Venlafaxine, Oral

What are other names for this medicine?

Type of medicine: antidepressant

Generic and brand names: venlafaxine, oral; Effexor; Effexor XR

What is this medicine used for?

This medicine is taken by mouth to treat depression. This medicine is also used to treat generalized anxiety disorder (GAD). The extended-release tablets are used to treat social anxiety disorder.

It may be used for other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• an allergic reaction to any medicine
• bleeding problems
• glaucoma
• heart disease or a heart attack
• high blood pressure
• high cholesterol
• liver or kidney disease
• problems with low levels of sodium in the blood
• problems with mania or bipolar disorder
• seizures
• a thyroid disorder

WARNING: Do not take an MAO inhibitor antidepressant and this medicine within 14 days of each other. Serious side effects can occur. Talk with your healthcare provider about this.

Females of childbearing age: Tell your healthcare provider if you are pregnant or plan to become pregnant. Taking this medicine in the last 3 months of pregnancy can cause problems for the baby. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I take it?

Check the label on the medicine for directions about your specific dose. Take this medicine with food exactly as your healthcare provider prescribes. During this treatment, your healthcare provider may adjust your dosage depending on your response. Be sure you understand how much medicine to take and when to take it. Do not take more or take it longer than prescribed.

Do not stop taking this medicine without your healthcare provider's approval. You may need to reduce your dose slowly to avoid withdrawal symptoms.

If you are taking the extended release capsules (Effexor XR), take them with food at the same time each day. Swallow the capsules whole with a full glass of water. Do not divide, crush, or chew them or put them in water.

What if I miss a dose?

If you miss a dose, take it as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Do not take double doses. If you miss a dose of the extended release capsules (Effexor XR) one day, do not double the dose the next day. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: dizziness, drowsiness, nausea, vomiting, fast heartbeat, seizures, numbness, tingling in your hands or feet.

What should I watch out for?

Antidepressant medicines may increase suicidal thoughts or actions in some children, teenagers, and young adults within the first few months of treatment. Talk with your provider about this.

Behavior changes may be caused by the medicine or by depression or another mental illness. Contact your provider right away if you or your family notice any disturbing changes in your thoughts or behavior, such as:

• more outgoing or aggressive behavior than normal
• confusion
• hallucinations
• worsening of depression
• suicidal thoughts

This medicine may cause drowsiness, dizziness, or blurred vision. Do not drive or operate machinery unless you are fully alert and can see clearly.

You may need to check your blood pressure regularly to make sure this medicine does not increase your blood pressure.

When taken for a long time, this medicine may cause loss of appetite and weight loss.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Serious (report these to your healthcare provider right away): Seizures, thoughts of suicide, worsening depression, panic attacks, severe confusion, irregular heart beat, migraine headache, chest pain, swelling in arms or legs, trouble breathing, chest infection, unusual bruising or bleeding.

Other: Nausea, gas, headache, drowsiness, dizziness, blurred vision, trouble sleeping, nervousness, constipation, loss of appetite, weight loss, sweating, rash, hives, dry mouth, change in sexual desire or ability.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• antihistamines such as diphenhydramine (Benadryl), chlorpheniramine (Chlor-Trimeton), brompheniramine (Dimetane), clemastine (Tavist, Tavist-1), and dexchlorpheniramine
• anti-HIV medicines such as delavirdine (Rescriptor), indinavir (Crixivan), and ritonavir (Norvir)
• antipsychotic medicines such as clozapine (Clozaril), risperidone (Risperdal), and haloperidol (Haldol)
• aspirin and other salicylates
• barbiturates such as phenobarbital, butabarbital (Butisol), and pentobarbital (Nembutal)
• benzodiazepines such as alprazolam (Xanax), diazepam (Valium), triazolam (Halcion), and lorazepam (Ativan)
• medicine that reduces the chance of blood clots forming such as warfarin (Coumadin) heparin, enoxaparin (Lovenox), ticlopidine (Ticlid), clopidogrel (Plavix), dipyridamole (Persantine), pentoxifylline (Trental), and dalteparin (Fragmin)
• cimetidine (Tagamet)
• delavirdine (Rescriptor)
• diuretics (water pills) such as furosemide (Lasix) and hydrochlorothiazide (Microzide, Oretic)
• ketoconazole (Nizoral)
• linezolid (Zyvox)
• lithium
• MAO inhibitor antidepressants such as isocarboxazid (Marplan), phenelzine (Nardil), and tranylcypromine (Parnate) (Do not take an MAO inhibitor and this medicine within 14 days of each other)
• medicines to treat migraines such as sumatriptan (Imitrex), naratriptan (Amerge), almotriptan (Axert), frovatriptan (Frova), rizatriptan (Maxalt), eletriptan (Relpax), and zolmitriptan (Zomig)
• metoprolol (Lopressor, Toprol)
• muscle relaxants such as carisoprodol (Soma), chlorzoxazone (Parafon Forte), cyclobenzaprine (Flexeril), metaxalone (Skelaxin), orphenadrine (Norflex), tizanidine (Zanaflex), and methocarbamol (Robaxin)
• narcotic analgesics such as morphine (Oramorph, MS Contin, Roxanol), codeine, oxycodone (OxyContin, Roxicodone), meperidine (Demerol), and hydrocodone/acetaminophen (Vicodin, Lortab)
• natural remedies such as St. John's wort, kava, gotu kola, valerian, SAMe, and tryptophan
• nonsteroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen (Motrin, Advil), naproxen (Naprosyn, Aleve), and ketoprofen
• other antidepressants such as amitriptyline, doxepin (Sinequan), nortriptyline (Pamelor), imipramine (Tofranil), desipramine (Norpramin), duloxetine (Cymbalta), sertraline (Zoloft), fluoxetine (Prozac), citalopram (Celexa), escitalopram (Lexapro), paroxetine (Paxil), trazodone (Desyrel), and fluvoxamine
• phenothiazines such as prochlorperazine (Compazine), chlorpromazine (Thorazine), thioridazine, and fluphenazine (Prolixin)
• quinidine
• quinine
• sedatives such as zolpidem (Ambien) and zaleplon (Sonata)
• tramadol (Ultram)

Do not drink alcohol while you are taking this medicine.

Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

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This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.

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