Effexor XR (venlafaxine) is a prescription drug that’s used to treat depression and anxiety disorders. This drug can interact with alcohol, other medications, and some supplements. For example, Effexor XR can interact with certain pain relievers.

Effexor XR is used in adults to treat:

Effexor XR contains the active ingredient venlafaxine. (An active ingredient is what makes a drug work.) The medication comes as an extended-release capsule that you swallow. (Extended-release capsules release the medication into your body slowly over time instead of all at once.)

An interaction can occur because one substance causes another substance to have a different effect than expected. Interactions can also occur if you have certain health conditions.

Keep reading to learn about Effexor XR’s possible interactions. And for more information about Effexor XR, including details about its uses, see this article.

Effexor XR may have other interactions. They could occur with supplements, foods, vaccines, or even lab tests. See below for details. Note that the information below does not include all other possible interactions with Effexor XR.

Does Effexor XR interact with supplements?

Before you start taking Effexor XR, talk with your doctor and pharmacist about any herbs or vitamins and supplements you take. Sharing this information with them may help you avoid possible interactions.

Effexor XR can interact with tryptophan and 5-HTP, which are used to help with mood and sleep problems. Taking Effexor XR with these supplements can raise your risk of serotonin syndrome (a serious condition caused by high levels of serotonin in your body). Your doctor will likely recommend avoiding these supplements while you’re taking Effexor XR.

If you have questions about other interactions that may affect you, talk with your doctor or pharmacist. They can advise you on whether there are supplements you should not take with Effexor XR (venlafaxine).

Effexor XR interactions with herbs

Effexor XR can interact with St John’s wort, which is used to treat depression and other conditions. Taking Effexor XR with St John’s wort can raise your risk of serotonin syndrome. Your doctor will likely recommend that you don’t take St John’s wort with Effexor XR.

If you have questions about other interactions that may affect you, talk with your doctor or pharmacist.

Effexor XR and vitamins

There are currently no reports of Effexor XR interactions with vitamins. But this doesn’t mean that vitamin interactions won’t be recognized in the future.

For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products while taking Effexor XR.

Does Effexor XR interact with food?

There are currently no reports of Effexor XR interacting with food. There aren’t any foods to avoid while taking this medication. If you have questions about eating certain foods during your treatment with Effexor XR, talk with your doctor.

Does Effexor XR interact with vaccines?

There are currently no reports of Effexor XR interacting with vaccines. If you have questions about getting certain vaccines during your Effexor XR treatment, talk with your doctor.

Does Effexor XR interact with lab tests?

Effexor XR can interact with urine screening tests for phencyclidine (PCP) and amphetamine. Effexor XR can cause false positive results in these tests. This means that while taking Effexor XR, your urine can test positive for PCP or amphetamine when you haven’t taken these drugs. Your urine can also test positive for these drugs for several days after stopping Effexor XR.

If you have a urine test for PCP or amphetamine, tell the healthcare professional ordering the test that you take Effexor XR.

If you have questions about having other lab tests during your treatment with Effexor XR, talk with the healthcare professional ordering the test.

Does Effexor XR interact with cannabis or CBD?

There are currently no reports of Effexor XR interacting with cannabis (commonly called marijuana) or cannabis products such as cannabidiol (CBD). But cannabis and Effexor XR can both cause sleepiness. So you may have an increased risk of sleepiness if you use cannabis while taking Effexor XR.

As with any drug or supplement, talk with your doctor before using cannabis with Effexor XR.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Before you start taking Effexor XR, tell your doctor and pharmacist about any prescription, over-the-counter, or other drugs you take. Sharing this information with them may help prevent possible interactions. (To learn whether Effexor XR interacts with herbs or vitamins and supplements, see the “Are there other interactions with Effexor XR?” section below.)

If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist. They can advise you on whether there are drugs you should not take with Effexor XR (venlafaxine).

The table below lists drugs that may interact with Effexor XR. Keep in mind that this table does not include all drugs that may interact with Effexor XR. For more information about some of these interactions, see the “Drug interactions explained” section below.

Drug group or drug nameDrug examplesWhat can happen
monoamine oxidase inhibitors (MAOIs)*• isocarboxazid (Marplan)
• linezolid (Zyvox)
• phenelzine (Nardil)
• rasagiline (Azilect)
• selegiline (Emsam, Zelapar)
can increase the risk of serotonin syndrome
nonsteroidal anti-inflammatory drugs (NSAIDs)• aspirin
ibuprofen (Advil, Motrin)
naproxen (Naprosyn, Aleve)
can increase the risk of bleeding
blood thinners• apixaban (Eliquis)
• dabigatran (Pradaxa)
warfarin (Jantoven)
can increase the risk of bleeding
selective serotonin reuptake inhibitors (SSRIs)• citalopram (Celexa)
• paroxetine (Paxil)
• sertraline (Zoloft)
can increase the risk of serotonin syndrome
triptans• eletriptan (Relpax)
• sumatriptan (Imitrex, others)
• zolmitriptan (Zomig)
can increase the risk of serotonin syndrome
amphetamines• amphetamine salts (Adderall, Mydayis)
• dextroamphetamine (Dexedrine)
• lisdexamfetamine (Vyvanse)
can increase the risk of serotonin syndrome
certain opioids• fentanyl (Fentora, others)
• tramadol (Conzip, Qdolo)
can increase the risk of serotonin syndrome
certain antibiotics and antifungals• clarithromycin
• itraconazole (Sporanox, Tolsura)
• ketoconazole
can increase the risk of side effects from Effexor XR
certain HIV drugs• nelfinavir (Viracept)
• ritonavir (Norvir)
can increase the risk of side effects from Effexor XR

* Effexor XR should not be taken with these drugs. See “When should I avoid Effexor XR?” just below for more information.

† To learn more about this interaction, see the section below called “Drug interactions explained”.

Find answers to some frequently asked questions about Effexor XR and possible interactions.

What allergy medicine can I take with Effexor XR?

Most allergy medications are safe to take with Effexor XR.

However, certain antihistamines (a type of allergy medication) can sometimes cause sleepiness. Examples include diphenhydramine (Benadryl) and chlorpheniramine. Effexor XR can also cause sleepiness in some people. So you may have a raised risk of sleepiness if you take one of these antihistamines with Effexor XR.

If you need an allergy medication while taking Effexor XR, talk with your doctor or pharmacist. They can recommend a medication that’s right for you.

Is it safe to take gabapentin and Effexor XR for anxiety?

Yes, it should usually be safe to take gabapentin (Neurontin) with Effexor XR. However, both drugs can sometimes cause sleepiness. So you may have a raised risk of this side effect if you take them together.

Effexor XR is used to treat depression and anxiety disorders. Gabapentin is used to treat seizures and certain types of nerve pain. But doctors may sometimes also prescribe gabapentin off-label for anxiety disorders. So doctors may sometimes prescribe these drugs together.

If you have bothersome sleepiness while taking gabapentin and Effexor XR together, talk with your doctor. If have other questions about taking these drugs together, talk with your doctor or pharmacist.

Does Effexor XR have interactions with caffeine?

No. There’s no known interactions between Effexor XR and caffeine. However, caffeine can cause trouble sleeping. And Effexor XR can cause trouble sleeping in some people. So you may have a raised risk of this side effect if you consume caffeine while taking Effexor XR.

If you have questions about taking Effexor XR with caffeine, talk with your doctor or pharmacist.

Certain health conditions or other factors could raise your risk of harm if you take Effexor XR. In such cases, your doctor may not prescribe Effexor XR for you. These are known as contraindications. The list below includes contraindications of Effexor XR.

If you take a monoamine oxidase inhibitor (MAOI): If you take an MAOI drug or have taken one in the past 14 days, your doctor will likely not prescribe Effexor XR. That’s because this combination of drugs has a high risk of causing serotonin syndrome (a serious condition caused by a high level of serotonin in the body). You can ask your doctor about other treatments that may be better options for you.

MAOI drugs include the antidepressant phenelzine (Nardil), the antibiotic linezolid (Zyvox), and the Parkinson’s disease drug rasagiline (Azilect). Some other examples are listed in the table in the section above called “Does Effexor XR interact with other drugs?”.

If you’ve had an allergic reaction: If you’ve had an allergic reaction to Effexor XR, any of its ingredients, or a very similar drug called desvenlafaxine (Pristiq), your doctor likely won’t prescribe Effexor XR for you. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better options for you.

Before you start taking Effexor XR, talk with your doctor if any of the factors above apply to you. Your doctor can determine whether Effexor XR is safe for you to take.

Effexor XR is not known to interact with alcohol. But Effexor XR and alcohol can cause some similar side effects, such as sleepiness, dizziness, and nausea. So you may be more likely to experience these side effects if you drink alcohol during your Effexor XR treatment.

Keep in mind that drinking alcohol can also worsen symptoms of depression and anxiety disorders, which Effexor XR is used to treat. Your doctor may recommend that you avoid drinking alcohol while you’re having treatment for these conditions.

If you have questions about consuming alcohol while taking Effexor XR, talk with your doctor or pharmacist.

Learn more about certain drug interactions that can occur with Effexor XR.

Interaction with nonsteroidal anti-inflammatory drugs (NSAIDs)

Effexor XR can interact with NSAIDs, which are a group of medications used to relieve pain and reduce inflammation (swelling).

Examples of NSAID medications include:

  • aspirin
  • ibuprofen (Advil, Motrin)
  • naproxen (Aleve, Naprosyn)

Many over-the-counter (OTC) pain medications contain NSAIDs among their active ingredients. (An active ingredient is what makes a drug work.)

What could happen

Taking NSAIDs with Effexor XR can raise your risk of unusual bleeding, such as nosebleeds, bruising easily, or bleeding in your digestive system.

If you also take anticoagulant or antiplatelet drugs (blood thinners), you may have a higher risk of bleeding if you take an NSAID with Effexor XR.

What you can do

While taking Effexor XR, you should check with your doctor or pharmacist before taking OTC pain relievers that contain NSAIDs. They can recommend if these pain relievers are safe for you.

If your doctor prescribes Effexor XR with an NSAID, or you take an OTC NSAID with Effexor XR, tell your doctor right away if you have symptoms of bleeding. These may include bruising easily, nosebleeds, passing bloody or tar-like stools, and vomiting blood or a substance that looks like coffee grounds.

If you have questions about taking Effexor XR with NSAIDs, talk with your doctor or pharmacist.

Interaction with triptans

Effexor XR can interact with triptans, which are a group of medications used to treat migraine episodes.

Examples of triptan medications:

  • eletriptan (Relpax)
  • sumatriptan (Imitrex, others)
  • zolmitriptan (Zomig)

What could happen

Triptans and Effexor XR can both increase the level of serotonin in your body. So taking a triptan with Effexor XR can make the level of serotonin in your body get too high. This can raise your risk of serotonin syndrome (a serious condition caused by a high level of serotonin in your body). In severe cases, serotonin syndrome can be life threatening.

What you can do

If you take a triptan medication with Effexor XR, call your doctor right away if you have symptoms of serotonin syndrome. These may include vomiting, diarrhea, fast heartbeat, dizziness, sweating, flushing, tremor, twitching, or seizures. You may also feel anxious, restless, or disorientated.

If you have questions about taking a triptan with Effexor XR, talk with your doctor or pharmacist.

Interaction with certain antibiotics and antifungals

Effexor XR can interact with certain antibiotics, which are used to treat bacterial infections. It can also interact with certain antifungals, which are used to treat fungal infections.

Examples of antibiotics and antifungals that can interact with Effexor XR include:

  • clarithromycin
  • itraconazole (Sporanox, Tolsura)
  • ketoconazole

What could happen

Certain antibiotics and antifungals can reduce the action of an enzyme (type of protein) in your body that helps break down Effexor XR. Taking one of these drugs with Effexor XR can make Effexor XR build up in your body. This can raise your risk of side effects from Effexor XR.

What you can do

If you take certain antibiotics or antifungals with Effexor XR, your doctor may temporarily lower your dosage of Effexor XR. You should not take a higher dose of either medication than your doctor prescribes.

If you take an antibiotic or antifungal and Effexor XR together, tell your doctor right away if you have new or increased Effexor XR side effects.

If you have questions about taking antibiotics or antifungals with Effexor XR, talk with your doctor or pharmacist.

Certain medical conditions or other health factors may raise the risk of interactions with Effexor XR. Before taking Effexor XR, talk with your doctor about your health history. They’ll determine whether Effexor XR is right for you.

Health conditions or other factors that might interact with Effexor XR include:

Age 24 years and younger: Effexor XR can increase the risk of suicidal thoughts and behavior in people ages 24 years and younger. The drug has a boxed warning for this risk. A boxed warning is the most serious warning from the FDA. For more information, see the boxed warning information at the top of this article.

High blood pressure: Effexor XR can increase your blood pressure. If you have high blood pressure, your doctor will check that this is well managed before prescribing Effexor XR. Your doctor will monitor your blood pressure during treatment with Effexor XR. If your blood pressure gets too high, they may prescribe medication to lower it. Or they may increase the dosage of blood pressure medication you already take.

Risk of closed-angle glaucoma: Effexor XR can trigger closed-angle glaucoma in certain people. If you know you have a risk of closed-angle glaucoma — for example, if you have narrow eye angles — talk with your doctor about whether Effexor XR is right for you.

History of bipolar disorder or mania: Effexor XR can sometimes trigger a manic episode in people with bipolar disorder. If you or a family member have ever been diagnosed with bipolar disorder or mania, talk with your doctor about whether Effexor XR is right for you.

Seizure disorders: Effexor XR may cause seizures in some people. If you have a seizure disorder such as epilepsy, talk with your doctor about whether Effexor XR is right for you.

Low sodium levels: Effexor can sometimes cause low sodium levels. If you’re age 65 years or older or take diuretic medications you may have a raised risk of this side effect. Talk with your doctor about whether Effexor XR is right for you.

Kidney or liver problems: If you have kidney or liver problems, Effexor XR could build up in your body. This could raise your risk of side effects. Your doctor will likely prescribe a dosage of Effexor that’s lower than usual if you have a kidney or liver problem.

Pregnancy: It’s not known whether Effexor XR is safe to take during pregnancy. If you’re pregnant or planning a pregnancy, talk with your doctor before taking Effexor XR.

If you do take Effexor XR while pregnant, consider enrolling in the National Pregnancy Registry for Antidepressants. This registry collects details about pregnancy issues reported with antidepressants such as Effexor XR. To learn more, call 844-405-6185 or talk with your doctor.

Breastfeeding: It’s not known whether it’s safe to take Effexor XR while breastfeeding. The drug passes into breast milk, but it isn’t known for sure whether the drug may cause side effects in a child who’s breastfed. If you’re breastfeeding or planning to breastfeed, talk with your doctor about your options.

Allergic reaction: If you’ve had an allergic reaction to Effexor XR or any of its ingredients, your doctor will likely not prescribe Effexor XR. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better choices for you.

Help is out there

If you or someone you know is in crisis and considering suicide or self-harm, please seek support:

If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.

If you are not in the same household, stay on the phone with them until help arrives.

Was this helpful?

Taking certain steps can help you avoid interactions with Effexor XR. Before starting treatment, talk with your doctor and pharmacist. Things to discuss with them include:

  • Whether you drink alcohol or use cannabis.
  • Other medications you take, as well as any vitamins, supplements, and herbs. Your doctor or pharmacist can help you fill out a medication list.
  • What to do if you start taking a new drug during your Effexor XR treatment.

It’s also important to understand Effexor XR’s label and other paperwork that may come with the drug. Colored stickers that describe interactions may be on the label. And the paperwork (sometimes called the patient package insert or medication guide) may have other details about interactions. (If you did not get paperwork with Effexor XR, ask your pharmacist to print a copy for you.)

If you have trouble reading or understanding this information, your doctor or pharmacist can help.

Taking Effexor XR exactly as prescribed can also help prevent interactions.

If you still have questions about Effexor XR and its possible interactions, talk with your doctor.

Questions you may want to ask your doctor include:

  • Does my risk of interactions depend on my dosage of Effexor XR?
  • Do I need to tell you if I start taking another medication or supplement during my Effexor XR treatment?
  • Do other drugs that could treat my condition have similar interactions?

To learn more about Effexor XR, see these articles:

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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 another 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.