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Venlafaxine Side Effects

In Summary

Commonly reported side effects of venlafaxine include: anorgasmia, asthenia, constipation, dizziness, drowsiness, insomnia, nausea, nervousness, headache, anorexia, decreased appetite, delayed ejaculation, diaphoresis, and xerostomia. Other side effects include: abdominal pain, anxiety, blurred vision, hypertension, impotence, tremor, visual disturbance, vomiting, diarrhea, dyspepsia, increased serum cholesterol, pharyngitis, vasodilatation, weight loss, decreased libido, increased dream activity, yawning, abnormal dreams, and flatulence. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to venlafaxine: oral capsule extended release, oral tablet, oral tablet extended release

Along with its needed effects, venlafaxine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking venlafaxine:

More Common

  • Lack or loss of strength
  • severe headache
  • sweating

Less Common

  • Blurred vision
  • chest pain
  • fast or irregular heartbeat
  • mood or mental changes
  • ringing or buzzing in the ears
  • suicidal thoughts

Rare

  • Actions that are out of control
  • convulsions
  • high fever
  • irritability
  • itching or skin rash
  • lightheadedness or fainting, especially when getting up suddenly from a sitting or lying position
  • menstrual changes
  • nervousness
  • problems with urinating or holding urine
  • severe muscle stiffness
  • talking, feeling, and acting with excitement that you cannot control
  • trouble breathing
  • unusually pale skin

Incidence Not Known

  • Agitation
  • bloody, black, or tarry stools
  • bloody stool or urine
  • dark urine
  • decreased frequency or amount of urine
  • diarrhea
  • drowsiness
  • fever
  • general feeling of tiredness or weakness
  • headache
  • increased thirst
  • light-colored stools
  • muscle cramps, spasms, or pain
  • nausea or vomiting
  • nosebleeds
  • overactive reflexes
  • poor coordination
  • red or purple spots on the skin
  • restlessness
  • shivering
  • stomach pain on the upper right side
  • swelling of the face, lower legs, ankles, hands, or fingers
  • trembling or shaking that is hard to control
  • twitching
  • unusual bruising
  • unusual tiredness or weakness
  • vomiting of blood or material that looks like coffee grounds
  • yellow eyes or skin

Some side effects of venlafaxine may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More Common

  • Abnormal dreams
  • chills
  • constipation
  • decrease in sexual desire or ability
  • diarrhea
  • dry mouth
  • heartburn
  • increased sweating
  • loss of appetite
  • nausea
  • stomach pain or gas
  • stuffy or runny nose
  • tingling, burning, or prickly sensations
  • trouble sleeping
  • vomiting
  • weight loss

Less Common

  • Change in taste
  • muscle tension
  • yawning

Incidence Not Known

For Healthcare Professionals

Applies to venlafaxine: oral capsule extended release, oral tablet, oral tablet extended release

Gastrointestinal

Very common (10% or more): Nausea (up to 35%), dry mouth ( up to 17%), constipation (12%)

Common (1% to 10%): Vomiting, abdominal pain, diarrhea, dyspepsia, flatulence, eructation

Uncommon (0.1% to 1%): Bruxism, colitis, dysphagia, tongue edema, esophagitis, gastritis, gastroenteritis, gastrointestinal ulcer, gingivitis, glossitis, rectal hemorrhage, hemorrhoids, melena, stomatitis, mouth ulceration

Rare (less than 0.1%): Cheilitis, cholecystitis, cholelithiasis, duodenitis, esophageal spasm, hematemesis, gastrointestinal hemorrhage, gum hemorrhage, ileitis, intestinal obstruction, parotitis, periodontitis, proctitis, increased salivation, soft stools, tongue discoloration

Postmarketing reports: Pancreatitis[Ref]

Nervous system

Very common (10% or more): Headache (up to 38%), dizziness (up to 20%), somnolence (up to 20%), fatigue (11%), nervousness (up to 10%)

Common (1% to 10%): Tremor, paraesthesia, twitching, hypertonia, migraine, trismus, vertigo

Uncommon (0.1% to 1%): Myoclonus, dysgeusia, akathisia, apathy, ataxia, circumoral paraesthesia, CNS stimulation, emotional lability, euphoria, hallucinations, hostility, hyperesthesia, hyperkinesia, hypotonia, incoordination, neuralgia, neuropathy, seizure, abnormal speech, stupor

Rare (less than 0.1%): Akinesia, alcohol abuse, aphasia, bradykinesia, buccoclusal syndrome, cerebrovascular accident, loss of consciousness, dementia, dystonia, facial paralysis, feeling drunk, abnormal gait, Guillain-Barre Syndrome, hyperchlorhydria, hypokinesia, impulse control difficulties, neuritis, paresis, torticollis

Frequency not reported: Neuroleptic malignant syndrome (NMS), serotonergic syndrome, extrapyramidal reactions (including dystonia, and dyskinesia), tardive dyskinesia[Ref]

Cardiovascular

Common (1% to 10%): Hypertension, vasodilatation (mostly hot flashes/flushes), palpitation, chest pain

Uncommon (0.1% to 1%): Hypotension, postural hypotension, syncope, angina pectoris, arrhythmia, extrasystoles, peripheral vascular disorder (mainly cold feet and/or cold hands), thrombophlebitis

Rare (less than 0.1%): Aortic aneurysm, arteritis, first-degree atrioventricular block, bigeminy, bradycardia, bundle branch block, capillary fragility, cardiovascular disorder (mitral valve and circulatory disturbance), coronary artery disease, congestive heart failure, heart arrest, mucocutaneous hemorrhage, myocardial infarct, pallor

Postmarketing reports: QT prolongation, ventricular fibrillation, ventricular tachycardia (including torsades de pointes)[Ref]

Genitourinary

Very common (10% or more): Abnormal ejaculation (up to 16%)

Common (1% to 10%): Impotence, decreased libido, anorgasmia, erectile dysfunction, impaired urination, dysuria, metrorrhagia, prostatic disorder (prostatitis and enlarged prostate), vaginitis

Uncommon (0.1% to 1%): Menorrhagia, urinary retention, pelvic pain, cystitis, hematuria, leukorrhea, nocturia, bladder pain, breast pain, polyuria, pyuria, urinary incontinence, urinary urgency, vaginal hemorrhage

Rare (less than 0.1%): BUN increased, creatinine increased, glucosuria, balanitis, breast discharge, breast engorgement, breast enlargement, endometriosis, fibrocystic breast, calcium crystalluria, cervicitis, ovarian cyst, gynecomastia (male), kidney calculus, kidney pain, mastitis, menopause, oliguria, orchitis, pyelonephritis, salpingitis, urolithiasis, uterine spasm, vaginal dryness

Postmarketing reports: Menstrual disorders associated with

increased bleeding or increased irregular bleeding, proteinuria[Ref]

Dermatologic

Very common (10% or more): Sweating (up to 14%)

Uncommon (0.1% to 1%): Photosensitivity, rash, acne, alopecia, brittle nails, contact dermatitis, dry skin, eczema, skin hypertrophy, maculopapular rash, psoriasis, urticaria

Rare (less than 0.1%): Erythema nodosum, exfoliative dermatitis, lichenoid dermatitis, hair discoloration, skin discoluration, furunculosis, leukoderma, petechial rash, pustular rash, vesiculobullous rash, seborrhea, skin atrophy, skin striae

Postmarketing reports: Night sweats, erythema multiforme, Stevens-Johnson syndrome, pruritus, toxic epidermal necrolysis[Ref]

Other

Very common (10% or more): Asthenia (up to 19%)

Common (1% to 10%): Accidental injury, trauma

Uncommon (0.1% to 1%): Face edema, malaise, intentional injury

Postmarketing reports: Chills[Ref]

Hepatic

Uncommon (0.1% to 1%): Abnormal liver function tests

Rare (less than 0.1%): Hepatitis, jaundice, bilirubinemia[Ref]

Psychiatric

Very common (10% or more): Insomnia (up to 25%)

Common (1% to 10%): Abnormal dreams, depression, agitation, anxiety

Uncommon (0.1% to 1%): Hallucination, derealization, apathy, hypomania

Rare (less than 0.1%): Mania

Frequency not reported: Suicidal ideation, suicidal behaviors, delirium, aggression

Postmarketing reports: Confusion, depersonalization[Ref]

Hematologic

Uncommon (0.1% to 1%): Ecchymosis, mucous membrane bleeding, anemia, leukocytosis, leukopenia, lymphadenopathy, thrombocythemia, thrombocytopenia

Rare (less than 0.1%): Prolonged bleeding time, basophilia, cyanosis, eosinophilia, lymphocytosis, multiple myeloma, purpura

Postmarketing reports: Blood dyscrasias (including agranulocytosis, aplastic anemia, neutropenia, pancytopenia)[Ref]

Musculoskeletal

Common (1% to 10%): Neck pain

Uncommon (0.1% to 1%): Neck rigidity, arthritis, arthrosis, bone pain, bone spurs, bursitis, leg cramps, myasthenia, tenosynovitis

Rare (less than 0.1%): Pathological fracture, myopathy, osteoporosis, osteosclerosis, plantar fasciitis, rheumatoid arthritis, tendon rupture

Postmarketing reports: Rhabdomyolysis[Ref]

Ocular

Common (1% to 10%): Abnormal vision, abnormality of accommodation, mydriasis

Uncommon (0.1% to 1%): Cataract, conjunctivitis, corneal lesion, diplopia, dry eyes, eye pain, photophobia, visual field defect

Rare (less than 0.1%): Blepharitis, chromatopsia, conjunctival edema, exophthalmos, angle-closure glaucoma, retinal hemorrhage, subconjunctival hemorrhage, keratitis, miosis, papilledema, decreased pupillary reflex, scleritis, uveitis[Ref]

Metabolic

Common (1% to 10%): Increased serum cholesterol , weight loss, decreased appetite, anorexia

Uncommon (0.1% to 1%): Hyponatremia, weight gain, increased alkaline phosphatase, dehydration, hyperglycemia, hyperlipemia, hypokalemia

Rare (less than 0.1%): Syndrome of inappropriate antidiuretic hormone secretion (SIADH), alcohol intolerance, diabetes mellitus, gout, hemochromatosis, hypercalcinuria, hyperkalemia, hyperuricemia, hypocholesteremia, hypoglycemia, hypophosphatemia, hypoproteinemia, uremia[Ref]

Respiratory

Common (1% to 10%): Pharyngitis, yawning, bronchitis, dyspnea

Uncommon (0.1% to 1%): Asthma, chest congestion, epistaxis, hyperventilation, laryngismus, laryngitis, pneumonia, voice alteration

Rare (less than 0.1%): Atelectasis, hemoptysis, hypoventilation, hypoxia, larynx edema, pleurisy, pulmonary embolus, sleep apnea

Postmarketing reports: Pulmonary eosinophilia[Ref]

Hypersensitivity

Very rare (less than 0.1%): Anaphylaxis[Ref]

Immunologic

Common (1% to 10%): Infection

Uncommon (0.1% to 1%): Moniliasis

Rare (less than 0.1%): Appendicitis, bacteremia, cellulitis[Ref]

Endocrine

Rare (less than 0.1%): Goiter, hyperthyroidism, hypothyroidism, thyroid nodule, thyroiditis

Postmarketing reports: Increased prolactin[Ref]

General

The most commonly reported side effects were headache, dizziness, somnolence, insomnia, and nausea.[Ref]

Oncologic

Rare (less than 0.1%): Carcinoma[Ref]

References

1. "Product Information. Effexor (venlafaxine)." Wyeth-Ayerst Laboratories, Philadelphia, PA.

2. Cerner Multum, Inc. "Australian Product Information." O 0

3. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

Further information

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

Some side effects may not be reported. You may report them to the FDA.

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