<p><strong>Renal Impairment</strong>: Severe (CrCl 5-29 mL/min): 25 mg bid, may increase to 50 mg bid according to response.<br />
<br />
<strong>End stage renal disease (ESRD)</strong>: Not recommended.<br />
<br />
<strong>Pediatric use</strong>: Safety and effectiveness of Milnacipran in a fibromyalgia pediatric population below the age of 18 have not been established.&nbsp;The use of Milnacipran is not recommended in pediatric patients.</p>

<p>&nbsp;</p>