• Basic Info
• Top Questions
• Clinical Info
• Interactions

What is venlafaxine?
Venlafaxine is an antidepressant in a group of drugs called selective serotonin and norepinephrine reuptake inhibitors (SSNRIs). Venlafaxine affects chemicals in the brain that may become unbalanced and cause depression. Venlafaxine is used to treat major depressive disorder, anxiety, and panic disorder. Venlafaxine may also be used for other purposes not listed in this medication guide.

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What is the price of this medication and similar alternatives?

This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.

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What are the possible side effects of venlafaxine?

Get emergency medical help if you have any of these signs of an allergic reaction: skin rash or hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Contact your doctor promptly if you have any of the following side effects, especially if they are new symptoms or if they get worse: mood changes, anxiety, panic attacks, trouble sleeping, irritability, agitation, aggressiveness, severe restlessness, mania (mental and/or physical hyperactivity), thoughts of suicide or hurting yourself.

Call your doctor at once if you have any of these serious side effects:

• increased blood pressure (severe headache, blurred vision);

• nausea, vomiting, diarrhea, fever, fast heartbeat; hallucinations, loss of coordination, fainting, coma;

• seizure (convulsions);

• extreme thirst with headache, nausea, vomiting, and weakness; or

• easy bruising or bleeding.

Less serious side effects may include:

• drowsiness, dizziness, nervousness, or anxiety;

• dry mouth, increased sweating;

• nausea, vomiting, diarrhea, constipation;

• decreased sex drive, impotence, or difficulty having an orgasm;

• headache, blurred vision;

• tremor or chills; or

• changes in appetite or weight.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

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How should I take venlafaxine?
Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Your doctor may occasionally change your dose to make sure you get the best results from the medication. Follow the directions on your prescription label. Take this medication with a full glass of water. Venlafaxine should be taken with food. Swallow the controlled-release capsule (Effexor XR) whole, without crushing or chewing. To make the medication easier to swallow, you may open the capsule and sprinkle the medicine into a small amount of applesauce. Swallow all of the mixture without chewing, and do not save any for later use.

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What is the most important information I should know about venlafaxine?
Do not take this medication if you are allergic to venlafaxine, or if you are also using a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate). You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment. Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

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What happens if I miss a dose?
Take the missed dose as soon as you remember. However, if it is almost time for the next regularly scheduled dose, skip the missed dose and take the next one as directed. Do not take extra medicine to make up the missed dose.

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What other drugs will affect venlafaxine?
Before taking venlafaxine, tell your doctor if you are using any of the following medicines: cimetidine (Tagamet, Tagamet HB); warfarin (Coumadin); ketoconazole (Nizoral); tryptophan (sometimes called L-tryptophan); haloperidol (Haldol) or risperidone (Risperdal); almotriptan (Axert), frovatriptan (Frova), sumatriptan (Imitrex), naratriptan (Amerge), rizatriptan (Maxalt), or zolmitriptan (Zomig); or any other antidepressants such as amitriptyline (Elavil), amoxapine (Ascendin), citalopram (Celexa), clomipramine (Anafranil), desipramine (Norpramin), escitalopram (Lexapro), fluoxetine (Prozac), fluvoxamine (Luvox), imipramine (Tofranil), nortriptyline (Pamelor), paroxetine (Paxil), protriptyline (Vivactil), sertraline (Zoloft), or trimipramine (Surmontil).

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Can I take this if I am pregnant or trying to get pregnant or if I am breastfeeding?

Venlafaxine has been assigned to pregnancy category C by the FDA. Data reported on 150 women exposed to venlafaxine during pregnancy has stated that 125 had live births, 18 had spontaneous abortions, and seven had therapeutic abortions. Two of the babies had major malformations. There were no significant differences between these women and the two comparison groups on any of the measures analyzed. Neonates exposed to venlafaxine (and other SSRIs and SNRIs) late in the third trimester have developed complications requiring prolonged hospitalization, respiratory support, and tube feeding. Reported clinical findings have included respiratory distress, cyanosis, tachypnea, apnea, seizures, temperature instability, feeding difficulty, tachycardia, bradycardia, jaundice, vomiting, hypoglycemia, hypotonia, hypertonia, hyperreflexia, tremor, jitteriness, irritability, and constant crying. (These features are consistent with either a direct toxic effect of SSRIs and SNRIs, or possibly a drug discontinuation syndrome.) In some cases, the clinical picture is consistent with serotonin syndrome. There are no controlled data in human pregnancy. Venlafaxine should be given during pregnancy and particularly during the third trimester, only if the potential benefits outweigh the potential risks to the fetus.

If venlafaxine is used until or shortly before birth, discontinuation effects in the newborn should be considered. According to the results of a retrospective cohort study, discontinuation effects typically appear during the first day of life and can last up to 5 days after birth. The authors state that in most cases symptoms were transient and self-limited. The results of a cohort study indicate that 30% of neonates who had prolonged exposure to SSRIs in utero experience symptoms, in a dose- response manner, of a neonatal abstinence syndrome (e.g., tremor, gastrointestinal or sleep disturbances, hypertonicity, high- pitched cry) after birth. The authors suggest that infants exposed to SSRIs should be closely monitored for a minimum of 48 hours after birth.

Venlafaxine and its active metabolite O-desmethylvenlafaxine are excreted into human milk. Adverse effects in the nursing infant are unlikely. Because many drugs are excreted in human milk and because of the potential for serious adverse reactions due to venlafaxine in nursing infants, a decision should be made to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.

A study of six breast-feeding mothers taking venlafaxine and their seven infants reported that the concentrations of venlafaxine and O-desmethylvenlafaxine in breast milk were 2.5 and 2.7 times those in maternal plasma. The mean total drug exposure (as venlafaxine equivalents) was reported to be 6.4%. There were no adverse effects reported for any of the infants. The authors stated that the data supported the use of venlafaxine in breast-feeding. However, since low concentrations of O-desmethylvenlafaxine were detected in the plasma of four of the seven infants studied, they recommended that the breast-fed infants be monitored closely. In one small case series (N=3) on the use of venlafaxine by breast-feeding mothers, the estimated mean dose the infants received from breast milk was 7.6% of the maternal weight-adjusted dose. No adverse effects were noted in the infant. However, the authors cautioned that this dose was high compared to the dose infants are estimated to receive when exposed to other antidepressants through breast milk. Two other infants have also been reported who received breast milk exclusively during their first six months from their mothers who were taking stable daily doses of venlafaxine. No adverse effects were reported. Venlafaxine was not detectable in either infant. The metabolite was present in both children at low concentrations. The authors felt that the presence of the metabolite suggested that these young infants were able to desmethylate the parent drug.

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Who should NOT use this medication?

• Concurrent or recent (i.e., within 2 weeks) therapy with an MAO inhibitor. (See MAO Inhibitors under Cautions and see Interactions.)
• Known hypersensitivity to venlafaxine or any ingredient in the formulation.

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What happens if I overdose?
Seek emergency medical attention if you think you have taken too much of this medication. Overdose symptoms may include dizziness, sleepiness, nausea, and numbness or tingling in your hands or feet.

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What should I discuss with my healthcare provider before taking venlafaxine?
Do not take this medication if you are allergic to venlafaxine, or if you are also using a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate). You must wait at least 14 days after stopping an MAOI before you can take venlafaxine. After you stop taking venlafaxine, you must wait at least 7 days before you start taking an MAOI. Before taking venlafaxine, tell your doctor if you are allergic to any medications, or if you have:

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Can I stop taking the medication if I feel better?
As a general rule, you should always take your medications exactly as prescribed and do not change the dosage or stop taking the medication without first discussing it with your healthcare provider.

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I am on so many medications; do I have to take them all?
This is called polypharmacy—many different medications being used at the same time by one person. Sometimes, being on multiple medications is acceptable and appropriate but at other times it may be problematic. If you are receiving your medications from multiple physicians you need to ensure that they all know what medications you are taking. The best way to do this is to make a list of all the medications you are currently using, including all nutritional supplements, homeopathic remedies, vitamins and over-the-counter drugs (if possible, also include all the diseases you have been diagnosed with). Give a copy to every doctor who takes care of you so they have it on file, this way they can avoid duplicating medications and perhaps even try to consolidate some. After every doctor's visit remember to update the list accordingly. Also, as much as you possibly can, try to use the same pharmacy to fill all your prescriptions, this way any potential drug interactions can be caught and averted.

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Where can I get more information?
More Information

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