Monograph Details
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Central Nervous System
> Mood disorders
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EFFEXOR XR |
| Manufacturer |
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Wyeth Pharmaceuticals |
| Legal Classification |
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Rx
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| Pharmacological Class |
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Serotonin and norepinephrine reuptake inhibitor. |
| Generic Name |
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Venlafaxine (as HCl) 37.5mg, 75mg, 150mg; ext-rel caps. |
| Indications |
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Depression. |
| Children |
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Not recommended. |
| Adults |
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Take with food. Swallow whole or sprinkle contents on spoonful of applesauce; do not chew. Transferring from immediate-release: give total daily dose on once-daily basis. Initially 75mg once daily; may start at 37.5mg once daily for 4–7 days before increasing to 75mg/day; may increase by increments of up tp 75mg/day at intervals of at least 4 days; usual max 225mg/day. Moderate hepatic impairment: reduce by 50%. Renal impairment: reduce by 25–50%; reduce dose by 50% in hemodialysis (hold dose until end of treatment). Withdraw gradually (reduce by 75mg/day at 1-week intervals). |
| Contraindications |
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MAOIs (see Interactions). |
| Precautions |
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Monitor blood pressure; reduce dose or discontinue if elevated BP persists. Heart disease (eg, recent MI, heart failure). Hypercholesterolemia (consider monitoring in long-term use). Renal or hepatic dysfunction. Increased intraocular pressure. Diseases that affect metabolism or hemodynamic response (eg, hyperthyroidism). Mania. Seizure disorders. Reevaluate periodically. Suicidal ideation. Write Rx for smallest practical amount. Elderly. Labor & delivery. Pregnancy (Cat.C) (avoid 3rd trimester; see literature for effects on neonate). Nursing mothers: not recommended. |
| Interactions |
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Allow at least 14 days after MAOI discontinuance before starting venlafaxine; allow at least 7 days after venlafaxine discontinuance before starting an MAOI. Avoid alcohol. Concomitant weight loss agents (eg, phentermine), serotonin precursors (tryptophan supplements): not recommended. Monitor for serotonin syndrome with SSRIs, SNRIs, triptans (esp. during initiation and dose increases). Caution with other CNS drugs, cimetidine, haloperidol, diuretics, drugs that inhibit both CYP2D6 and CYP3A4. |
| Adverse Reactions |
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GI upset, dizziness, somnolence, insomnia, sexual dysfunction, sweating, dry mouth, nervousness, asthenia, tremor, vasodilation, hypertension, abnormal dreams or vision, yawn, paresthesia, agitation, ecchymosis, anorexia, weight changes; hyponatremia/SIADH (esp in elderly). |
| How Supplied |
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Caps, tabs—100 |
| Additional Resources |
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• Related Prescribing Note |
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