Venlafaxine

💊 What is Venlafaxine used for?

• •The label says venlafaxine is used to treat major depressive disorder. Studies in adult outpatients and inpatients showed it helped with depression, and a separate study looked at keeping the response going in people with recurrent depression. The label says it is not approved for use in children.

How it works

How it is usually taken

• •The label says venlafaxine is taken with food. The daily amount is usually split into two or three doses. Your prescriber may adjust the dose over time, and the label says increases should be made gradually. Follow the instructions from your prescriber or pharmacist. The label also says your doctor should periodically review whether the medicine is still useful for you.

Comes as

• •Venlafaxine Tablets, USP 75 mg: peach colored, shield-shaped, uncoated tablets, debossed with '395' on one side and scored on the other side. Sold in bottles of 90.

⚠️ Venlafaxine side effects

🛑 Who should not take Venlafaxine, and who should be careful

The label says not to take it if

• 🚨You are allergic to venlafaxine or any of its ingredients.
• 🚨You have uncontrolled narrow-angle glaucoma.
• 🚨You are taking an MAOI (a type of antidepressant) for a psychiatric disorder, or you have stopped one within the last 14 days. The label says use with an MAOI, or within 7 days of stopping venlafaxine, is contraindicated because of the risk of serotonin syndrome.
• 🚨You are being treated with linezolid or intravenous methylene blue. The label says starting venlafaxine in this situation is contraindicated.

Tell your doctor before taking it if

• •Read the Medication Guide that comes with the medicine before you start and each time you get a refill.
• •The label says to control high blood pressure before starting treatment and to monitor blood pressure regularly.
• •Tell your healthcare provider about any history of eye problems, since the label mentions visual problems and says an eye exam may help see if you are at risk.
• •The label says venlafaxine may increase the risk of bleeding, especially with warfarin, NSAIDs, or aspirin.
• •The label says dose reductions may be needed for people with liver or kidney problems.
• •The label says that for people in the third trimester of pregnancy, the prescriber should carefully weigh the risks and benefits.

🔀 Venlafaxine with other medicines, food and alcohol

The label says to discuss these with your doctor or pharmacist

• •Warfarin, NSAIDs (such as ibuprofen or naproxen), and aspirin: may increase the risk of bleeding or bruising.
• •MAOIs: the label says these should not be used with venlafaxine or within 7 days of stopping it, and venlafaxine should not be used within 14 days of stopping an MAOI.
• •Linezolid and intravenous methylene blue: the label says starting venlafaxine in a patient taking these is contraindicated.
• •Cimetidine: the label says cimetidine raised venlafaxine levels in a study. The label advises caution in people with high blood pressure, older adults, or people with liver problems, because the effect in these groups is not known and could be stronger.
• •Haloperidol: the label says venlafaxine increased haloperidol levels in a study.
• •Diazepam: the label says a study did not find that diazepam changed how venlafaxine or diazepam was processed by the body.
• •Lithium: the label discusses this interaction, but the text provided is cut off before the result is stated.

Alcohol and food

The label says venlafaxine is taken with food. In a study, a single dose of alcohol (ethanol) did not change how venlafaxine was processed by the body, and the medicine did not make alcohol's effects on thinking and coordination stronger in the study participants. The label also notes that the potential for interactions is always possible, so ask your prescriber or pharmacist about alcohol use.

🤰 Venlafaxine in pregnancy and breastfeeding

Pregnancy

The label says studies in rats and rabbits did not show malformations at high doses, but rat pups had lower weight, more stillbirths, and more deaths at higher doses. The label says there are no adequate and well-controlled studies in pregnant women, so the medicine should be used during pregnancy only if clearly needed. The label also says that babies exposed late in the third trimester to venlafaxine, other SNRIs, or SSRIs have developed complications requiring prolonged hospitalization, breathing support, and tube feeding. The label says prescribers should carefully consider the risks and benefits of treatment during the third trimester.

Breastfeeding

The label says venlafaxine and its active breakdown product are passed into human milk. Because of the potential for serious side effects in nursing infants, the label says a decision should be made whether to stop nursing or stop the drug, considering how important the drug is to the mother.

🗓️ Storage, missed doses and taking too much

Storage

The label says to store at 20 to 25 degrees C (68 to 77 degrees F), with brief excursions permitted between 15 and 30 degrees C (59 to 86 degrees F). Protect from light and moisture.

If a dose is missed

The label does not say.

If too much is taken

The label reports 14 cases of acute overdose in premarketing studies, either alone or with other drugs or alcohol. Most involved amounts that were no more than several times higher than the usual dose. Some patients took much higher amounts, and the label reports blood levels for some of them. The label text provided is cut off before it gives full overdose guidance.

🗒️ Questions to ask about Venlafaxine

• Should I take venlafaxine with food, and how should I split my daily dose?
• How will you check my blood pressure while I take venlafaxine?
• What should I do if I notice changes in my mood, thoughts, or behavior?
• Are any of my current medicines, such as warfarin, aspirin, or ibuprofen, a concern with venlafaxine?
• What steps should I take before stopping venlafaxine, since the label warns against stopping too quickly?
• Do I need an eye exam while taking this medicine?

❓ Venlafaxine: frequently asked questions