Generic Name: venlafaxine (VEN la fax een)
Brand Name: Effexor, Effexor XR

What is venlafaxine?

Venlafaxine is an antidepressant in a group of drugs called selective serotonin and norepinephrine reuptake inhibitors (SSNRIs). Venlafaxine affects chemicals in the brain that may become unbalanced and cause depression.

Venlafaxine is used to treat major depressive disorder, anxiety, and panic disorder.

Venlafaxine may also be used for purposes not listed in this medication guide.

What is the most important information I should know about venlafaxine?

You should not take this medication if you are being treated with methylene blue injection.

Do not use venlafaxine if you have taken an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, and tranylcypromine. After you stop taking venlafaxine, you must wait at least 7 days before you start taking an MAOI.

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What should I discuss with my healthcare provider before taking venlafaxine?

You should not take this medication if you are allergic to venlafaxine or desvenlafaxine (Pristiq), or if you are being treated with methylene blue injection.

Do not use venlafaxine if you have taken an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, and tranylcypromine. After you stop taking venlafaxine, you must wait at least 7 days before you start taking an MAOI.

To make sure venlafaxine is safe for you, tell your doctor if you have:

  • bipolar disorder (manic depression);

  • cirrhosis or other liver disease;

  • kidney disease;

  • heart disease, high blood pressure, high cholesterol;

  • diabetes;

  • glaucoma;

  • a thyroid disorder;

  • a history of seizures;

  • a bleeding or blood clotting disorder;

  • low levels of sodium in your blood; or

  • if you are switching to venlafaxine from another antidepressant.

Some young people have thoughts about suicide when first taking an antidepressant. Your doctor will need to check your progress at regular visits while you are using venlafaxine. Your family or other caregivers should also be alert to changes in your mood or symptoms.

FDA pregnancy category C. Taking an SSRI antidepressant during pregnancy may cause serious lung problems or other complications in the baby. However, you may have a relapse of depression if you stop taking your antidepressant. Tell your doctor right away if you become pregnant while taking venlafaxine. Do not start or stop taking this medicine during pregnancy without your doctor's advice.

Venlafaxine can pass into breast milk and may harm a nursing baby. You should not breast-feed while using this medicine.

Do not give this medication to anyone under 18 years old without the advice of a doctor.

How should I take venlafaxine?

Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Venlafaxine should be taken with food. Try to take venlafaxine at the same time each day.

Swallow the controlled-release capsule (Effexor XR) whole, without crushing or chewing. To make the medication easier to swallow, you may open the capsule and sprinkle the medicine into a small amount of applesauce. Swallow all of the mixture without chewing, and do not save any for later use.

Your blood pressure will need to be checked often.

It may take 4 weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve.

This medicine can cause you to have a false positive drug screening test. If you provide a urine sample for drug screening, tell the laboratory staff that you are taking venlafaxine.

You should not stop using venlafaxine suddenly. Follow your doctor's instructions about tapering your dose.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking venlafaxine?

Ask your doctor before taking a nonsteroidal anti-inflammatory drug (NSAID) for pain, arthritis, fever, or swelling. This includes aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib (Celebrex), diclofenac, indomethacin, meloxicam, and others. Using an NSAID with venlafaxine may cause you to bruise or bleed easily.

Avoid drinking alcohol, which can increase some of the side effects of venlafaxine.

Venlafaxine may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Venlafaxine side effects

Get emergency medical help if you have any of these signs of an allergic reaction: skin rash or hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have:

  • seizure (convulsions);

  • very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, feeling like you might pass out;

  • agitation, hallucinations, fever, fast heart rate, overactive reflexes, nausea, vomiting, diarrhea, loss of coordination;

  • headache, slurred speech, severe weakness, muscle cramps, feeling unsteady, fainting, shallow breathing (breathing may stop);

  • cough, chest tightness, trouble breathing; or

  • easy bruising.

Common side effects may include:

  • drowsiness, dizziness, weakness, feeling nervous;

  • increased sweating;

  • blurred vision;

  • dry mouth;

  • changes in appetite or weight;

  • mild nausea, constipation; or

  • decreased sex drive, impotence, or difficulty having an orgasm.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

What other drugs will affect venlafaxine?

Taking venlafaxine with other drugs that make you sleepy or slow your breathing can increase these effects. Ask your doctor before taking venlafaxine with a sleeping pill, narcotic pain medicine, muscle relaxer, or medicine for anxiety or seizures.

Many drugs can interact with venlafaxine. Not all possible interactions are listed here. Tell your doctor about all your medications and any you start or stop using during treatment with venlafaxine, especially:

  • a blood thinner (warfarin, Coumadin);

  • cimetidine;

  • lithium;

  • St. John's wort;

  • tramadol;

  • tryptophan (sometimes called L-tryptophan);

  • medicines to treat psychiatric disorders--chlorpromazine, fluphenazine, haloperidol, iloperidone, paliperidone, perphenazine, pimozide, prochlorperazine, quetiapine, risperidone, thioridazine, trifluoperazine, ziprasidone;

  • migraine headache medicine--sumatriptan, zolmitriptan, and others; or

  • other antidepressants--amoxapine, amitriptyline, clomipramine, desipramine, doxepin, fluoxetine, imipramine, maprotiline, nortriptyline, protriptyline, trimipramine.

This list is not complete and many other drugs can interact with venlafaxine. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Give a list of all your medicines to any healthcare provider who treats you.

Where can I get more information?

  • Your pharmacist can provide more information about venlafaxine.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 13.02. Revision Date: 2014-01-21, 10:28:24 PM.

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