Venlafaxine | Side Effects, Dosage, Uses & More
Advertisement

Generic Name:

venlafaxine, Oral tablet

All Brands

  • Effexor (Discontinued)
A discontinued drug is a drug that has been taken off the market due to safety issues, shortage of raw materials, or low market demand.
SECTION 1 of 5

Highlights for venlafaxine

Oral tablet
1

Venlafaxine is an antidepressant.

2

This drug comes in three forms: an oral tablet, an extended-release oral tablet, and an extended-release oral capsule. Both tablets are used to treat depression. The capsule is used to treat depression, social anxiety disorder, general anxiety disorder, and panic disorder.

3

Both tablet forms are only available as generic drugs. The capsule is available as a generic and also as the brand-name drug Effexor XR.

IMPORTANT INFORMATION

FDA warning

This drug has a black box warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients about drug effects that may be dangerous.

Suicidal behavior warning. Venlafaxine may increase suicidal thoughts or actions in some children and young adults. This usually happens within the first few months of treatment or during dosage changes. Call your doctor right away if you notice new or sudden changes in your or your child’s mood, behavior, thoughts, or feelings, especially if they are severe.

Incorrect drug screening results

This drug may interfere with the results of urine tests for some illegal drugs, including phencyclidine (PCP) and amphetamine. It may make these test results positive even when you haven’t used the illegal drugs. This effect may last for several days after you stop taking venlafaxine.

High blood pressure

Venlafaxine may increase your blood pressure. Your doctor will likely make sure your blood pressure is normal before you start taking venlafaxine. They will check your blood pressure regularly during your treatment.

What is venlafaxine?

Venlafaxine is a prescription drug. It’s available as a tablet, an extended-release tablet, and an extended-release capsule. All forms are taken by mouth.

Both tablet forms are only available as generic drugs. The capsule is available as a generic and also as the brand-name drug Effexor XR. Generic drugs usually cost less. In some cases, they may not be available in every strength or form as the brand-name version.

Venlafaxine may be used as part of a combination therapy. This means you may need to take it with other medications to treat your condition.

Why it's used

Venlafaxine is used to treat depression, anxiety disorders, and panic disorder.

How it works

Venlafaxine belongs to a class of antidepressant drugs called serotonin norepinephrine reuptake inhibitors (SNRIs).

See Details

How it works

Venlafaxine belongs to a class of antidepressant drugs called serotonin norepinephrine reuptake inhibitors (SNRIs). A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

SNRIs work by increasing the levels of substances called serotonin and norepinephrine in your brain. Having more serotonin and norepinephrine in your brain can improve your symptoms of depression and anxiety.

Advertisement
SECTION 2 of 5

venlafaxine Side Effects

Oral tablet

More common side effects

The more common side effects of venlafaxine can include:

  • unusual dreams

  • sexual problems, such as:

    • decreased interest in sex
    • impotence (not being able to get or keep an erection)
    • trouble having an orgasm
  • loss of appetite

  • constipation

  • nausea or vomiting

  • dry mouth

  • tiredness

  • trouble sleeping or change in sleep habits

  • yawning

  • tremor or shaking

  • dizziness

  • blurry vision

  • sweating

  • feling anxious, nervous, or jitterey

  • headache

  • increased heart rate

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 9-1-1 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Attempts to commit suicide

  • Acting on dangerous impulses

  • Aggressive or violent behavior

  • Thoughts about suicide or dying

  • New or worsened depression

  • New or worsened anxiety or panic attacks

  • Agitation, restlessness, anger, or irritability

  • Trouble sleeping

  • Serotonin syndrome. Symptoms can include:

    • agitation
    • hallucinations (seeing or hearing something that isn’t there)
    • coma
    • changes in your mental status
    • coordination problems
    • muscle twitching or overactive reflexes
    • fast heart rate
    • high or low blood pressure
    • sweating
    • fever
    • nausea
    • vomiting
    • diarrhea
    • muscle stiffness
  • High blood pressure. Symptoms can include:

    • headache
    • chest pain
  • Mania. Symptoms can include:

    • greatly increased energy
    • severe trouble sleeping
    • racing thoughts
    • reckless behavior
    • unusually grand ideas
    • excessive happiness or irritability
    • talking more or faster than usual
  • Seizures

  • Eye problems. Symptoms can include:

    • eye pain
    • vision changes
    • enlarged pupils
    • swelling or redness in or around your eyes
  • Low sodium levels. Symptoms can include:

    • headache
    • weakness
    • feeling unsteady
    • confusion
    • problems concentrating
    • thinking or memory problems
  • Bruising easily

  • Frequent nosebleeds

  • Frequent bleeding from your gums while brushing your teeth or flossing

  • Dark, tar-like stool

  • Bleeding from wounds that's hard to stop

  • Lung disease or pneumonia. Symptoms can include:

    • shortness of breath that gets worse
    • cough
    • chest discomfort
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

Venlafaxine may cause drowsiness. It may also affect your ability to make decisions, think clearly, or react quickly. You should not drive, use heavy machinery, or do things that require you to be alert until you know you can function normally.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
SECTION 3 of 5

venlafaxine May Interact with Other Medications

Oral tablet

Venlafaxine can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Alcohol interaction

Do not drink alcohol with venlafaxine. Drinking alcohol raises your risk of sleepiness from venlafaxine. This may affect your ability to make decisions, think clearly, and react quickly. If you drink alcohol, talk to your doctor.

Medications that might interact with this drug

Drugs you should not use with venlafaxine

Do not take these drugs with venlafaxine. When used with venlafaxine, these drugs can cause dangerous effects in your body. Examples of these drugs include:

  • Monoamine oxidase inhibitors (MAOIs), including linezolid
    • Unless directed by your doctor, do not start venlafaxine within 2 weeks of stopping an MAOI and do not take an MAOI within 7 days of stopping venlafaxine. Taking venlafaxine and an MAOI too close together in time may cause serious or life-threatening side effects. These side effects can include high fever, uncontrolled muscle spasms, and stiff muscles. Other side effects can include sudden changes in your heart rate or blood pressure, confusion, and passing out.
  • Drugs for weight loss, such as phentermine
    • Venlafaxine can cause weight loss. Using it with drugs such as phentermine may lead to excessive weight loss, serotonin syndrome, and heart problems such as rapid heart rate and high blood pressure.

Interactions that increase your risk of side effects

Taking venlafaxine with certain medications raises your risk of side effects. Examples of these drugs include:

  • Cimetidine
    • Taking this drug with venlafaxine raises your risk of high blood pressure or liver disease. These risks are greater if you are a senior.
  • Haloperidol
    • Taking this drug with venlafaxine raises your risk of QT prolongation. This is a heart condition with symptoms such as dizziness and an irregular heart rhythm.
  • Warfarin
    • Taking this drug with venlafaxine raises your risk of bleeding. Your doctor will monitor you closely, especially when starting or stopping your venlafaxine therapy. Tell your doctor right away if you notice any abnormal bleeding or bruising.
  • Anti-inflammatory drugs such as aspirin, ibuprofen, naproxen, and ketoprofen
    • Taking any of these drugs with venlafaxine raises your risk of bleeding. Your doctor will monitor you closely, especially when starting or stopping your venlafaxine therapy. Tell your doctor right away if you notice any abnormal bleeding or bruising.
  • Drugs such as ritonavir, clarithromycin, or ketoconazole
    • Drugs such as ritonavir, clarithromycin, or ketoconazole can slow the breakdown of drugs in your body. If you take any of these drugs with venlafaxine, the amount of venlafaxine may build up in your body. This would increase your risk of side effects.
  • Drugs that cause drowsiness, such as zolpidem, lorazepam, and diphenhydramine
    • Taking any of these drugs with venlafaxine may make the sleepiness from venlafaxine even worse.
  • Other drugs that can increase serotonin levels, such as fluoxetine, paroxetine, citalopram, duloxetine, linezolid, lithium, tramadol, and methylene blue
    • Venlafaxine increases your levels of serotonin. Taking it with any of these drugs may increase your serotonin levels even more. If your serotonin levels are too high, a life-threatening condition called serotonin syndrome can occur. Your doctor will monitor you closely when starting or increasing your dosage of either drug.
  • Certain drugs for migraine, called triptans, such as sumatriptan, rizatriptan, and zolmitriptan
    • Venlafaxine increases your levels of serotonin. Taking it with any of these drugs may increase your serotonin levels even more. If your serotonin levels are too high, a life-threatening condition called serotonin syndrome can occur. Your doctor will monitor you closely when starting or increasing your dosage of either drug.

Interactions that can make your drugs less effective

When certain drugs are used with venlafaxine, they may not work as well. This is because the amount of these drugs in your body may be decreased. Examples of these drugs include:

  • Metoprolol
    • Metoprolol may be less effective when you take it with venlafaxine. This may cause your blood pressure to rise. Talk to your doctor before taking these drugs together.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
Venlafaxine warnings
liver disease warning
People with liver disease

If you have a history of liver disease, your liver may not process this drug as quickly as it should. This could lead to a buildup of this drug in your body. Your doctor may start you on a reduced dosage. If they increase your dosage later, they will monitor you closely.

kidney disease warning
People with kidney disease

If you have kidney disease or a history of kidney disease, you may not be able to clear this drug from your body well. This may increase the levels of venlafaxine in your body. This can cause more side effects. Your doctor may start you on a low dosage and monitor you closely if they increase your dosage.

heart problem warning
People with heart problems

Venlafaxine can increase your heart rate, especially if you’re taking doses greater than 200 mg per day. If you have heart failure or if you’ve recently had a heart attack, your heart may not be able to tolerate this side effect.

hyperthyroidism warning
People with hyperthyroidism

Hyperthyroidism can increase your heart rate. Venlafaxine can also increase your heart rate. If you have hyperthyroidism and take venlafaxine, your heart rate may increase to a dangerous level. You are especially at risk if you take venlafaxine doses greater than 200 mg per day.

nervous system warning
People with a history of seizures

Venlafaxine raises your risk of seizures. If you have a seizure, stop taking venlafaxine and call your doctor right away.

eye pressure warning
People with increased eye pressure (glaucoma)

Venlafaxine can widen your pupils and block the flow of fluid in your eye. These effects can increase the pressure in your eyes. People with a history of increased eye pressure or glaucoma should have their eye pressure checked regularly while taking venlafaxine. Do not take venlafaxine if you have uncontrolled angle-closure glaucoma.

pregnancy warning
Pregnant women

Venlafaxine is a category C pregnancy drug. That means two things:

  1. Research in animals has shown adverse effects to the fetus when the mother takes the drug.
  2. There haven’t been enough studies done in humans to be certain how the drug might affect the fetus.

Talk to your doctor if you’re pregnant or plan to become pregnant. This drug should only be used if the potential benefit justifies the potential risk to the fetus.

breast feeding warning
Women who are breast-feeding

Venlafaxine may pass into breast milk and cause side effects in a child who is breastfed.

Talk to your doctor about breastfeeding your child. You may need to decide whether to stop breastfeeding or stop taking this medication.

senior warning
For seniors

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects. Older adults may be at higher risk than younger people for low sodium levels in their blood when taking venlafaxine.

childrens warnings
For children

This drug should not be used in people younger than 18 years of age.

call the doctor
When to call the doctor

Call your doctor right away if you become pregnant while taking this drug.

Also call your doctor if you don’t think your depression is getting better while you’re taking venlafaxine. It may take more than several months of antidepressant therapy to treat an episode of depression. If you don’t think your depression or anxiety is getting better, do not stop taking venlafaxine without talking to your doctor first. Your doctor will need to decrease your dosage over time to avoid serious symptoms from stopping venlafaxine too quickly.

allergy warning
Allergies

Venlafaxine can cause a severe allergic reaction. Symptoms can include:

  • trouble breathing
  • swelling of your face, tongue, eyes, or mouth
  • rash, hives, or blisters, alone or with joint paint or fever

If you have an allergic reaction, call your doctor or local poison control center right away. If your symptoms are severe, call 9-1-1 or go to the nearest emergency room.

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

SECTION 4 of 5

How to Take venlafaxine (Dosage)

Oral tablet

All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What are you taking this medication for?

Depression

Generic: venlafaxine

Form: oral tablet
Strengths: 25 mg, 37.5 mg, 50 mg, 75 mg, 100 mg
Form: extended-release oral tablet
Strengths: 37.5 mg, 75 mg, 150 mg
Form: extended-release oral capsule
Strengths: 37.5 mg, 75 mg, 150 mg

Brand: Effexor XR

Form: extended-release oral capsule
Strengths: 37.5 mg, 75 mg, 150 mg
Adult dosage (ages 18 years and older)
  • Oral tablets:
    • Typical starting dosage: 75 mg total per day, taken in two or three divided doses
    • Dosage increases: If needed, your doctor may increase your dosage to 150 mg per day.
    • Typical maximum dosage: 225 mg per day. If you have more severe depression, your doctor may prescribe a dosage as high as 375 mg per day, taken in three divided doses.
  • Extended-release oral tablets and extended-release oral capsules:
    • Typical starting dosage: 75 mg per day, taken in a single dose in the morning or evening. Some patients should start at a lower dosage of 37.5 mg per day for 4–7 days.
    • Dosage increases: If needed, your doctor may increase your dosage. They may increase it every 4 days by 75 mg until you reach 225 mg per day.
    • Typical maximum dosage: 225 mg per day. If you have more severe depression, your doctor may prescribe you 375 mg per day.
Child dosage (ages 0–17 years)

This medication should not be used in people younger than 18 years of age.

Special considerations

People with liver problems: People with mild to moderate liver problems should take about half of the typical dose. People with severe liver disease or cirrhosis may need an even lower dosage. Your doctor can tell you more.

People with kidney problems: People with mild to moderate kidney problems should take 75% of the typical dosage. People who are on dialysis should take half of the typical dosage. Your doctor can tell you more.

Anxiety disorders

Generic: venlafaxine

Form: oral tablet
Strengths: 25 mg, 37.5 mg, 50 mg, 75 mg, 100 mg
Form: extended-release oral tablet
Strengths: 37.5 mg, 75 mg, 150 mg
Form: extended-release oral capsule
Strengths: 37.5 mg, 75 mg, 150 mg

Brand: Effexor XR

Form: extended-release oral capsule
Strengths: 37.5 mg, 75 mg, 150 mg
Adult dosage (ages 18 years and older)
  • Extended-release oral capsules:
    • Typical starting dosage:
      • 75 mg per day, given in a single dose in the morning or evening.
      • Some patients with generalized anxiety should start at a lower dosage of 37.5 mg per day for 4–7 days.
    • Dosage increases: For generalized anxiety, your doctor may increase your dosage by 75 mg per day if needed. Increases should be made no more than every 4 days.
    • Maximum dosage:
      • For generalized anxiety: 225 mg per day
      • For social anxiety: 75 mg per day
Child dosage (ages 0–17 years)

This medication should not be used in people younger than 18 years of age.

Special considerations

People with liver problems: People with mild to moderate liver problems should take about half of the typical dose. People with severe liver disease or cirrhosis may need an even lower dosage. Your doctor can tell you more.

People with kidney problems: People with mild to moderate kidney problems should take 75% of the typical dosage. People who are on dialysis should take half of the typical dosage. Your doctor can tell you more.

Panic disorder

Generic: venlafaxine

Form: oral tablet
Strengths: 25 mg, 37.5 mg, 50 mg, 75 mg, 100 mg
Form: extended-release oral tablet
Strengths: 37.5 mg, 75 mg, 150 mg
Form: extended-release oral capsule
Strengths: 37.5 mg, 75 mg, 150 mg

Brand: Effexor XR

Form: extended-release oral capsule
Strengths: 37.5 mg, 75 mg, 150 mg
Adult dosage (ages 18 years and older)
  • Extended-release oral capsules:
    • Typical starting dosage: 37.5 mg per day for 7 days in the morning or evening
    • Dosage increases: If needed, your doctor may increase your dosage by 75 mg per day. Increases should be made no more than every 7 days.
    • Maximum dosage: 225 mg per day
Child dosage (ages 0–17 years)

This medication should not be used in people younger than 18 years of age.

Special considerations

People with liver problems: People with mild to moderate liver problems should take about half of the typical dose. People with severe liver disease or cirrhosis may need an even lower dosage. Your doctor can tell you more.

People with kidney problems: People with mild to moderate kidney problems should take 75% of the typical dosage. People who are on dialysis should take half of the typical dosage. Your doctor can tell you more.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

Venlafaxine comes with serious risks if you don’t take it as prescribed.

If you stop taking the drug suddenly or don’t take it at all

Your depression or anxiety may not get better and may get worse. Do not stop venlafaxine without talking to your doctor. Stopping venlafaxine too quickly can cause serious symptoms such as:

  • anxiety
  • irritability
  • tiredness
  • restlessness
  • trouble sleeping
  • headache
  • sweating
  • dizziness
  • tingling or “pins and needles” feeling
  • shaking
  • confusion
  • nightmares
  • nausea
  • vomiting
  • diarrhea

If this happens, your doctor may have you start taking venlafaxine again and decrease your dosage slowly.

If you miss doses or don’t take the drug on schedule

Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.

If you take too much

You could have dangerous levels of the drug in your body. This can lead to death. Symptoms of an overdose of this drug can include:

  • fast heart rate
  • unusual sleepiness
  • enlarged pupils
  • seizure
  • vomiting
  • heart rhythm changes
  • low blood pressure
  • muscle aches or pains
  • dizziness

If you think you’ve taken too much of this drug, call your doctor or local poison control center. If your symptoms are severe, call 9-1-1 or go to the nearest emergency room right away.

What to do if you miss a dose

Take your dose as soon as you remember. If you remember just a few hours before your next scheduled dose, take only one dose. Never try to catch up by taking two doses at once. This could result in dangerous side effects.

How to tell if the drug is working

The symptoms of your depression or anxiety should be less severe or happen less often.

Venlafaxine is used for long-term treatment.

Important considerations for taking venlafaxine
take with food
Take venlafaxine with food
timing considerations
Take this drug at the time(s) recommended by your doctor
can crush or cut
You can cut or crush one form of this drug
See Details
storage considerations
Store this drug carefully
See Details
medication is refillable
A prescription for this medication is refillable
See Details
travel considerations
Travel
See Details
self management considerationsa
Self-management
See Details
not usually stocked
Not every pharmacy stocks this drug. When filling your prescription, be sure to call ahead
prior authorization needed
Insurance
See Details

You can cut or crush one form of this drug

  • You can cut or crush the immediate-release oral tablet.
  • Do not cut or crush the extended-release tablet or the extended-release capsule.

Store this drug carefully

  • Store venlafaxine oral tablets and extended-release oral capsules at room temperature between 68°F and 77°F (20°C and 25°C).
  • Store the extended-release oral tablet at temperatures between 59°F and 86°F (15°C and 30°C).
  • Keep this drug away from light.
  • Don’t store this medication in moist or damp areas, such as bathrooms.

A prescription for this medication is refillable

You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

  • Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
  • Don’t worry about airport x-ray machines. They can’t hurt your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled box with you.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Self-management

The extended-release oral capsule contains tiny beads. These beads release the drug slowly into your digestive tract. Not all of the beads break down, so you may notice some beads in your stool. This is normal.

Insurance

Many insurance companies require a prior authorization for this drug. This means your doctor may need to get approval from your insurance company before your insurance company will pay for the prescription.

Are there any alternatives?

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.

SECTION 5 of 5

How Much Does venlafaxine Cost?

Oral tablet

We've partnered with GoodRx so you can compare prices, find discounts and save up to 80% on your next prescription. Check out the low coupon prices below — no insurance required.

Compare prices and save up to 80% on your next refill!

Lowest price for venlafaxine

Walgreens $15.00
Kroger Pharmacy $21.89
Membership warehouse $24.68
These prices represent the lowest priced national pharmacies for venlafaxine on GoodRx. They may be lower than your insurance.

Enter your zip code to find the best deal near you.

These prices represent the lowest priced national pharmacies for venlafaxine on GoodRx. They may be lower than your insurance.

Show Sources

Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on March 14, 2016

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
Advertisement
Advertisement
Advertisement