![EFFEXOR XR (venlafaxine [as HCl]) 37.5mg, 75mg, 150mg extended-release capsules by Pfizer](http://media.empr.com/images/2013/03/04/effexor-xr_351071_351072.jpg "EFFEXOR XR (venlafaxine [as HCl]) 37.5mg, 75mg, 150mg extended-release capsules by Pfizer")
Generic Name and Formulations:
Venlafaxine (as HCl) 37.5mg, 75mg, 150mg; ext-rel caps.
Company:
Pfizer Inc.
Generalized anxiety disorder. Social anxiety disorder. Panic disorder.
Take with food. Swallow whole or sprinkle contents on spoonful of applesauce; do not chew. Generalized or social anxiety disorder: 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 to 75mg/day at intervals of at least 4 days. Panic disorder: Initially 37.5mg once daily for 7 days, then may increase to 75mg/day; then may increase in increments of up to 75mg/day at intervals of at least 7 days. For all: 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).
Not established.
Serotonin and norepinephrine reuptake inhibitor.
MAOIs (see Interactions). Concomitant linezolid or IV methylene blue.
Increased risk of suicidal thinking and behavior in children, adolescents, and young adults. Monitor BP; 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.Write ℞ for smallest practical amount. Elderly. Labor & delivery. Pregnancy (Cat.C) (avoid 3rd trimester; see literature for effects on neonate). Nursing mothers: not recommended.
See Contraindications. Allow at least 14 days after MAOI discontinuance before starting venlafaxine; allow at least 7 days after venlafaxine discontinuance before starting an MAOI. Risk of serotonin syndrome with concomitant serotonergic drugs (eg, triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, tryptophan, buspirone, St. John's Wort) and with drugs that impair serotonin metabolism (eg, MAOIs, linezolid, IV methylene blue). Avoid alcohol. Concomitant weight loss agents (eg, phentermine), serotonin precursors (tryptophan supplements): not recommended. Caution with other CNS drugs, cimetidine, haloperidol, diuretics, metoprolol, drugs that inhibit CYP2D6, CYP3A4. Increased risk of bleeding with NSAIDs, aspirin, warfarin. False (+) urine immunoassay screening tests for PCP and amphetamine.
GI upset, dizziness, somnolence, insomnia, headache, nervousness, asthenia, sweating, dry mouth, vasodilation, abnormal dreams or vision, tremor, hypertension, sexual dysfunction, yawn, ecchymosis, anorexia, weight changes; hyponatremia/SIADH (esp in elderly); rare: interstitial lung disease, eosinophilic pneumonia.
Hepatic (CYP2D6).
Renal.
YES
Caps—15, 30, 90
Major depressive disorder.
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 to 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).
Not established.
Serotonin and norepinephrine reuptake inhibitor.
MAOIs (see Interactions). Concomitant linezolid or IV methylene blue.
Increased risk of suicidal thinking and behavior in children, adolescents, and young adults. Monitor BP; 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.Write ℞ for smallest practical amount. Elderly. Labor & delivery. Pregnancy (Cat.C) (avoid 3rd trimester; see literature for effects on neonate). Nursing mothers: not recommended.
See Contraindications. Allow at least 14 days after MAOI discontinuance before starting venlafaxine; allow at least 7 days after venlafaxine discontinuance before starting an MAOI. Risk of serotonin syndrome with concomitant serotonergic drugs (eg, triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, tryptophan, buspirone, St. John's Wort) and with drugs that impair serotonin metabolism (eg, MAOIs, linezolid, IV methylene blue). Avoid alcohol. Concomitant weight loss agents (eg, phentermine), serotonin precursors (tryptophan supplements): not recommended. Caution with other CNS drugs, cimetidine, haloperidol, diuretics, metoprolol, drugs that inhibit CYP2D6, CYP3A4. Increased risk of bleeding with NSAIDs, aspirin, warfarin. False (+) urine immunoassay screening tests for PCP and amphetamine.
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); rare: interstitial lung disease; eosinophilic pneumonia.
Hepatic (CYP2D6).
Renal.
YES
Caps—15, 30, 90; Tabs 25mg, 37.5mg—60; 50mg, 75mg—30; 100mg—20