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.

Precautions

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:

  • bipolar disorder (manic depression);
  • cirrhosis or other liver disease;
  • kidney disease;
  • high blood pressure;
  • glaucoma;
  • seizures or epilepsy;
  • a bleeding or blood clotting disorder; or
  • high cholesterol.

If you have any of the conditions listed above, you may need a dose adjustment or special test to safely take venlafaxine.

You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Tell your doctor if you have worsening symptoms of depression or suicidal thoughts during the first several weeks of treatment, or whenever your dose is changed.

Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

FDA pregnancy category C. Venlafaxine may be harmful to an unborn baby, and may cause problems in a newborn baby if the mother takes the medication late in pregnancy (during the third trimester). Tell your doctor if you are pregnant or plan to become pregnant during treatment.

Venlafaxine can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Do not give this medication to anyone under 18 years old without the advice of a doctor.

Avoid drinking alcohol, which can increase some of the side effects of venlafaxine.

Venlafaxine can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Tell your doctor if you regularly use other drugs that can cause sleepiness (such as cold or allergy medicine, narcotic pain medication, sedatives, muscle relaxers, or medicines to treat seizures or anxiety). These may add to sleepiness caused by venlafaxine.

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Instructions

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.

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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Side Effects

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);
  • easy bruising or bleeding;
  • severe blistering, peeling, and red skin rash;
  • very stiff (rigid) muscles, high fever, sweating, fast or uneven heartbeats, tremors, overactive reflexes;
  • nausea, vomiting, diarrhea, loss of appetite, feeling unsteady, loss of coordination; or
  • headache, trouble concentrating, memory problems, weakness, confusion, hallucinations, fainting, seizure, shallow breathing or breathing that stops.

Less serious side effects may include:

  • drowsiness, dizziness, feeling nervous;
  • dry mouth;
  • mild nausea, constipation;
  • decreased sex drive, impotence, or difficulty having an orgasm;
  • blurred vision;
  • increased appetite; or
  • changes in weight.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

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Interactions

Talk to your doctor before taking any medicine for pain, arthritis, fever, or swelling. This includes aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), diclofenac (Voltaren), indomethacin, piroxicam (Feldene), nabumetone (Relafen), etodolac (Lodine), and others. Taking any of these drugs with venlafaxine may cause you to bruise or bleed easily.

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).

This list is not complete and there may be other drugs that can interact with venlafaxine. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Other Names

Effexor, Effexor XR, and venlafaxine

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Disclaimer

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2004 Cerner Multum, Inc. Version 2.05. Revision date 8/23/04

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