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

What is Effexor?

Effexor (venlafaxine) is an antidepressant belonging to a group of drugs called selective serotonin and norepinephrine reuptake inhibitors (SSNRIs). Venlafaxine affects chemicals in the brain that may be unbalanced in people with depression.

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

Important information

You should not take Effexor if you have uncontrolled narrow-angle glaucoma, or if you are being treated with methylene blue injection.

Do not use Effexor within 7 days before or 14 days after you have used a MAO inhibitor, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine.

Some young people have thoughts about suicide when first taking an antidepressant. Stay alert to changes in your mood or symptoms. 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.

Do not stop using Effexor without first talking to your doctor.

Do not give this medicine to anyone younger than 18 years old without the advice of a doctor. Effexor is not approved for use in children.

Before taking this medicine

You should not take Effexor if you are allergic to venlafaxine or desvenlafaxine (Pristiq).

Do not use Effexor within 7 days before or 14 days after you have used an MAO inhibitor, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine. A dangerous drug interaction could occur.

Some medicines can interact with venlafaxine and cause a serious condition called serotonin syndrome. Be sure your doctor knows if you also take opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. Ask your doctor before making any changes in how or when you take your medications.

To make sure Effexor is safe for you, tell your doctor if you have ever had:

  • bipolar disorder (manic depression);

  • cirrhosis or other liver disease;

  • kidney disease;

  • heart disease, high blood pressure, high cholesterol;

  • diabetes;

  • narrow-angle 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 Effexor 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 Effexor. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Effexor may cause serious lung problems in a newborn if the mother takes the medicine late in pregnancy (during the third trimester). 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 Effexor. 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.

Effexor is not approved for use by anyone younger than 18 years old.

How should I take Effexor?

Take Effexor exactly as prescribed by your doctor. Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Effexor should be taken with food. Try to take this medicine at the same time each day.

Do not crush, chew, break, or open an extended-release capsule. Swallow the capsule whole.

To make the extended-release Effexor XR capsule 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.

It may take several weeks before your symptoms improve. Keep using the medication as directed. Do not stop using Effexor without first talking to your doctor. You may have unpleasant side effects if you stop taking this medicine suddenly.

Your blood pressure will need to be checked often.

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.

Store at room temperature away from moisture and heat.

Effexor dosing information

Usual Adult Dose of Effexor for Depression:

Immediate release:
Initial dose: 37.5 mg orally twice a day or 25 mg orally 3 times a day
Maintenance dose: May increase in daily increments of up to 75 mg orally at intervals of no less than 4 days
Maximum dose: (moderately depressed outpatients): 225 mg orally per day
Maximum dose (severely depressed inpatients): 375 mg orally per day
Comments:
-Daily dosage may be divided in 2 or 3 doses/day

Extended release:
Initial dose: 75 mg orally once a day
Maintenance dose: May increase in daily increments of up to 75 mg orally at intervals of no less than 4 days
Maximum dose (moderately depressed outpatients): 225 mg orally per day
Maximum dose (severely depressed inpatients): 375 mg orally per day

Use: Treatment of major depressive disorder (MDD)

Usual Adult Dose of Effexor for Anxiety:

Extended release:
Initial dose: 75 mg orally once a day
Maintenance dose: May increase in daily increments of 75 mg orally at intervals of no less than 4 days
Maximum dose: 225 mg orally per day

Uses:
-Treatment of Generalized Anxiety Disorder (GAD)
-Treatment of Social Anxiety Disorder (SAD)

Usual Adult Dose of Effexor for Panic Disorder:

Extended release:
Initial dose: 37.5 mg orally once a day
Maintenance dose: May increase dose in daily increments of 75 mg orally at intervals of no less than 7 days
Maximum dose: 225 mg orally per day

Use: Treatment of Panic Disorder (PD), with or without agoraphobia

See also: Dosage Information (in more detail)

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 Effexor?

Drinking alcohol with venlafaxine can cause side effects.

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.

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

Effexor side effects

Get emergency medical help if you have signs of an allergic reaction to Effexor: 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:

  • blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights;

  • easy bruising or bleeding (nosebleeds, bleeding gums), blood in your urine or stools, coughing up blood;

  • cough, chest tightness, trouble breathing;

  • a seizure (convulsions);

  • low levels of sodium in the body - headache, confusion, slurred speech, severe weakness, vomiting, hallucinations, feeling unsteady, slow breathing; or

  • severe nervous system reaction - very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, feeling like you might pass out.

Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea

Common Effexor side effects may include:

  • vision changes;

  • nausea, vomiting, diarrhea;

  • changes in appetite or weight;

  • dry mouth, yawning;

  • dizziness, headache, anxiety, feeling nervous;

  • fast heartbeats, tremors or shaking;

  • sleep problems (insomnia), strange dreams, tired feeling;

  • increased sweating; 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 Effexor?

Taking this medicine with other drugs that make you sleepy can worsen this effect. Ask your doctor before taking Effexor with a sleeping pill, narcotic pain medicine, muscle relaxer, or medicine for anxiety, depression, or seizures.

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

  • any other antidepressant;

  • cimetidine;

  • St. John's wort;

  • tramadol;

  • tryptophan (sometimes called L-tryptophan);

  • a blood thinner - warfarin, Coumadin, Jantoven;

  • medicine to treat mood disorders, thought disorders, or mental illness - buspirone, lithium, and many others; or

  • migraine headache medicine - sumatriptan, zolmitriptan, and others.

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 Effexor.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Effexor 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 1996-2017 Cerner Multum, Inc. Version: 14.01.

Date modified: August 10, 2017
Last reviewed: July 11, 2017

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