Description
Effexor® (Venlafaxine) is an
antidepressant medication. It affects chemicals in your brain that may
become unbalanced and cause depression. Venlafaxine is used to relieve
symptoms of depression such as feelings of sadness, worthlessness, or
guilt; loss of interest in daily activities; changes in appetite;
tiredness; sleeping too much; insomnia; and thoughts of death or
suicide. Venlafaxine is also used to relieve symptoms of generalized
anxiety disorder. It is also being prescribed by some doctors as
Migraine preventive. In addition to use as a Migraine preventive,
Migraineurs may find antidepressants useful for clinical (chemical)
depression. Migraine and depression have a definite link —
47% of Migraineurs experience clinical depression as opposed to just 17%
of the general population.
Before Using This Medicine
In deciding to use a medicine, the risks
of taking the medicine must be weighed against the good it will do. This
is a decision you and your doctor will make. For venlafaxine, the
following should be considered:
Allergies-
Tell your doctor if you have ever had any unusual or allergic
reaction to citalopram. Also tell your health care professional if you
are allergic to any other substances, such as foods, preservatives, or
dyes.
Pregnancy-
Venlafaxine is in the FDA pregnancy category C. This means that it
is not known whether venlafaxine will harm an unborn baby. Do not take
this medication without first talking to your doctor if you are
pregnant.
Breast-feeding-
Venlafaxine passes into breast milk and it is not known if it will
affect a nursing baby. Do not take venlafaxine without first talking to
your doctor if you are breast-feeding a baby..
Children-
Studies on this medicine have been done only in adult patients, and
there is no specific information comparing use of venlafaxine in
children with use in other age groups.
Older adults-
In studies done to date that have included elderly people,
venlafaxine did not cause different side effects or problems in older
people than it did in younger adults.
Other medicines-
Although certain medicines
should not be used together at all, in other cases two different
medicines may be used together even if an interaction might occur. In
these cases, your doctor may want to change the dose, or other
precautions may be necessary. When you are taking venlafaxine, it is
especially important that your health care professional know if you are
taking the following:
- Buspirone (e.g., BuSpar)
- Bromocriptine (e.g., Parlodel)
- Certain tricyclic antidepressants (amitriptyline
[e.g., Elavil], clomipramine [e.g., Anafranil], or imipramine [e.g.,
Tofranil])
- Dextromethorphan (cough medicine
- Levodopa (e.g., Sinemet)
- Lithium (e.g., Eskalith)
- Meperidine (e.g., Demerol)
- Nefazodone (e.g., Serzone)
- Pentazocine (e.g., Talwin)
- Selective serotonin reuptake
inhibitors (fluoxetine [e.g., Prozac], fluvoxamine [e.g., Luvox],
paroxetine [e.g., Paxil], sertraline [e.g., Zoloft])
- Street drugs (LSD, MDMA [e.g.,
ecstasy], marijuana)
- Sumatriptan (e.g., Imitrex, Amerge,
Maxalt, Zomig, Axert, Frova)
- Tramadol (e.g., Ultram)
- Trazodone (e.g., Desyrel)
- Tryptophan—Using these medicines
with venlafaxine may increase the chance of developing a rare, but
very serious, unwanted effect known as the serotonin syndrome;
symptoms of this syndrome include confusion, diarrhea, fever, poor
coordination, restlessness, shivering, sweating, talking or acting
with excitement you cannot control, trembling or shaking, or
twitching; if you experience these symptoms contact your doctor as
soon as possible
- Moclobemide (e.g., Manerex)—Taking
moclobemide and venlafaxine together or less than 3 days apart may
increase the chance of developing serious unwanted effects, including
the serotonin syndrome, and is not recommended
- Monoamine oxidase (MAO) inhibitors (furazolidone
[e.g., Furoxone], phenelzine [e.g., Nardil], isocarboxazid [e.g.,
Marplan] procarbazine [e.g., Matulane], selegiline [e.g., Eldepryl],
tranylcypromine [e.g., Parnate])— Do not take venlafaxine while you
are taking or within 2 weeks of taking an MAO inhibitor; if you do,
you may develop confusion, agitation, restlessness, stomach or
intestinal symptoms, sudden high body temperature, extremely high
blood pressure, and severe convulsions; at least 14 days should be
allowed between stopping treatment with an MAO inhibitor and starting
treatment with venlafaxine, and at least 7 days should be allowed
between stopping treatment with venlafaxine and starting treatment
with an MAO inhibitor.
Other medical problems-
The presence of other medical
problems may affect the use of venlafaxine. Make sure you tell your
doctor if you have any other medical problems, especially:
- Brain disease or damage, or mental
retardation
- Seizures (history of)—The risk of
seizures may be increased
- Heart disease
- High or low blood pressure—Venlafaxine
may make these conditions worse
- Kidney disease
- Liver disease—Higher blood levels of
venlafaxine may occur, increasing the chance of side effects; your
doctor may need to adjust your venlafaxine dose
- Mania (history of)—The risk of
developing mania may be increased
- Weight loss—Venlafaxine may cause
weight loss; this weight loss is usually small, but if a large weight
loss occurs, it may be harmful in some patients
Proper Use of This Medicine
It is important to use this
medicine properly:
- Take this medicine only as directed
by your doctor
- You may have to take venlafaxine for
4 weeks or longer before you begin to feel better
- Venlafaxine should be taken with
food or on a full stomach to lessen the chance of stomach upset.
However, if your doctor tells you to take the medicine a certain way,
take it exactly as directed.
- If you are taking the
extended-release capsule dosage form, swallow the capsule whole with
fluid.
Dosing-
The dose of venlafaxine will be different for different
patients. Follow your doctor's orders or the directions on the label.
The following information includes only the average doses of venlafaxine.
If your dose is different, do not change it unless your doctor tells you
to do so.
The number of capsules or tablets that you take depends on the strength
of the medicine. Also, the number of doses you take each day, the time
allowed between doses, and the length of time you take the medicine
depend on your special needs.
-
For mental depression:
-
For oral extended-release capsule dosage
form:
-
Adults—At first, 75 milligrams (mg) a day,
taken in one dose in the morning or evening. Your doctor may
increase your dose if needed. However, the dose is usually not
more than 225 mg a day.
-
Children—Use and dose must be determined
by your doctor.
-
For oral tablet dosage form:
-
Adults—At first, a total of 75 mg a day,
taken in smaller doses two or three times during the day. Your
doctor may increase your dose if needed. However, the dose is
usually not more than 375 mg a day.
-
Children up to 18 years of age—Use and
dose must be determined by your doctor.
-
For anxiety:
-
For oral extended-release capsule dosage
form:
-
Adults—At first, 75 mg a day, taken in one
dose in the morning or evening. Your doctor may increase your dose
if needed. However, the dose is usually not more than 225 mg per
day.
-
Children—Use and dose must be determined
by your doctor
Missed Dose-
Take the missed dose as soon as you
remember. However, if it is almost time for your next regularly
scheduled dose, skip the missed dose and take only the next one as
directed. Do not take a double dose of this medication.
Storage-
To store this medicine:
- Keep out of the reach of children.
- Store away from heat and direct
light.
- Do not store in the bathroom, near
the kitchen sink, or in other damp places. Heat or moisture may cause
the medicine to break down.
- Do not keep outdated medicine or
medicine no longer needed. Be sure that any discarded medicine is out
of the reach of children.
Precautions While Using This Medicine
-
It is important that your doctor check
your progress at regular visits, to allow for changes in your dose and
to help reduce any side effects.
-
Tell your doctor right away if you develop any allergic reactions, such
as skin rash or hives, while taking venlafaxine.
-
Do not stop taking this medicine without first checking with your
doctor. Your doctor may want you to reduce gradually the amount you are
taking before stopping completely. This is to decrease the chance of
side effects.
-
It is not known how venlafaxine will interact with alcohol and other
central nervous system (CNS) depressants (medicines that may make you
drowsy or less alert). Some examples of CNS depressants are
antihistamines or medicine for hay fever, other allergies, or colds;
sedatives, tranquilizers, or sleeping medicine; prescription pain
medicine or narcotics; barbiturates; medicine for seizures; muscle
relaxants; or anesthetics, including some dental anesthetics. Check with
your doctor before taking any of the above while you are using this
medicine.
-
Venlafaxine may cause some people to become drowsy or have blurred
vision. Make sure you know how you react to this medicine before you
drive, use machines, or do anything else that could be dangerous if you
are not alert or able to see clearly.
-
Dizziness, lightheadedness, or fainting may occur.
Side Effects of This Medicine
Along with its needed effects,
a medicine may cause some unwanted effects. Although not all of these
side effects may occur, if they do occur they may need medical
attention.
Check with your doctor as soon as
possible if any of the following side effects occur:
- More common: Changes in vision, such
as blurred vision; decrease in sexual desire or ability; headache
- Less common: Chest pain; fast or
irregular heartbeat; mood or mental changes; ringing or buzzing in
ears
- Rare: Convulsions (seizures);
itching or skin rash; lightheadedness or fainting, especially when
getting up suddenly from a sitting or lying position; lockjaw;
menstrual changes; problems in urinating or in holding urine;
swelling; talking, feeling, and acting with excitement and activity
you cannot control; trouble in breathing
This medicine may also cause the
following side effect that your doctor will watch for:
- More common: High blood pressure
Other side effects may occur that
usually do not need medical attention. These side effects may go away
during treatment as your body adjusts to the medicine. However, check
with your doctor if any of the following side effects continue or are
bothersome:
- More common: Abnormal dreams;
anxiety or nervousness; chills; constipation; diarrhea; dizziness;
drowsiness; dryness of mouth; heartburn; increased sweating; loss of
appetite; nausea; stuffy or runny nose; stomach pain or gas; tingling,
burning, or prickly sensations; trembling or shaking; trouble in
sleeping; unusual tiredness or weakness; vomiting; weight loss
- Less common: Change in sense of
taste; muscle tension ; yawning
After you stop using this medicine,
your body may need time to adjust. The length of time this takes depends
on the amount of medicine you were using and how long you used it.
During this period of time check with your doctor if you notice any of
the following side effects:
- Changes in dreaming; dizziness;
dryness of mouth; headache; increased sweating; nausea; nervousness;
trouble in sleeping; unusual tiredness or weakness
Brand Names-
U.S. and Canada: Effexor®, Effexor XR®
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