Select therapeutic use:

Anxiety/OCD:

Indications for: EFFEXOR XR

Generalized anxiety disorder (GAD). Social anxiety disorder (SAD). Panic disorder (PD).

Adult Dosage:

Take with food. Swallow whole or sprinkle contents on spoonful of applesauce; do not chew. GAD: 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. SAD: 75mg once daily. PD: 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 GAD or PD: usual max 225mg/day. Hepatic impairment: reduce by at least 50%. Renal impairment (mild or moderate): reduce by 25–50%; (severe or undergoing hemodialysis): reduce dose by at least 50%. Withdraw gradually (reduce by 75mg/day at 1-week intervals).

Children Dosage:

Not established.

EFFEXOR XR Contraindications:

During or within 14 days of MAOIs (see Interactions). Concomitant linezolid or IV methylene blue.

Boxed Warning:

Suicidal thoughts and behaviors.

EFFEXOR XR Warnings/Precautions:

Increased risk of suicidal thinking and behavior in children, adolescents, and young adults; monitor closely for clinical worsening or unusual changes. Screen for bipolar disorder, mania or hypomania prior to initiation. Monitor for serotonin syndrome; discontinue immediately if occurs. Pre-existing hypertension, cardio- or cerebrovascular disease. Monitor BP before and during treatment; consider dose reduction or discontinuation if elevated BP persists. Heart disease (eg, recent MI, heart failure). Increased risk of bleeding. Angle-closure glaucoma. Avoid in those with untreated anatomically narrow angles. History of mania/hypomania. Seizure disorders. Volume-depleted. Hyponatremia (esp. in elderly). Sexual dysfunction. Renal or hepatic dysfunction. Avoid abrupt disruption; monitor. Reevaluate periodically. Write ℞ for smallest practical amount. Elderly. Labor & delivery. Pregnancy; see full labeling for effects on mother and neonates. Nursing mothers.

EFFEXOR XR Classification:

SNRI.

EFFEXOR XR 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. Increased risk of serotonin syndrome with concomitant other serotonergic drugs (eg, other SNRIs, SSRIs, triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, tryptophan, buspirone, amphetamines, St. John's Wort) or with drugs that impair serotonin metabolism (eg, MAOIs such as linezolid, IV methylene blue). Avoid alcohol. Potentiated by CYP3A inhibitors; consider reducing dose of venlafaxine. Potentiates CYP2D6 substrates; consider reducing dose of substrate. 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 aspirin, NSAIDs, warfarin, or other drugs that affect coagulation; monitor closely. 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; rare: interstitial lung disease, eosinophilic pneumonia.

Generic Drug Availability:

YES

How Supplied:

XR caps—15, 30, 90

Pricing for EFFEXOR XR

150mg capsule (Qty: 30)
Appx. price $14
GoodRx

Mood disorders:

Indications for: EFFEXOR XR

Major depressive disorder.

Adult Dosage:

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. Hepatic impairment: reduce by at least 50%. Renal impairment (mild or moderate): reduce by 25–50%; (severe or undergoing hemodialysis): reduce dose by at least 50%. Withdraw gradually (reduce by 75mg/day at 1-week intervals).

Children Dosage:

Not established.

EFFEXOR XR Contraindications:

During or within 14 days of MAOIs (see Interactions). Concomitant linezolid or IV methylene blue.

Boxed Warning:

Suicidal thoughts and behaviors.

EFFEXOR XR Warnings/Precautions:

Increased risk of suicidal thinking and behavior in children, adolescents, and young adults; monitor closely for clinical worsening or unusual changes. Screen for bipolar disorder, mania or hypomania prior to initiation. Monitor for serotonin syndrome; discontinue immediately if occurs. Pre-existing hypertension, cardio- or cerebrovascular disease. Monitor BP before and during treatment; consider dose reduction or discontinuation if elevated BP persists. Heart disease (eg, recent MI, heart failure). Increased risk of bleeding. Angle-closure glaucoma. Avoid in those with untreated anatomically narrow angles. History of mania/hypomania. Seizure disorders. Volume-depleted. Hyponatremia (esp. in elderly). Sexual dysfunction. Renal or hepatic dysfunction. Avoid abrupt disruption; monitor. Reevaluate periodically. Write ℞ for smallest practical amount. Elderly. Labor & delivery. Pregnancy; see full labeling for effects on mother and neonates. Nursing mothers.

See Also:

EFFEXOR XR Classification:

SNRI.

EFFEXOR XR 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. Increased risk of serotonin syndrome with concomitant other serotonergic drugs (eg, other SNRIs, SSRIs, triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, tryptophan, buspirone, amphetamines, St. John's Wort) or with drugs that impair serotonin metabolism (eg, MAOIs such as linezolid, IV methylene blue). Avoid alcohol. Potentiated by CYP3A inhibitors; consider reducing dose of venlafaxine. Potentiates CYP2D6 substrates; consider reducing dose of substrate. 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 aspirin, NSAIDs, warfarin, or other drugs that affect coagulation; monitor closely. 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; rare: interstitial lung disease, eosinophilic pneumonia.

Generic Drug Availability:

YES

How Supplied:

XR caps—15, 30, 90; Tabs—Contact supplier

Pricing for EFFEXOR XR

150mg capsule (Qty: 30)
Appx. price $14
GoodRx