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VENLANEO XL 37.5 MG PROLONGED RELEASE CAPSULES
VENLANEO XL 37.5 mg, 75 mg & 150 mg
Prolonged Release Capsules
Read all of this leaflet carefully before you start taking this medicine.
• Keep this leaflet. You may need to read it again.
• If you have further questions, please ask your doctor or your pharmacist.
• This medicine has been prescribed for you. Do not pass it on to others. It may
harm them, even if their symptoms are the same as yours.
• If any of the side effects gets serious, or if you notice any side effects not listed
in this leaflet, please tell your doctor or pharmacist.
In this leaflet:
1. What Venlaneo XL Prolonged Release Capsules are and what they are used for
2. Before you take Venlaneo XL Prolonged Release Capsules
3. How to take Venlaneo XL Prolonged Release Capsules
4. Possible side effects
5. How to store Venlaneo XL Prolonged Release Capsules
6. Further information
1. WHAT VENLANEO XL PROLONGED RELEASE CAPSULES ARE AND WHAT
THEY ARE USED FOR
Venlaneo XL Prolonged Release Capsules contain the active ingredient venlafaxine
hydrochloride. Venlafaxine hydrochloride is an antidepressant that belongs to a
group of medicines called serotonin and norepinephrine reuptake inhibitors
(SNRIs). This group of medicines is used to treat depression and other conditions
such as anxiety disorders. It is thought that people who are depressed and/or
anxious have lower levels of serotonin and noradrenaline in the brain. It is not fully
understood how antidepressants work, but they may help by increasing the levels
of serotonin and noradrenaline in the brain.
Venlaneo XL Prolonged Release Capsules are used to treat adults with depression.
Venlaneo XL Prolonged Release Capsules are also a treatment for adults with the
following anxiety disorders: generalised anxiety disorder, social anxiety disorder
(fear or avoidance of social situations) and panic disorder (panic attacks). Treating
depression or anxiety disorders properly is important to help you get better. If it is
not treated, your condition may not go away and may become more serious and
more difficult to treat.
2. BEFORE YOU TAKE VENLANEO XL PROLONGED RELEASE CAPSULES
Do not take Venlaneo XL Prolonged Release Capsules if:
• You are allergic (hypersensitive) to venlafaxine hydrochloride, or to any of the
other ingredients of Venlaneo XL Prolonged Release Capsules.
• You are also taking or have taken any time within the last 14 days any medicines
known as irreversible monoamine oxidase inhibitors (MAOIs), used to treat
depression or Parkinson’s disease. Taking an irreversible MAOI together with
other medicines, including Venlaneo XL Prolonged Release Capsules, can cause
serious or even life-threatening side effects. Also, you must wait at least 7 days
after you stop taking Venlaneo XL Prolonged Release Capsules before you take
any MAOI (see also the sections “Serotonin syndrome” and “Taking other
Take special care with Venlaneo XL Prolonged Release Capsules
• If you use other medicines that taken concomitantly with Venlaneo XL
Prolonged Release Capsules could increase the risk of developing serotonin
syndrome (see the section “Taking other medicines”).
• If you have eye problems, such as certain kinds of glaucoma (increased
pressure in the eye).
• If you have a history of high blood pressure.
• If you have a history of heart problems.
• If you have a history of fits (seizures).
• If you have a history of low sodium levels in your blood (hyponatraemia).
• If you have a tendency to develop bruises or a tendency to bleed easily (history
of bleeding disorders), or if you are taking other medicines that may increase
the risk of bleeding.
• If your cholesterol levels get higher.
• If you have a history of, or if someone in your family has had, mania or
bipolar disorder (feeling over-excited or euphoric).
• If you have a history of aggressive behaviour.
• If you have been told by your doctor that you have an intolerance to some
sugars (e.g. sucrose).
Venlaneo XL Prolonged Release Capsules may cause a sensation of restlessness or
an inability to sit or stand still. You should tell your doctor if this happens to you.
If any of these conditions apply to you, please talk with your doctor before taking
Venlaneo XL Prolonged Release Capsules.
Thoughts of suicide and worsening of your depression or anxiety disorder
If you are depressed and/or have anxiety disorders, you can sometimes have
thoughts of harming or killing yourself. These may be increased when you first start
taking antidepressants, since these medicines all take time to work, usually about
two weeks, but sometimes longer.
You may be more likely to think like this:
• If you have previously had thoughts about killing yourself or harming yourself.
• If you are a young adult. Information from clinical trials has shown an increased
risk of suicidal behaviour in young adults (less than 25 years old) with psychiatric
conditions who were treated with an antidepressant.
If you have thoughts of harming or killing yourself at any time, contact your doctor
or go to a hospital straight away.
You may find it helpful to tell a relative or close friend that you are depressed or
have an anxiety disorder, and ask them to read this leaflet. You might ask them to
tell you if they think your depression or anxiety is getting worse, or if they are
worried about changes in your behaviour.
Dry mouth is reported in 10% of patients treated with venlafaxine. This may
increase the risk of caries. Therefore, you should take special care in your dental
Use in children and adolescents under 18 years of age
Venlaneo XL Prolonged Release Capsules should normally not be used for children
and adolescents under 18 years. Also, you should know that patients under 18 have
an increased risk of side effects, such as suicide attempt, suicidal thoughts and
hostility (predominantly aggression, oppositional behaviour and anger) when they
take this class of medicines. Despite this, your doctor may prescribe Venlaneo XL
Prolonged Release Capsules for patients under 18 because he/she decides that this
is in their best interests. If your doctor has prescribed Venlaneo XL
Prolonged Release Capsules for a patient under 18, and you want to discuss
this, please go back to your doctor. You should inform your doctor if any of
the symptoms listed above develop or worsen when patients under 18 are
taking Venlaneo XL Prolonged Release Capsules. Also, the long-term safety
effects concerning growth, maturation and cognitive and behavioural
development of Venlaneo XL Prolonged Release Capsules in this age group
has not yet been demonstrated.
Taking other medicines
Please tell your doctor or pharmacist if you are taking or have recently taken
any other medicines, including medicines obtained without a prescription.
Your doctor should decide whether you can take Venlaneo XL Prolonged
Release Capsules with other medicines. Do not start or stop taking any
medicines, including those bought without a prescription, natural and herbal
remedies, before checking with your doctor or pharmacist.
• Monoamine oxidase inhibitors (MAOIs: see the section “Before you take
Venlaneo XL Prolonged Release Capsules”).
• Serotonin syndrome:
• Serotonin syndrome, a potentially life threatening condition (see the
section “Possible Side Effects”), may occur with venlafaxine treatment,
particularly when taken with other medicines. Examples of these
• Triptans (used for migraine)
• Medicines to treat depression, for instance SNRI, SSRIs, tricyclics, or
medicines containing lithium
• Medicines containing linezolid, an antibiotic (used to treat infections)
• Medicines containing moclobemide, a reversible MAOI (used to treat
• Medicines containing sibutramine (used for weight loss)
• Medicines containing tramadol (a pain killer)
• Products containing St. John’s Wort (also called Hypericum perforatum, a
natural or herbal remedy used to treat mild depression)
• Products containing tryptophan (used for problems such as sleep and
Signs and symptoms of serotonin syndrome may include a combination of
the following: restlessness, hallucinations, loss of coordination, fast
heart beat, increased body temperature, fast changes in blood pressure,
overactive reflexes, diarrhoea, coma, nausea, vomiting. Get medical care
right away if you think serotonin syndrome is happening to you.
The following medicines may also interact with Venlaneo XL Prolonged
Release Capsules and should be used with caution. It is especially important
to mention to your doctor or pharmacist if you are taking medicines containing:
• Ketoconazole (an antifungal medicine)
• Haloperidol or risperidone (to treat psychiatric conditions)
• Metoprolol (a beta blocker to treat high blood pressure and heart
Taking your medicine with food and alcohol
Venlaneo XL Prolonged Release Capsules should be taken with food (see
section 3 “HOW TO TAKE VENLANEO XL PROLONGED RELEASE
You should avoid alcohol while you are taking Venlaneo XL Prolonged Release
Pregnancy and breast-feeding
Tell your doctor if you become pregnant, or you are trying to become
pregnant. You should take Venlaneo XL Prolonged Release Capsules only
after discussing the potential benefits and the potential risks to your unborn
child with your doctor.
If you are taking Venlaneo XL Prolonged Release Capsules during pregnancy,
let your midwife and/or doctor know, as your baby might have some
symptoms when it is born. These symptoms usually begin during the first 24
hours after the baby is born. They include not feeding properly and trouble
with breathing. If your baby has these symptoms when it is born and you are
concerned, contact your doctor and/or midwife who will be able to advise
Make sure your midwife and/or doctor know you are on Venlaneo XL
Prolonged Release Capsules. When taken during pregnancy, similar drugs
(SSRIs) may increase the risk of a serious condition in babies, called
persistent pulmonary hypertension of the new born (PPHN), making the
baby breathe faster and appear bluish. These symptoms usually begin
during the first 24 hours after the baby is born. If this happens to your baby
you should contact your midwife and/or doctor immediately.
Venlafaxine hydrochloride passes into breast milk. There is a risk of an effect
on the baby. Therefore, you should discuss the matter with your doctor, and
he/she will decide whether you should stop breast-feeding or stop the
therapy with Venlaneo XL Prolonged Release Capsules.
Driving and using machines
Do not drive or use any tools or machines until you know how Venlaneo XL
Prolonged Release Capsules affect you.
Important information about some of the ingredients of Venlaneo XL
Prolonged Release Capsules
Some of the colourants in Venlaneo XL Prolonged Release Capsules may
cause allergic reactions. If you have been told by your doctor that you have
an intolerance to some sugars, contact your doctor before taking this
3. HOW TO TAKE VENLANEO XL PROLONGED RELEASE CAPSULES
Always take Venlaneo XL Prolonged Release Capsules exactly as your doctor
has told you. You should check with your doctor or pharmacist if you are not
Take Venlaneo XL Prolonged Release Capsules at approximately the same
time each day, either in the morning or in the evening. Capsules must be
swallowed whole with fluid and not opened, crushed, chewed or dissolved.
Venlaneo XL Prolonged Release Capsules should be taken with food.
The usual adult doses for different conditions are as follows:
• The usual recommended starting dose for treatment of depression is
75 mg per day. The dose can be raised by your doctor gradually, and if
needed, even up to a maximum dose of 375 mg per day.
Generalised Anxiety Disorder and Social Anxiety Disorder:
• The usual recommended starting dose for treatment of generalised anxiety
disorder and social anxiety disorder is 75 mg per day. The maximum dose
is 225 mg per day.
• If you are being treated for panic disorder, your doctor will start with a lower
dose (37.5 mg) and then increase the dose gradually. The maximum dose is
225 mg per day.
If you have liver or kidney problems, talk to your doctor, since your dose of
Venlaneo XL Prolonged Release Capsules may need to be different.
Do not stop taking Venlaneo XL Prolonged Release Capsules without talking to
your doctor (see the section “If you stop taking Venlaneo XL Prolonged Release
If you take more Venlaneo XL Prolonged Release Capsules than you should:
Call your doctor or pharmacist immediately if you take more Venlaneo XL
Prolonged Release Capsules than prescribed by your doctor.
The symptoms of a possible overdose may include a rapid heart beat, changes
in level of alertness (ranging from sleepiness to coma), blurred vision, seizures
or fits, and vomiting.
If you forget to take Venlaneo XL Prolonged Release Capsules:
If you miss a dose, take it as soon as you remember. However, if it is time for
your next dose, skip the missed dose and take only a single dose as usual. Do
not take a double dose to make up for a forgotten dose. Do not take more than
the daily amount of Venlaneo XL Prolonged Release Capsules that have been
prescribed for you in one day.
If you stop taking Venlaneo XL Prolonged Release Capsules:
Do not stop taking your treatment or reduce the dose without the advice of your
doctor even if you feel better. If your doctor thinks that you no longer need to
take Venlaneo XL Prolonged Release Capsules, he/she may ask you to reduce
your dose slowly before stopping treatment altogether. Side effects are known
to occur when people stop taking Venlaneo XL Prolonged Release Capsules,
especially when treatment is stopped suddenly or the dose is reduced too
quickly. Some patients may experience symptoms such as tiredness, dizziness,
light-headedness, headache, sleeplessness, nightmares, dry mouth, loss of
appetite, nausea, diarrhoea, nervousness, agitation, confusion, ringing in the
ears, tingling or rarely electric shock sensations, weakness, sweating, seizures,
or flu-like symptoms.
Your doctor will advise you on how you should gradually discontinue treatment
with Venlaneo XL Prolonged Release Capsules. If you experience any of these
or other symptoms that are troublesome, ask your doctor for further advice.
If you have any further questions on the use of this product, ask your doctor or
Uncommon: lack of feeling or emotion; hallucinations; involuntary movement
of the muscles; agitation; impaired coordination and balance
Rare: a sensation of restlessness or an inability to sit or stand still; seizures
or fits; feeling over-excited or euphoric
Not known: a high temperature with rigid muscles, confusion or agitation, and
sweating, or if you experience jerky muscle movements which you can't
control, these may be symptoms of serious conditions known as neuroleptic
malignant syndrome; euphoric feelings, drowsiness, sustained rapid eye
movement, clumsiness, restlessness, feeling of being drunk, sweating or
rigid muscles, which are symptoms of serotonergic syndrome; disorientation
and confusion often accompanied by hallucination (delirium); stiffness,
spasms and involuntary movements of the muscles; thoughts of harming or
• Sight and hearing disorders
Common: blurred vision
Uncommon: altered taste sensation; ringing in the ears (tinnitus)
Not known: severe eye pain and decreased or blurred vision
• Heart or circulation disorders
Common: increase in blood pressure; flushing; palpitations
Uncommon: feeling dizzy (particularly when standing up too quickly), fainting,
Not known: decrease in blood pressure; abnormal, rapid or irregular heart
beat, which could lead to fainting
• Breathing disorders
Not known: coughing, wheezing, shortness of breath and a high temperature,
which are symptoms of inflammation of the lungs associated with an
increase in white blood cells (pulmonary eosinophilia)
• Digestive disorders
Very common: nausea
Common: appetite decreased; constipation; vomiting
Uncommon: grinding of the teeth; diarrhoea
Not known: severe abdominal or back pains (which could indicate a serious
problem in the gut, liver or pancreas)
• Skin disorders
Very common: sweating (including night sweats)
Uncommon: rash; abnormal hair loss
Not known: skin rash, which may lead to severe blistering and peeling of the
skin; itching; mild rash
• Muscle disorders
Not known: unexplained muscle pain, tenderness or weakness (rhabdomyolysis)
• Urinary system disorders
Common: difficulties passing urine; increased frequency in urination
Uncommon: inability to pass urine
4. POSSIBLE SIDE EFFECTS
Like all medicines, Venlaneo XL Prolonged Release Capsules can cause side
effects, although not everybody gets them.
Do not be concerned if you see small white granules or balls in your stools after
taking Venlaneo XL Prolonged Release Capsules. Inside Venlaneo XL Prolonged
Release Capsules are spheroids or small white balls that contain the venlafaxine
active ingredient. These spheroids are released from the capsule into your
gastrointestinal tract. As the spheroids travel the length of your gastrointestinal
tract, venlafaxine is slowly released. The spheroid “shell” remains undissolved
and is eliminated in your stools. Therefore, even though you may see spheroids
in your stools, your dose of venlafaxine has been absorbed.
If any of the following happen, do not take more Venlaneo XL Prolonged Release
Capsules. Tell your doctor immediately, or go to the casualty department at your
• Chest tightness, wheezing, trouble swallowing or breathing
• Swelling of the face, throat, hands, or feet
• Feeling nervous or anxious, dizziness, throbbing sensations, sudden
reddening of the skin and/or a warm feeling
• Severe rash, itching, or hives (elevated patches of red or pale skin that often
Serious side effects
If you notice any signs of the following, you may need urgent medical attention:
• Heart problems, such as fast or irregular heart rate, increased blood pressure
• Eye problems, such as blurred vision, dilated pupils
• Nerve problems, such as dizziness, pins and needles, movement disorder,
seizures or fits
• Psychiatric problems, such as hyperactivity and euphoria
• Treatment withdrawal (see the section “HOW TO TAKE VENLANEO XL PROLONGED
RELEASE CAPSULES, if you stop taking Venlaneo XL Prolonged Release
Complete side effect listing
The frequency (likelihood of occurring) of side effects is classified as follows:
• Reproductive and sexual disorders
Common: abnormal ejaculation/orgasm (males); lack of orgasm; erectile
dysfunction (impotence); menstrual irregularities such as increased bleeding
or increased irregular bleeding
Uncommon: abnormal orgasm (females)
Common: weakness (asthenia); chills
Uncommon: sensitivity to sunlight
Not known: swollen face or tongue, shortness of breath or difficulty breathing,
often with skin rashes (this may be a serious allergic reaction)
Venlaneo XL Prolonged Release Capsules sometimes causes unwanted effects
that you may not be aware of, such as increases in blood pressure or abnormal
heart beat; slight changes in blood levels or liver enzymes, sodium or cholesterol.
More rarely, Venlaneo XL Prolonged Release Capsules may reduce the function
of platelets in your blood, leading to an increased risk of bruising or bleeding.
Therefore, your doctor may wish to do blood tests occasionally, particularly if
you have been taking Venlaneo XL Prolonged Release Capsules for a long time.
If any of the side effects gets serious, or if you notice any side effects not
listed in this leaflet, please tell your doctor or pharmacist.
5. HOW TO STORE VANLANEO XL PROLONGED RELEASE CAPSULES
Keep your capsules in the pack in which they are supplied to protect them from
moisture. Store the pack below 30ºC. Do not use them after the expiry date
which is shown on the pack after EXP. The expiry date refers to the last day of
Keep all medicines out of the reach and sight of children.
Medicines should not be disposed of via waste water or household waste. Ask
your pharmacist how to dispose of medicines no longer required. These
measures will help protect the environment.
6. FURTHER INFORMATION
Affects more than 1 user in 10
Affects 1 to 10 users in 100
Affects 1 to 10 users in 1,000
Affects 1 to 10 users in 10,000
Frequency cannot be estimated from the available data
What Venlaneo XL Prolonged Release Capsules contain:
The active ingredient in Venlaneo XL Prolonged Release Capsules is venlafaxine
The inactive ingredients are: sucrose, maize starch, hydroxypropyl cellulose,
hydroxypropylmethyl cellulose, talc, ethyl cellulose, dibutyl sebacate,
oleic acid, colloidal anhydrous silica, sodium lauryl sulphate and gelatin
(capsule shell only). Colouring agents included in the 37.5 mg capsule shells
are Ponceau 4R (E124), quinoline yellow (E104) and titanium dioxide (E171).
Colouring agents included in the 75 mg capsule shells are sunset yellow
(E110), quinoline yellow and titanium dioxide. Colouring agents included in the
150 mg shells are sunset yellow, quinoline yellow, patent blue (E131) and
• Blood disorders
Uncommon: bruising; black tarry stools (faeces) or blood in stools, which can
be a sign of internal bleeding
Not known: reduced number of platelets in your blood, leading to an increased
risk of bruising or bleeding; blood disorders which may lead to an increased
risk of infection
What Venlaneo XL Prolonged Release Capsules look like and contents of the
Venlaneo XL Prolonged Release Capsules come in three strengths. Venlaneo
XL 37.5 mg Capsules are orange/clear capsules. Venlaneo XL 75 mg Capsules
are yellow/clear capsules. Venlaneo XL 150 mg Capsules are buff/clear
capsules. All three strengths of capsules are filled with white to off-white
pellets. Your medicine is available in blister packs containing 14 or 28 capsules.
Not all pack sizes may be marketed
Marketing Authorisation Holder:
Fannin (UK) Limited, 42-46 Booth Drive, Park Farm South, Wellingborough,
NN8 6GT, UK
• Nervous system disorders
Very common: dry mouth; headache
Common: abnormal dreams; decreased libido; dizziness; increased muscle
tonus; insomnia; nervousness; pins and needles; sedation; tremor;
confusion; feeling separated (or detached) from yourself and reality
• Metabolism/nutritional disorders
Common: weight loss; increased cholesterol
Uncommon: weight gain
Not known: slight changes in blood levels of liver enzymes; decrease in blood
sodium levels; itchiness, yellow skin or eyes, dark urine, or flu-like
symptoms, which are symptoms of inflammation of the liver (hepatitis);
confusion, excessive water intake (known as SIADH); abnormal breast milk
Manufacturer responsible for batch release: Fannin (UK) Limited,
42-46 Booth Drive, Park Farm South, Wellingborough, NN8 6GT, UK
This leaflet was last approved in October 2012.