What is venlafaxine used for. How does venlafaxine work as an SNRI antidepressant. What are the potential side effects and warnings for venlafaxine. How should venlafaxine be taken properly. What precautions should be considered when using venlafaxine.

Understanding Venlafaxine: A Potent SNRI Antidepressant

Venlafaxine is a widely prescribed antidepressant medication belonging to the class of drugs known as Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs). This powerful medication is primarily used to treat depression and can significantly improve mood, energy levels, and overall interest in daily activities. By helping to restore the balance of crucial neurotransmitters in the brain, particularly serotonin and norepinephrine, venlafaxine offers relief to those struggling with depressive disorders.

How does venlafaxine work in the brain?

Venlafaxine works by inhibiting the reuptake of serotonin and norepinephrine in the brain. This action increases the availability of these neurotransmitters in the synaptic cleft, leading to improved mood regulation and emotional stability. The dual action on both serotonin and norepinephrine distinguishes venlafaxine from selective serotonin reuptake inhibitors (SSRIs), potentially making it more effective for some patients, especially those with more severe depressive symptoms or those who haven’t responded well to SSRIs.

Proper Usage and Dosage Guidelines for Venlafaxine

Adhering to the proper usage and dosage guidelines is crucial for maximizing the benefits of venlafaxine while minimizing potential side effects. Here are some key points to consider:

• Always take venlafaxine as prescribed by your healthcare provider
• Typically taken 2 to 3 times daily with food
• Dosage is based on individual medical condition and response to treatment
• Starting with a low dose and gradually increasing is common to reduce side effects
• Consistency in timing of doses is important for optimal effect

It’s essential to continue taking venlafaxine even when you start feeling better. Abruptly stopping the medication can lead to withdrawal symptoms and potentially worsen your condition. Always consult your doctor before making any changes to your dosage or stopping the medication.

Can venlafaxine be taken with or without food?

Venlafaxine is typically recommended to be taken with food. Taking it with meals can help reduce the likelihood of experiencing nausea, which is a common side effect, especially when starting the medication. Additionally, consuming food with venlafaxine may help improve its absorption and overall effectiveness.

Potential Side Effects and Monitoring

While venlafaxine can be highly effective in treating depression, it’s important to be aware of potential side effects. Common side effects may include:

• Nausea
• Drowsiness
• Dizziness
• Dry mouth
• Constipation
• Loss of appetite
• Blurred vision
• Nervousness
• Sleep disturbances
• Excessive sweating

Most side effects are mild and tend to improve over time as your body adjusts to the medication. However, it’s crucial to report any persistent or worsening side effects to your healthcare provider promptly.

Are there any serious side effects to watch out for?

While less common, some serious side effects may occur with venlafaxine use. These can include:

1. Easy bleeding or bruising
2. Decreased libido or changes in sexual function
3. Muscle cramps or weakness
4. Tremors
5. Significant changes in blood pressure
6. Serotonin syndrome (a rare but serious condition caused by excessive serotonin levels)

If you experience any of these serious side effects, seek medical attention immediately. Regular check-ups and open communication with your healthcare provider are essential for monitoring your response to venlafaxine and addressing any concerns promptly.

Important Warnings and Precautions for Venlafaxine Use

Venlafaxine, like other antidepressants, comes with important warnings that patients and healthcare providers should be aware of. The U.S. Food and Drug Administration (FDA) has issued a black box warning for antidepressants, including venlafaxine, regarding an increased risk of suicidal thoughts and behaviors, particularly in children, adolescents, and young adults under 25 years old.

What is the black box warning for venlafaxine?

The black box warning for venlafaxine emphasizes the following points:

• Increased risk of suicidal thoughts and behaviors in patients under 25 years old
• Need for close monitoring, especially during the initial treatment period or dose changes
• Importance of balancing the potential benefits of the medication against the risks
• Necessity of informing healthcare providers about any worsening depression, unusual behavior changes, or suicidal thoughts

It’s crucial for patients, family members, and caregivers to be vigilant and report any concerning changes in mood or behavior to the prescribing healthcare provider immediately. This warning doesn’t mean that venlafaxine is unsafe or ineffective, but rather underscores the need for careful monitoring and open communication during treatment.

Venlafaxine’s Impact on Blood Pressure and Cardiovascular Health

One notable consideration when using venlafaxine is its potential impact on blood pressure. Some patients may experience an increase in blood pressure while taking this medication. This effect is thought to be related to the norepinephrine reuptake inhibition properties of venlafaxine.

How often should blood pressure be monitored while taking venlafaxine?

The frequency of blood pressure monitoring may vary depending on individual patient factors and healthcare provider recommendations. However, general guidelines suggest:

• Baseline blood pressure measurement before starting venlafaxine
• Regular monitoring during the initial weeks of treatment
• Ongoing periodic checks throughout the course of treatment
• More frequent monitoring for patients with pre-existing hypertension or cardiovascular concerns

Your healthcare provider will determine the most appropriate monitoring schedule based on your individual health status and response to the medication. It’s important to follow their recommendations and report any significant changes in blood pressure or related symptoms promptly.

Drug Interactions and Precautions with Venlafaxine

Venlafaxine can interact with various medications and substances, potentially altering its effectiveness or increasing the risk of side effects. It’s crucial to inform your healthcare provider about all medications, supplements, and herbal products you’re taking before starting venlafaxine.

Which medications should not be taken with venlafaxine?

Several medications and substances can interact with venlafaxine, including:

• Monoamine Oxidase Inhibitors (MAOIs): These should not be taken within 14 days of starting or stopping venlafaxine due to the risk of serotonin syndrome
• Other antidepressants: Combining venlafaxine with other antidepressants may increase the risk of serotonin syndrome
• Blood thinners: Venlafaxine may increase the risk of bleeding when taken with anticoagulants
• NSAIDs: Combining venlafaxine with non-steroidal anti-inflammatory drugs may increase bleeding risk
• Certain pain medications: Tramadol and similar drugs may interact with venlafaxine
• St. John’s Wort: This herbal supplement may increase the risk of serotonin syndrome when combined with venlafaxine

Always consult your healthcare provider or pharmacist before starting any new medication or supplement while taking venlafaxine. They can provide personalized advice based on your specific health situation and medication regimen.

Managing Withdrawal and Discontinuation of Venlafaxine

Discontinuing venlafaxine requires careful management to minimize withdrawal symptoms and ensure a smooth transition. Abruptly stopping the medication can lead to a range of uncomfortable and potentially serious symptoms, often referred to as discontinuation syndrome.

What are the common symptoms of venlafaxine withdrawal?

Venlafaxine withdrawal symptoms may include:

• Dizziness or vertigo
• Nausea and vomiting
• Headaches
• Fatigue
• Irritability
• Anxiety or agitation
• Insomnia or vivid dreams
• Electric shock-like sensations (often called “brain zaps”)
• Flu-like symptoms

To minimize these symptoms, your healthcare provider will typically recommend a gradual tapering of the medication over several weeks or even months, depending on your dosage and individual factors. Never attempt to stop venlafaxine on your own without medical supervision.

Long-term Use and Effectiveness of Venlafaxine

Venlafaxine can be an effective long-term treatment option for many individuals with depression. However, the decision to continue long-term use should be made in consultation with a healthcare provider, taking into account the individual’s response to the medication, potential side effects, and overall health status.

How long does it typically take for venlafaxine to show its full effect?

The timeline for experiencing the full benefits of venlafaxine can vary from person to person. Generally:

• Some improvements in sleep, appetite, and energy levels may be noticed within 1-2 weeks
• Significant improvements in mood and overall depressive symptoms often take 4-6 weeks
• Full therapeutic effect may not be realized until 8-12 weeks of consistent use

It’s important to be patient and maintain open communication with your healthcare provider during this initial period. They may adjust your dosage or recommend additional supportive treatments to optimize your response to venlafaxine.

In conclusion, venlafaxine is a powerful antidepressant that can significantly improve the lives of those struggling with depression. However, its use requires careful consideration, monitoring, and adherence to medical guidance. By understanding the proper usage, potential side effects, and important precautions associated with venlafaxine, patients can work closely with their healthcare providers to maximize the benefits of this medication while minimizing risks. Remember, depression is a treatable condition, and with the right approach, including medications like venlafaxine and appropriate therapeutic support, many individuals can achieve substantial improvement in their mental health and overall quality of life.

Venlafaxine Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing

Warnings:

Antidepressant medications are used to treat a variety of conditions, including depression and other mental/mood disorders. These medications can help prevent suicidal thoughts/attempts and provide other important benefits. However, a small number of people (especially people younger than 25) who take antidepressants for any condition may experience worsening depression, other mental/mood symptoms, or suicidal thoughts/attempts. It is very important to talk with the doctor about the risks and benefits of antidepressant medication (especially for people younger than 25), even if treatment is not for a mental/mood condition.

Tell the doctor right away if you notice worsening depression/other psychiatric conditions, unusual behavior changes (including possible suicidal thoughts/attempts), or other mental/mood changes (including new/worsening anxiety, panic attacks, trouble sleeping, irritability, hostile/angry feelings, impulsive actions, severe restlessness, very rapid speech). Be especially watchful for these symptoms when a new antidepressant is started or when the dose is changed.

Warnings:

Antidepressant medications are used to treat a variety of conditions, including depression and other mental/mood disorders. These medications can help prevent suicidal thoughts/attempts and provide other important benefits. However, a small number of people (especially people younger than 25) who take antidepressants for any condition may experience worsening depression, other mental/mood symptoms, or suicidal thoughts/attempts. It is very important to talk with the doctor about the risks and benefits of antidepressant medication (especially for people younger than 25), even if treatment is not for a mental/mood condition.

Tell the doctor right away if you notice worsening depression/other psychiatric conditions, unusual behavior changes (including possible suicidal thoughts/attempts), or other mental/mood changes (including new/worsening anxiety, panic attacks, trouble sleeping, irritability, hostile/angry feelings, impulsive actions, severe restlessness, very rapid speech). Be especially watchful for these symptoms when a new antidepressant is started or when the dose is changed.

… Show More

Uses

Venlafaxine is used to treat depression. It may improve your mood and energy level, and may help restore your interest in daily living. Venlafaxine is known as a serotonin-norepinephrine reuptake inhibitor (SNRI). It works by helping to restore the balance of certain natural substances (serotonin and norepinephrine) in the brain.

How to use Venlafaxine HCL

Read the Medication Guide provided by your pharmacist before you start using venlafaxine and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

Take this medication by mouth as directed by your doctor, usually 2 to 3 times daily with food.

The dosage is based on your medical condition and response to treatment. To reduce your risk of side effects, your doctor may direct you to start this medication at a low dose and gradually increase your dose. Follow your doctor’s instructions carefully. Take this medication regularly to get the most benefit from it. To help you remember, take it at the same times each day.

Keep taking this medication even if you feel well. Do not stop taking this medication without consulting your doctor. Some conditions may become worse when this drug is suddenly stopped. Also, you may experience symptoms such as confusion, mood swings, blurred vision, headache, tiredness, sleep changes, and brief feelings similar to electric shock. Your dose may need to be gradually decreased to reduce side effects. Report any new or worsening symptoms right away.

It may take several weeks to feel the benefit of this medication. Tell your doctor if your condition lasts or gets worse.

Side Effects

See also Warning section.

Nausea, drowsiness, dizziness, dry mouth, constipation, loss of appetite, blurred vision, nervousness, trouble sleeping, unusual sweating, or yawning may occur. If any of these effects last or get worse, tell your doctor promptly.

Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

This medication may raise your blood pressure. Check your blood pressure regularly and tell your doctor if the results are high.

Tell your doctor right away if you have any serious side effects, including: easy bleeding/bruising, decreased interest in sex, changes in sexual ability, muscle cramps/weakness, shaking (tremor).

Get medical help right away if you have any very serious side effects, including: cough that doesn’t go away, shortness of breath, chest pain, severe/pounding headache, black stools, vomit that looks like coffee grounds, eye pain/swelling/redness, widened pupils, vision changes (such as seeing rainbows around lights at night), seizure.

This medication may increase serotonin and rarely cause a very serious condition called serotonin syndrome/toxicity. The risk increases if you are also taking other drugs that increase serotonin, so tell your doctor or pharmacist of all the drugs you take (see Drug Interactions section). Get medical help right away if you develop some of the following symptoms: fast heartbeat, hallucinations, loss of coordination, severe dizziness, severe nausea/vomiting/diarrhea, twitching muscles, unexplained fever, unusual agitation/restlessness.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US – Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before taking venlafaxine, tell your doctor or pharmacist if you are allergic to it; or to desvenlafaxine; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: bleeding problems, personal or family history of glaucoma (angle-closure type), high blood pressure, heart problems (such as heart failure, previous heart attack), high cholesterol, kidney disease, liver disease, seizure disorder, thyroid disease.

This drug may make you dizzy or drowsy or blur your vision. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely. Avoid alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Older adults may be more sensitive to the side effects of this drug, especially bleeding and dizziness when standing. Older adults may also be more likely to develop a type of salt imbalance (hyponatremia), especially if they are taking “water pills” (diuretics). Dizziness and salt imbalance can increase the risk of falling.

Children may be more sensitive to the side effects of the drug, especially loss of appetite and weight loss. Monitor weight and height in children who are taking this drug.

During pregnancy, this medication should be used only when clearly needed. It may harm an unborn baby. Also, babies born to mothers who have used this drug during the last 3 months of pregnancy may rarely develop withdrawal symptoms such as feeding/breathing difficulties, seizures, muscle stiffness, or constant crying. If you notice any of these symptoms in your newborn, tell the doctor promptly.

Since untreated mental/mood problems (such as depression, anxiety, panic attacks) can be a serious condition, do not stop taking this medication unless directed by your doctor. If you are planning pregnancy, become pregnant, or think you may be pregnant, immediately discuss the benefits and risks of using this medication during pregnancy with your doctor.

This drug passes into breast milk and may have undesirable effects on a nursing infant. Consult your doctor before breast-feeding.

Interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

Some products that may interact with this drug are: other drugs that can cause bleeding/bruising (including antiplatelet drugs such as clopidogrel, NSAIDs such as ibuprofen/naproxen, “blood thinners” such as dabigatran/warfarin).

Aspirin can increase the risk of bleeding when used with this medication. However, if your doctor has directed you to take low-dose aspirin for heart attack or stroke prevention (usually 81-162 milligrams a day), you should continue taking it unless your doctor instructs you otherwise. Ask your doctor or pharmacist for more details.

Taking MAO inhibitors with this medication may cause a serious (possibly fatal) drug interaction. Avoid taking MAO inhibitors (isocarboxazid, linezolid, metaxalone, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, tranylcypromine) during treatment with this medication. Most MAO inhibitors should also not be taken for two weeks before and at least 7 days after treatment with this medication. Ask your doctor when to start or stop taking this medication.

The risk of serotonin syndrome/toxicity increases if you are also taking other drugs that increase serotonin. Examples include street drugs such as MDMA/”ecstasy,” St. John’s wort, certain antidepressants (including SSRIs such as fluoxetine/paroxetine, other SNRIs such as duloxetine/milnacipran), tryptophan, among others. The risk of serotonin syndrome/toxicity may be more likely when you start or increase the dose of these drugs.

Tell your doctor or pharmacist if you are taking other products that cause drowsiness such as opioid pain or cough relievers (such as codeine, hydrocodone), alcohol, marijuana (cannabis), drugs for sleep or anxiety (such as alprazolam, lorazepam, zolpidem), muscle relaxants (such as carisoprodol, cyclobenzaprine), or antihistamines (such as cetirizine, diphenhydramine).

Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.

Venlafaxine is very similar to desvenlafaxine. Do not take medications containing desvenlafaxine while using venlafaxine.

This medication may interfere with certain lab tests (including urine tests for amphetamines), possibly causing false test results. Make sure lab personnel and all your doctors know you use this drug.

Does Venlafaxine HCL interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: severe drowsiness, seizures, fast/irregular heartbeat.

Do not share this medication with others.

Lab and/or medical tests (such as blood pressure, cholesterol) should be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details.

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

Images

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Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

Venlafaxine Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing

Warnings:

Antidepressant medications are used to treat a variety of conditions, including depression and other mental/mood disorders. These medications can help prevent suicidal thoughts/attempts and provide other important benefits. However, a small number of people (especially people younger than 25) who take antidepressants for any condition may experience worsening depression, other mental/mood symptoms, or suicidal thoughts/attempts. It is very important to talk with the doctor about the risks and benefits of antidepressant medication (especially for people younger than 25), even if treatment is not for a mental/mood condition.

Tell the doctor right away if you notice worsening depression/other psychiatric conditions, unusual behavior changes (including possible suicidal thoughts/attempts), or other mental/mood changes (including new/worsening anxiety, panic attacks, trouble sleeping, irritability, hostile/angry feelings, impulsive actions, severe restlessness, very rapid speech). Be especially watchful for these symptoms when a new antidepressant is started or when the dose is changed.

Warnings:

Antidepressant medications are used to treat a variety of conditions, including depression and other mental/mood disorders. These medications can help prevent suicidal thoughts/attempts and provide other important benefits. However, a small number of people (especially people younger than 25) who take antidepressants for any condition may experience worsening depression, other mental/mood symptoms, or suicidal thoughts/attempts. It is very important to talk with the doctor about the risks and benefits of antidepressant medication (especially for people younger than 25), even if treatment is not for a mental/mood condition.

Tell the doctor right away if you notice worsening depression/other psychiatric conditions, unusual behavior changes (including possible suicidal thoughts/attempts), or other mental/mood changes (including new/worsening anxiety, panic attacks, trouble sleeping, irritability, hostile/angry feelings, impulsive actions, severe restlessness, very rapid speech). Be especially watchful for these symptoms when a new antidepressant is started or when the dose is changed.

… Show More

Uses

Venlafaxine is used to treat depression, anxiety, panic attacks, and social anxiety disorder (social phobia). It may improve your mood and energy level and may help restore your interest in daily living. It may also decrease fear, anxiety, unwanted thoughts, and the number of panic attacks. Venlafaxine is known as a serotonin-norepinephrine reuptake inhibitor (SNRI). It works by helping to restore the balance of certain natural substances (serotonin and norepinephrine) in the brain.

How to use venlafaxine oral

Read the Medication Guide and, if available, the Patient Information Leaflet provided by your pharmacist before you start using venlafaxine and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

Take this medication by mouth as directed by your doctor, usually once daily with food, either in the morning or evening.

Do not crush, chew, or dissolve this medication. Doing so can release all of the drug at once, increasing the risk of side effects. Swallow whole without crushing or chewing.

If you are taking the capsules, swallow them whole. If you have trouble swallowing the capsules whole, you may open the capsule and sprinkle the contents onto a spoonful of applesauce. Swallow all of the mixture right away without chewing. Drink a glass of water after each dose.

The dosage is based on your medical condition and response to treatment. To reduce your risk of side effects, your doctor may direct you to start this medication at a low dose and gradually increase your dose. Follow your doctor’s instructions carefully. Take this medication regularly to get the most benefit from it. To help you remember, take it at the same time each day.

Keep taking this medication even if you feel well. Do not stop taking this medication without consulting your doctor. Some conditions may become worse when this drug is suddenly stopped. Also, you may experience symptoms such as confusion, mood swings, blurred vision, headache, tiredness, sleep changes, and brief feelings similar to electric shock. Your dose may need to be gradually decreased to reduce side effects. Report any new or worsening symptoms right away.

It may take several weeks to feel the benefit of this medication. Tell your doctor if your condition lasts or gets worse.

Side Effects

See also Warning section.

Nausea, drowsiness, dizziness, dry mouth, constipation, loss of appetite, blurred vision, nervousness, trouble sleeping, unusual sweating, or yawning may occur. If any of these effects last or get worse, tell your doctor promptly.

Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

This medication may raise your blood pressure. Check your blood pressure regularly and tell your doctor if the results are high.

Tell your doctor right away if you have any serious side effects, including: easy bleeding/bruising, decreased interest in sex, changes in sexual ability, muscle cramps/weakness, shaking (tremor).

Get medical help right away if you have any very serious side effects, including: cough that doesn’t go away, shortness of breath, chest pain, severe/pounding headache, black stools, vomit that looks like coffee grounds, eye pain/swelling/redness, widened pupils, vision changes (such as seeing rainbows around lights at night), seizure.

This medication may increase serotonin and rarely cause a very serious condition called serotonin syndrome/toxicity. The risk increases if you are also taking other drugs that increase serotonin, so tell your doctor or pharmacist of all the drugs you take (see Drug Interactions section). Get medical help right away if you develop some of the following symptoms: fast heartbeat, hallucinations, loss of coordination, severe dizziness, severe nausea/vomiting/diarrhea, twitching muscles, unexplained fever, unusual agitation/restlessness.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US – Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before taking venlafaxine, tell your doctor or pharmacist if you are allergic to it; or to desvenlafaxine; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: bleeding problems, personal or family history of glaucoma (angle-closure type), high blood pressure, heart problems (such as heart failure, previous heart attack), high cholesterol, kidney disease, liver disease, seizure disorder, thyroid disease.

This drug may make you dizzy or drowsy or blur your vision. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely. Avoid alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Older adults may be more sensitive to the side effects of this drug, especially dizziness when standing. Older adults may also be more likely to develop a type of salt imbalance (hyponatremia), especially if they are taking “water pills” (diuretics). Dizziness and salt imbalance can increase the risk of falling. Older adults may also be at greater risk for bleeding while using this drug.

Children may be more sensitive to the side effects of the drug, especially loss of appetite and weight loss. Monitor weight and height in children who are taking this drug.

During pregnancy, this medication should be used only when clearly needed. It may harm an unborn baby. Also, babies born to mothers who have used this drug during the last 3 months of pregnancy may rarely develop withdrawal symptoms such as feeding/breathing difficulties, seizures, muscle stiffness, or constant crying. If you notice any of these symptoms in your newborn, tell the doctor promptly.

Since untreated mental/mood problems (such as depression, anxiety, panic attacks) can be a serious condition, do not stop taking this medication unless directed by your doctor. If you are planning pregnancy, become pregnant, or think you may be pregnant, immediately discuss the benefits and risks of using this medication during pregnancy with your doctor.

This drug passes into breast milk and may have undesirable effects on a nursing infant. Consult your doctor before breast-feeding.

Interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

Some products that may interact with this drug are: other drugs that can cause bleeding/bruising (including antiplatelet drugs such as clopidogrel, NSAIDs such as ibuprofen/naproxen, “blood thinners” such as dabigatran/warfarin).

Aspirin can increase the risk of bleeding when used with this medication. However, if your doctor has directed you to take low-dose aspirin for heart attack or stroke prevention (usually 81-162 milligrams a day), you should continue taking it unless your doctor instructs you otherwise. Ask your doctor or pharmacist for more details.

Taking MAO inhibitors with this medication may cause a serious (possibly fatal) drug interaction. Avoid taking MAO inhibitors (isocarboxazid, linezolid, metaxalone, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, tranylcypromine) during treatment with this medication. Most MAO inhibitors should also not be taken for two weeks before and at least 7 days after treatment with this medication. Ask your doctor when to start or stop taking this medication.

The risk of serotonin syndrome/toxicity increases if you are also taking other drugs that increase serotonin. Examples include street drugs such as MDMA/”ecstasy,” St. John’s wort, certain antidepressants (including SSRIs such as fluoxetine/paroxetine, other SNRIs such as duloxetine/milnacipran), tryptophan, among others. The risk of serotonin syndrome/toxicity may be more likely when you start or increase the dose of these drugs.

Tell your doctor or pharmacist if you are taking other products that cause drowsiness such as opioid pain or cough relievers (such as codeine, hydrocodone), alcohol, marijuana (cannabis), drugs for sleep or anxiety (such as alprazolam, lorazepam, zolpidem), muscle relaxants (such as carisoprodol, cyclobenzaprine), or antihistamines (such as cetirizine, diphenhydramine).

Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.

Venlafaxine is very similar to desvenlafaxine. Do not take medications containing desvenlafaxine while using venlafaxine.

This medication may interfere with certain lab tests (including urine tests for amphetamines), possibly causing false test results. Make sure lab personnel and all your doctors know you use this drug.

Does venlafaxine oral interact with other drugs you are taking?

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Overdose

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: severe drowsiness, seizures, fast/irregular heartbeat.

Do not share this medication with others.

Lab and/or medical tests (such as blood pressure, cholesterol) should be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details.

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

Images

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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

Use of the antidepressant venlafaxine in patients with chronic pain | Kamchatnov P.R., Radysh B.B., Kutenev A.V., Kazakov A.Yu.

Use of the antidepressant venlafaxine in patients with chronic pain

September 03, 2009

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• Kamchatnov P. R.

  1

,

• Radysh B.B.

,

• Kutenev A.V.

,

• Kazakov A.Yu.

  1

1

RNIMU them. N.I. Pirogov of the Ministry of Health of Russia, Moscow, Russia

For citation: Kamchatnov P.R., Radysh B. B., Kutenev A.V., Kazakov A.Yu. Use of the antidepressant venlafaxine in patients with chronic pain syndrome. breast cancer. 2009;20:1382.

Chronic pain that lasts longer than necessary for normal healing and persists for more than 12 weeks is a fairly common condition in the population. The results of a population study conducted in Europe, which included 50 thousand people, allow us to state that every fifth adult suffers from severe or moderate chronic pain [8]. It turned out that the most common causes of chronic pain syndrome are diseases of the musculoskeletal system – lesions of bones, joints, periarticular tissues. The vast majority of respondents who confirmed the presence of chronic pain receive systematic pain treatment, but more than half of them do not believe that the therapy is quite effective.

Chronic pain that lasts longer than necessary for normal healing and persists for more than 12 weeks is a fairly common condition in the population. The results of a population study conducted in Europe, which included 50 thousand people, allow us to state that every fifth adult suffers from severe or moderate chronic pain [8]. It turned out that the most common causes of chronic pain syndrome are diseases of the musculoskeletal system – lesions of bones, joints, periarticular tissues. The vast majority of respondents who confirmed the presence of chronic pain receive systematic pain treatment, but more than half of them do not believe that the therapy is quite effective.
A serious problem is neuropathic pain, the occurrence of which is caused by a direct lesion of the somatosensory system and is not associated with irritation of pain receptors. The results of epidemiological studies suggest that at least 3% of the members of the population experience neuropathic pain, although there are data on its wider prevalence [25]. According to modern views on the pathophysiology of neuropathic pain, the lesion that causes it can be localized at different levels of the peripheral or central nervous system [1,5]. The developing complex restructuring of the nervous system leads to the formation of a pathological algic system that ensures the existence of a persistent pain syndrome.
An important role in the formation of neuropathic pain syndrome is played by the dysfunction of the mechanisms of perception and processing of pain impulses [4]. Of great importance is also a decrease in the activity of the body’s own anti-pain systems, in particular, the pathways emanating from the nuclei of the brain stem (in particular, the periaqueductal gray matter), the neurotransmitters in which are serotonin and norepinephrine [19]. Violation of the functioning of this system is of great importance for the occurrence of chronic pain syndromes due to various reasons.
Taking into account the complex pathophysiological mechanisms of the formation of chronic pain, neuropathic pain syndromes, painkillers (for example, paracetamol) and non-steroidal anti-inflammatory drugs are not always effective for their relief. Moreover, their extremely low efficacy in true neuropathic pain has been established. At the same time, the results of repeated surveys of medical workers indicate that it is non-steroidal anti-inflammatory drugs that are most often prescribed to this group of patients. It should be borne in mind that their long-term, often uncontrolled use is associated with a high risk of complications, including severe ones, the most common of which are lesions of the gastric mucosa with ulceration, increased blood pressure, and an increased risk of atherothrombotic complications [8,20 ].
The results of a number of experimental works and clinical studies indicate that today the optimal approach to the treatment of such patients is the use of antidepressants and antiepileptic drugs. There is sufficient experience in the clinical use of antidepressants for the relief of pain in patients with neuropathic pain and chronic pain syndromes. For this purpose, tricyclic antidepressants are most widely used, and the maximum experience gained in the conditions of randomized clinical trials has been accumulated in relation to amitriptyline.
Based on the results of a meta-analysis of 19 double-blind randomized clinical trials (a total of 2515 patients with neuropathic pain syndromes, excluding headaches and migraine), it was found that antidepressants are most effective against neuropathic pain syndromes caused by distal pain diabetic polyneuropathy and postherpetic neuralgia. This group of drugs was less effective against pain syndromes caused by HIV infection and some other clinical conditions [24]. The authors of the cited meta-analysis, like most other researchers, note that in order to achieve a therapeutic effect, the use of drugs in high doses is often required, which is associated with an increased risk of side effects. In particular, this complicates the widespread use of drugs on an outpatient basis, reduces the adherence of patients to treatment.
For the treatment of patients with neuropathic pain, chronic pain syndromes, in addition to tricyclic antidepressants, drugs from the group of serotonin reuptake inhibitors are also used, which, in addition, when administered in therapeutic doses, have the ability to suppress the reuptake and noradrenaline – drugs “dual action”, representative which is venlafaxine (Velafax) [19].
The results of experimental studies convincingly prove that venlafaxine has its own analgesic activity, which is not related to its antidepressant properties. Thus, the positive effect of venlafaxine, associated with the peculiarities of its chemical structure, is observed in patients with chronic pain syndromes associated with depressive disorders, and without them [7]. Interestingly, in some cases, the analgesic effect occurs when using doses of the drug that are smaller than those that cause the actual antidepressant effect. It is also believed that the analgesic effect in this situation is due to the interaction of the drug with both serotonin and norepinephrine receptors, and modulation of the synaptic uptake of mediators by dopamine can play a significant role. In addition, there is evidence that the analgesic effect of the drug to a certain extent can be explained by its interaction with opioid systems (primarily with

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