Hi, Thanks for posting in HCM. I understand your concern. Savella contains milnacipran as ingredient, which affects certain chemicals in the brain called neurotransmitters. It is a serotonin–norepinephrine reuptake inhibitor used in the clinical treatment of fibromyalgia. Common side effects associated with use of Savella include: hypertensive crisis, constipation, dizziness, headache, hot flash, nausea and insomnia. Tamoxifen blocks the actions of estrogen, a female hormone. It is used in the treatment of certain types of breast cancer which utilises estrogen to grow. Commonly reported side effects of use of tamoxifen include: amenorrhea, fluid retention, hot flash, nausea, vaginal discharge, vaginal hemorrhage, weight loss and skin changes. You many need a review of the dose and intake of medication if such side effects persists or becomes bothersome. Otherwise, you may need to take symptomatic treatment to overcome the same. Hope the information provided would be helpful. All the best.