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EFFEXOR
Mood disorders
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Drug Name:

EFFEXOR Rx

Generic Name and Formulations:
Venlafaxine (as HCl) 25mg, 37.5mg, 50mg, 75mg, 100mg; scored tabs.

Company:
Pfizer Inc.

Therapeutic Use:

Indications for EFFEXOR:

Major depressive disorder.

Adult:

Take with food. ≥18yrs: Initially 75mg/day in 2–3 divided doses; may increase at 4-day intervals in 75mg/day increments to 150mg/day; max 375mg/day, in 3 divided doses. Hepatic impairment: reduce by at least 50%. Mild-to-moderate renal impairment: reduce by at least 25%; hemodialysis: reduce by 50% (hold dose until end of dialysis treatment). Withdraw gradually (over 2 weeks).

Children:

<18yrs: not established.

See Also:

EFFEXOR XR

Pharmacological Class:

SNRI.

Contraindications:

MAOIs (see Interactions). Concomitant linezolid or IV methylene blue.

Warnings/Precautions:

Increased risk of suicidal thinking and behavior in children, adolescents, and young adults; monitor for clinical worsening or changes. Screen for bipolar disorder. Monitor for serotonin syndrome; discontinue if occurs. History of seizure disorders, mania/hypomania. Monitor BP; reduce dose or discontinue if elevated BP persists. Heart disease (eg, recent MI, heart failure). Angle-closure glaucoma. Avoid abrupt disruption. Reevaluate periodically. Write ℞ for smallest practical amount. Renal or hepatic dysfunction. Elderly. Labor & delivery. Pregnancy (Cat.C) (avoid 3rd trimester; see full labeling for effects on neonate). Nursing mothers: not recommended.

Interactions:

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, others that affect coagulation. False (+) urine immunoassay screening tests for PCP and amphetamine.

Adverse Reactions:

Nausea, somnolence, dry mouth, sweating, abnormal ejaculation, anorexia, constipation, erectile dysfunction, decreased libido, weight changes, dizziness, insomnia, headache, nervousness, asthenia, vasodilation, abnormal dreams or vision, tremor, yawn, ecchymosis; hyponatremia/SIADH (esp in elderly); rare: interstitial lung disease, eosinophilic pneumonia.

Metabolism:

Hepatic (CYP2D6).

Elimination:

Renal.

Generic Availability:

YES

How Supplied:

Caps—15, 30, 90; Tabs 25mg, 37.5mg—60; 50mg, 75mg—30; 100mg—20

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