Benefits of using this medication

Venlafaxine belongs to the class of antidepressant and anxiolytic medications known as serotonin and norepinephrine reuptake inhibitors (SNRIs). It is used to treat depression. It works on the central nervous system (CNS) to elevate mood in people with depression.

Venlafaxine is also used to treat the symptoms of anxiety causing distress in generalized anxiety disorder (GAD), social anxiety disorder (social phobia), and panic disorder (panic attacks). SNRIs work by increasing the amount of two chemicals called serotonin and norepinephrine, which are available in certain parts of the brain.

This medication may be available under several brands and/or in several different dosage forms. Any brand name of this medication may not be available in all of the dosage forms or approved for all of the conditions discussed in this article. As well, some forms of this medication may not be used for all of the conditions discussed in this article.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their physician has not prescribed it.

dosage forms of medication

37.5 mg
Each extended release, hard gelatin capsule, with gray cap and peach-coloured body, with “W” and “Effexor XR” on the cap and “37.5” on the body, in red ink, contains venlafaxine HCl equivalent to 37.5 mg of venlafaxine base. Nonmedicinal ingredients: ethylcellulose, gelatin, hydroxypropyl methylcellulose, iron oxide, microcrystalline cellulose, talc, titanium dioxide, and Opacode Red S-1-15034 ink. Gluten-free.

75 mg
Each extended release, hard gelatin capsule, with peach-coloured cap and body, with “W” and “Effexor XR” on the cap and “75” on the body, in red ink, contains venlafaxine HCl equivalent to 75 mg of venlafaxine base. Nonmedicinal ingredients: ethylcellulose, gelatin, hydroxypropyl methylcellulose, iron oxide, microcrystalline cellulose, talc, titanium dioxide, and Opacode Red S-1-15034 ink. Gluten-free.

150 mg
Each extended release, hard gelatin capsule, with dark orange cap and body, with “W” and “Effexor XR” on the cap and “150” on the body, in white ink, contains venlafaxine HCl equivalent to 150 mg of venlafaxine base. Nonmedicinal ingredients: ethylcellulose, gelatin, hydroxypropyl methylcellulose, iron oxide, microcrystalline cellulose, talc, titanium dioxide, and White Tek SB-0007 ink. Gluten-free.

dose of medication

Venlafaxine should be taken once daily with food, either in the morning or in the evening. Do not crush, chew, or split the capsules.

Depression: The recommended dose of venlafaxine for people with depression is 75 mg once daily. For some people, the physician may recommend starting with a lower dose of 37.5 mg daily for the first 4 to 7 days of treatment so they can get used to the medication. The dose can then be increased to 75 mg daily. If the expected benefit doesn’t occur after a few weeks, your physician may gradually increase the dose to a maximum of 225 mg daily, until improvement is seen.

Generalized anxiety disorder (GAD): For people with GAD, the recommended initial dose of venlafaxine is 37.5 mg once daily for 4 to 7 days. Your physician may gradually increase the dose to a maximum of 225 mg daily, based on your response to the medication.

Social anxiety disorder (social phobia): The usual recommended starting dose of venlafaxine is 75 mg once daily. For some people, the physician may recommend starting with a lower dose of 37.5 mg daily for the first 4 to 7 days of treatment so they can get used to the medication. The dose can then be increased to 75 mg daily. Your physician may gradually increase the dose based on your response to the medication, to a maximum of 225 mg daily.

Panic disorder (panic attacks): For people with panic attacks, the recommended initial dose of venlafaxine extended release is 37.5 mg once daily for 7 days. The dose can then be increased to 75 mg daily. Your physician may gradually increase the dose based on your response to the medication to a maximum of 225 mg daily.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your physician has recommended a dose different from the ones listed here, don’t change the way that you are taking the medication without consulting your physician.

It is important that this medication be taken exactly as prescribed by your physician. in case of missed dose,  skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you aren’t sure what to do after missing a dose, contact your physician or pharmacist for advice.

Store this medication at room temperature, protect it from moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Contraindications to the use of the medication

Do not take venlafaxine if you:

  • are allergic to venlafaxine or any ingredients of the medication
  • are currently taking an MAO inhibitor (e.g., phenelzine, tranylcypromine), have taken one in the last 14 days, or will start treatment with one in the next 14 days

side effects of the medication

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below aren’t experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your physician.

These symptoms may occur in some patients and in this case, you should refer to your consultant. But the majority of the patients don’t suffer from any side effects, so do not stop using the medicine because of fear of in listed side effect . , .

Contact your physician if you experience these side effects and intolerable. Your pharmacist may be able to advise you on managing side effects.

  • abnormal dreams
  • constipation
  • dizziness
  • drowsiness
  • dry mouth
  • headache
  • increased sweating
  • loss of appetite
  • nausea
  • nervousness
  • sexual difficulties
  • trouble sleeping
  • unusual tiredness or weakness
  • vomiting

Although most of the side effects listed below don’t happen very often, they could lead to serious problems if you don’t check with your physician or seek medical attention.

Check with your physician as soon as possible if any of the following side effects occur:

  • agitation
  • changes in vision, such as blurred vision
  • fast heartbeat
  • hallucinations (hearing or seeing things that aren’t there)
  • increased blood pressure
  • lightheadedness or fainting, especially when rising suddenly from a sitting or lying down position
  • mood or mental changes
  • restlessness or inability to sit still
  • serotonin syndrome (symptoms include confusion, diarrhea, fever, poor coordination, restlessness, shivering, sweating, trembling or shaking, or twitching)
  • severe abdominal pain
  • signs of bleeding (e.g., unusual nosebleeds, bruising, blood in urine, coughing blood, bleeding gums, cuts that don’t stop bleeding)
  • signs of liver damage (e.g., yellowing of the skin and eyes, abdominal pain, dark urine, clay-coloured stools, loss of appetite, or nausea and vomiting)
  • signs of low sodium (e.g., tiredness, weakness, confusion, achy, stiff, uncoordinated muscles)
  • trouble holding or releasing urine
  • unusual or sudden body or facial movements or postures

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • attempts at suicide or thoughts of suicide or self-harm
  • convulsions (seizures)
  • signs of an allergic reaction (e.g., difficulty breathing, hives, swelling of the face or throat)
  • signs of bleeding in the stomach (e.g., bloody, black, or  tarry stools, spitting up of blood, vomiting blood or material that looks like coffee grounds)
  • signs of extremely high blood pressure (e.g., severe headache upon wakening that is concentrated in the back of the head and neck, fast or irregular heartbeat, dizziness, chest pain)

Some people may experience side effects other than those listed. Check with your physician if you notice any symptom that worries you while you are taking this medication.

precautions of the medication

Before you start using a medication, be sure to inform your physician of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Allergic reactions: In rare cases, some people may develop an allergic reaction to this medication. Signs of an allergic reaction include a severe rash, swollen face, or difficulty breathing. If these occur, get immediate medical attention.

Behaviour changes or suicidal behaviour: Some people taking this medication experience erratic or aggressive behaviour, agitation, depressed mood, or they may have thoughts of harming themselves or others. If you experience any mood or behaviour changes, or if your friends or family observe any of these changes while you are taking this medication, stop taking this medication and contact your physician immediately.

Bleeding disorders: Venlafaxine may increase bruising and bleeding from cuts may take longer to stop. If you have a bleeding disorder or a history of bleeding problems, discuss with your physician how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Blood pressure: Treatment with venlafaxine has been associated with increases in blood pressure. Your physician may monitor your blood pressure while you are taking venlafaxine. Rarely, some people may experience a large increase in blood pressure. This extremely high blood pressure can cause rapid or irregular heartbeat, chest pain, dizziness, feeling overly tired, blurred vision, and symptoms of severe headache upon awakening that is mainly in the back of the head and neck region. If any of these symptoms occur, contact your physician immediately.

Bone health and Osteoporosis: Recent studies have shown that there may be an increased risk of bone fractures (breaks) with the use of venlafaxine and other antidepressants. People with osteoporosis or those with risk factors for developing osteoporosis, may be more likely to experience a fracture. If you have osteoporosis or are at risk for developing osteoporosis, discuss with your physician how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Drowsiness/reduced alertness: Venlafaxine may cause drowsiness or dizziness, affecting your ability to drive or operate machinery. Avoid these and other hazardous tasks until you have determined how this medication affects you.

Glaucoma: If you have glaucoma, discuss with your physician how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Heart disease: If you have heart disease, discuss with your physician how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Venlafaxine may cause increased blood pressure or increased cholesterol levels.

Kidney function:  Kidney disease or reduced kidney function may cause this medication to build up in the body, causing side effects. If you have kidney disease or reduced kidney function, discuss with your physician how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Liver function: Liver disease or reduced liver function may cause this medication to build up in the body, causing side effects. If you have liver problems, discuss with your physician how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Your physician may want to test your liver function regularly with blood tests while you are taking this medication.

If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your physician immediately.

Mania/hypomania: Venlafaxine may cause activation of mania or hypomania. People with a history of bipolar disorder should be closely monitored by their physician while taking this medication.

Neuroleptic malignant syndrome (NMS): Venlafaxine can rarely cause a potentially fatal syndrome known as neuroleptic malignant syndrome (NMS). If you notice the symptoms of NMS such as high fever, muscle stiffness, confusion or loss of consciousness, sweating, racing or irregular heartbeat, or fainting, get immediate medical attention.

Seizures: If you have a history of seizures, discuss with your physician how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Serotonin syndrome: This medication may cause a potentially life-threatening condition called serotonin syndrome, especially when used with other medications that increase serotonin levels (e.g., sumatriptan, rizatriptan). If you experience symptoms of serotonin syndrome such as agitation, hallucinations, fast heart rate, fever, lack of coordination, nausea, vomiting, and diarrhea, get immediate medical attention.

Stopping the medication: Stopping this medication suddenly may lead to side effects. If you are thinking of stopping this medication, check with your physician first. When stopping venlafaxine treatment after more than one week, it is recommended that the dose of the medication be reduced gradually to prevent symptoms such as anxiety, agitation, confusion, diarrhea, dizziness, dry mouth, fatigue, headache, nausea, loss of appetite, nervousness, sleep disturbances, sweating, and vomiting.

Pregnancy: Newborns whose mothers take medications such as venlafaxine during the third trimester of pregnancy may experience complications that require prolonged hospitalization. These complications normally resolve over time.

This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your physician immediately.

Breast-feeding: This medication passes into breast milk. If you are a breast-feeding mother and are taking venlafaxine, it may affect your baby. Talk to your physician about whether you should continue breast-feeding.

Children: The safety and effectiveness of this medication have not been established for children less than 18 years of age. There have been reports that using this and similar medications in children below the age of 18 may cause behavioural and emotional changes, such as suicidal thoughts and behaviour.

Seniors: Seniors may be more sensitive to the side effects of this medication.

Drug-Drug interaction of the medication

There may be an interaction between venlafaxine and any of the following:

  • abiraterone
  • alcohol
  • alfuzosin
  • alpha agonists (e.g., clonidine, methyldopa)
  • alpha/beta agonists (e.g., epinephrine, norepinephrine)
  • amiodarone
  • amphetamines (e.g., dextroamphetamine, lisdexamphetamine)
  • anticoagulants (e.g., warfarin)
  • antihistamines (e.g,. cetirizine, doxylamine, diphenhydramine, hydroxyzine, loratadine)
  • antiplatelet medications (e.g., acetylsalicylic acid [ASA], clopidogrel)
  • antipsychotics (e.g., chlorpromazine, clozapine, haloperidol, olanzapine, quetiapine, risperidone)
  • aprepitant
  • asunaprevir
  • “azole” antifungals (e.g., itraconazole, ketoconazole, voriconazole)
  • barbiturates (e.g., butalbital, phenobarbital)
  • boceprevir
  • bosentan
  • bosutinib
  • brimonidine
  • bromocriptine
  • buprenorphine
  • bupropion
  • buspirone
  • calcium channel blockers (e.g., amlodipine, diltiazem, nifedipine, verapamil)
  • carbamazepine
  • chloroquine
  • cinacalcet
  • cobicistat
  • conivaptan
  • cyclobenzaprine
  • dabigatran
  • dabrafenib
  • darifenacin
  • dasatinib
  • deferasirox
  • desvenlafaxine
  • dextromethorphan
  • disopyramide
  • domperidone
  • dronedarone
  • enzalutamide
  • ergot alkaloids (e.g., ergotamine, dihydroergotamine)
  • flecainide
  • grapefruit juice
  • heparin
  • HIV non-nucleoside reverse transcriptase inhibitors (NNRTIs; e.g., delavirdine, efavirenz, etravirine, nevirapine)
  • HIV protease inhibitors (e.g., atazanavir, indinavir, ritonavir, saquinavir)
  • imatinib
  • linezolid
  • lithium
  • macrolide antibiotics (e.g., clarithromycin, erythromycin)
  • maprotiline
  • methadone
  • metoclopramide
  • mifepristone
  • mirabegron
  • mirtazapine
  • monoamine oxidase inhibitors (MAOIs; e.g., moclobemide, phenelzine, rasagiline, selegiline, tranylcypromine)
  • nefazodone
  • nilotinib
  • nonsteroidal anti-inflammatory drugs (NSAIDs; e.g., ibuprofen, indomethacin, naproxen)
  • peginterferon Alfa-2b
  • pentamidine
  • phenytoin
  • primidone
  • procainamide
  • propafenone
  • pseudoephedrine
  • quinidine
  • quinine
  • quinolone antibiotics (e.g., ciprofloxacin, norfloxacin, ofloxacin)
  • rifabutin
  • rifampin
  • St. John’s wort
  • selective serotonin reuptake inhibitors (SSRIs; e.g., citalopram, fluoxetine, sertraline)
  • serotonin / norepinephrine reuptake inhibitors (SNRIs; e.g., desvenlafaxine, duloxetine)
  • serotonin antagonists (anti-emetic medications; e.g., granisetron, ondansetron)
  • sotalol
  • sunitinib
  • tapentadol
  • terbinafine
  • tetrabenazine
  • tocilizumab
  • tramadol
  • trazodone
  • tricyclic antidepressants(e.g., amitriptyline, desipramine, imipramine)
  • ‘triptan’ migraine medications (e.g., sumatriptan, rizatriptan, zolmitriptan)
  • tryptophan supplements

If you are taking any of these medications, talk to your physician or pharmacist. Depending on your specific circumstances, your physician may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications doesn’t always mean that you must stop taking one of them. talk to your physician about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your physician or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

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