トレドミン15 (back, edge)Toledomin15
(front, body)トレドミン15 (back, body)トレドミン, 15mg

Effects of this medicine

This medicine is SNRI (Serotonin and Noradrenalin Reuptake Inhibitor). It makes intracerebral neurotransmission smooth to relieve depressive mood and anxiety.
It is usually used to treat depression/depressive state.

Before using this medicine, be sure to tell your doctor and pharmacist

  • If you have previously experienced any allergic reactions (itch, rash, etc.) to any medicines.
    If you have: urinary retention due to prostate disease, dysuria, glaucoma, elevated intraocular pressure, cardiac disease, hypertension, liver dysfunction, renal dysfunction, convulsive disorders such as epilepsy or its history, manic-depressive illness, suicidal thought/suicide attempt or its history, organic brain disorder, predisposition to schizophrenia, highly impulsive comorbid disorders.
  • If you are pregnant or breastfeeding.
  • If you are taking any other medicinal products. (Some medicines may interact to enhance or diminish medicinal effects. Beware of over-the-counter medicines and dietary supplements as well as other prescription medicines.)

Dosing schedule (How to take this medicine)

  • Your dosing schedule prescribed by your doctor is ((        to be written by a healthcare professional))
  • In general, for adults, take as an initial dose 25mg of the active ingredient a day. Then the dosage will be gradually increased up to 100 mg a day. Take them in 2 to 3 divided doses after meals. The dosage may be adjusted according to your age or symptoms.
    For elderly, take as an initial dose 25mg a day. Then the dosage will be gradually increased up to 60 mg a day. Take them in 2 to 3 divided doses after meals.
    This medicine contains 15 mg of the active ingredient in a tablet. Strictly follow the instructions.
  • If you miss a dose, take the missed dose as soon as possible. However, if it is almost time for the next dose, skip the missed dose and follow your regular dosing schedule. You should never take two doses at one time.
  • If you accidentally take more than your prescribed dose, consult with your doctor or pharmacist.
  • Do not stop taking this medicine unless your doctor instructs you to do so.

Precautions while taking this medicine

  • This medicine may cause drowsiness or dizziness. Pay close attention when operating dangerous machinery such as driving a car. If you become aware of these symptoms, do not operate dangerous machinery such as driving a car.
  • Alcohol may intensify medicinal effects of this medicine. Refrain from drinking alcohol.
  • This medicine may cause elevation of blood pressure. Blood pressure and pulse rate measurement may be performed. In particular, if you have hypertension or cardiac injury, these measurements are performed on a regular basis.

Possible adverse reactions to this medicine

The most commonly reported adverse reactions include nausea/vomiting, drowsiness, urinary dysfunction (urinary retention, dysuria), constipation, abdominal pain, headache, tachycardia, thirst/dry mouth, rash and itch. If any of these symptoms occur, consult with your doctor or pharmacist.
The symptoms described below are rarely seen as initial symptoms of the adverse reactions indicated in brackets. If any of these symptoms occur, stop taking this medicine and see your doctor immediately.
  • intense muscle rigidity, difficulty in swallowing, fever [neuroleptic malignant syndrome]
  • sweating, excitement, anxiety [serotonin syndrome]
  • high fever (38 degrees Celcius or higher), erythema (facial/generalized redness), bloodshot eyes, mouth/lip erosion [serious skin disorder such as muco-cutaneo-ocular syndrome]
  • loss of appetite/nausea, headache, general malaise [syndrome of inappropriate antidiuretic hormone secretion]
  • dizziness, headache, nausea [hypertensive crisis]
The above symptoms do not describe all the adverse reactions to this medicine. Consult with your doctor or pharmacist if you notice any symptoms of concern other than those listed above.

Storage conditions and other information

  • Keep out of the reach of children. Store away from direct sunlight and heat. Store in a dry container away from moisture, as this medicine may become discolored by moisture.
  • Discard the remainder. Do not store them. Consult with your pharmacy or medical institution how to discard.
  • [To family members] Patients may show behavioral changes such as suicidal thought/aggression, or decline of depression/depressive states etc. If family members notice any of these conditions, contact the doctor.

For healthcare professional use only : Day Month Year

For further information, talk to your doctor or pharmacist.