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Venlafaxine

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

Medically reviewed on May 4, 2018

What is venlafaxine?

Venlafaxine is a selective serotonin and norepinephrine reuptake inhibitor (SNRIs) antidepressant. 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.

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

Important Information

Do not use venlafaxine 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.

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.

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

Before taking this medicine

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

Do not use venlafaxine 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 stimulant medicine, 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.

Tell your doctor if you have ever had:

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

Venlafaxine 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. Do not start or stop taking venlafaxine during pregnancy without your doctor's advice.

You should not breast-feed while using this medicine.

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

How should I take venlafaxine?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

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

Swallow the extended-release capsule or tablet whole and do not crush, chew, break, or open it.

If you cannot swallow a capsule whole, open it and sprinkle the medicine into a spoonful of applesauce. Swallow the mixture right away without chewing. Do not save it for later use.

It may take several weeks before your symptoms improve. Keep using the medication as directed. Do not stop using venlafaxine 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 may affect a drug-screening urine test and you may have false results. Tell the laboratory staff that you use venlafaxine.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

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?

Drinking alcohol with venlafaxine can cause side effects.

Ask your doctor before taking a nonsteroidal anti-inflammatory drug (NSAID) such as 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 driving or hazardous activity until you know how this medicine will affect you. Your reactions could be impaired.

Venlafaxine side effects

Get emergency medical help if you have 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:

  • 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 sodium level --headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady; 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 side effects may include:

  • dizziness, drowsiness,

  • anxiety, feeling nervous;

  • sleep problems (insomnia);

  • vision changes;

  • nausea, vomiting, diarrhea;

  • changes in weight or appetite;

  • dry mouth, yawning;

  • increased sweating; or

  • decreased sex drive, impotence, abnormal ejaculation, 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)

Venlafaxine dosing information

Usual Adult Dose 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 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 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

What other drugs will affect venlafaxine?

Using venlafaxine with other drugs that make you drowsy can worsen this effect. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety or seizures.

Tell your doctor about all your current medicines. Many drugs can affect venlafaxine, especially:

This list is not complete and many other drugs may affect venlafaxine. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Further information

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.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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