Venlafaxine XR 37.5mg

Antidepressant, Serotonin/Norepinephrine Reuptake Inhibitor

“ALERT: US Boxed Warning

Suicidality and antidepressant drugs:

Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults in short-term studies of major depressive disorder (MDD) and other psychiatric disorders. Anyone considering the use of venlafaxine or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24; there was a reduction in risk with antidepressants compared to placebo in adults aged 65 and older. Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide. Patients of all ages who are started on antidepressant therapy should be monitored appropriately and observed closely for clinical worsening, suicidality, or unusual changes in behaviour. Families and caregivers should be advised of the need for close observation and communication with the prescriber. Venlafaxine is not approved for use in pediatric patients.”

CSA NA – FDA Approved – REMS (N) – Can Ship

Venlafaxine/Effexor XR is a strong inhibitor of serotonin and norepinephrine reuptake and a weak inhibitor of dopamine reuptake within the neuron.  It does not affect muscarinic, histamine 1, or alpha 2 adrenergic receptors or MAO.  Venlafaxine mostly inhibits serotonin reuptake and at higher doses has the dual mechanism.

Venlafaxine/Effexor XR is officially indicated for generalized anxiety disorder, major depressive disorder, panic disorder, or social anxiety disorder.  It is also prescribed off-label for migraine prevention, narcolepsy with cataplexy, diabetic neuropathy, obsessive compulsive disorder, post-traumatic stress disorder, or vasomotor symptoms associated with menopause.  (may be used for conditions not listed)

Before starting Venlafaxine/Effexor XR make sure your physician is aware of any allergies or medications you currently take, if you have liver disease, if you have bipolar disorder, kidney disease, a seizure disorder, cardiovascular disease, or are pregnant or breastfeeding.  This medication has risk of causing serotonin syndrome especially if combined with other serotonergic drugs.  It can cause suicidal ideation, usually in young patients, with major depressive disorder so must be used with caution and any major changes in personality or mood should be reported to physician immediately.

37.5-375mg once daily

How to Take: Follow instructions provided by physician/pharmacy label, swallow whole with food, take consistently at same times each day unless otherwise directed, store at room temperature.  If required capsule may be opened and contents sprinkled onto soft food such as apple sauce and swallowed if it is not chewed.  Chewing will release all the medication at once rather than over the entire day.

You Need to Avoid: This medication can increase the psychomotor impairment from alcohol consumption so extra care should be taken if choosing to consume alcohol.  Do not stop this medication without tapering dose down over time to prevent withdrawal symptoms (nausea, diarrhea, sweating, headaches, agitation, insomnia, anxiety, tremor, vertigo, dizziness).  This medication especially in higher dosages can cause withdrawal within a day of missing a dosage so consistent use is important to avoid uncomfortable symptoms.

Insomnia, dizziness, drowsiness, sweating, nausea, dry mouth, muscle weakness

Note this is not a complete list of side effects, only common ones

1. What do I do if side effects are intolerable?
   If you are just starting this medication or just had a dosage increase, then it is common to have more prominent side effects for 2 weeks or so and if any remain at that point they will likely remain.  If the symptoms are causing a lot of distress speak to your physician as soon as possible to discuss how to come off the medication.
2. What do I do if my mood worsens on this medication and I feel much worse?
   Contact your physician immediately, it is rare however antidepressant medications can cause suicidal ideation, generally in those under the age of 24.
3. What is serotonin syndrome?
   Serotonin syndrome is a rare, but potentially life-threatening condition of serotonin toxicity from too much of it in your system generally from the use of certain medications and supplements.  Usually multiple agents are at play or high doses are involved.  The signs and symptoms include agitation, hallucinations, delirium, coma, tachycardia (rapid heart rate), diaphoresis (excessive sweating), tremor, muscle rigidity, nausea, vomiting, diarrhea, and/or seizures.  If serotonin syndrome is suspected, discontinue any serotonergic medications, and seek immediate medical attention.