Generic Name: venlafaxine (VEN-la-fax-een)

Brand Names: Effexor®, Effexor XR®

Classification: Antidepressant - Selective Serotonin

Issue Date: 2002

Effexor is an antidepressant in a group of drugs called selective serotonin and norepinephrine reuptake inhibitors (SSNRIs). Effexor affects chemicals in the brain that may become unbalanced and cause depression. Effexor is used to treat major depressive disorder, anxiety, and panic disorder. Effexor may also be used for purposes other than those listed here.

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Your doctor may occasionally change your dose to make sure you get the best results from the medication. Follow the directions on your prescription label.

Take this medication with a full glass of water. You should take Effexor with food. Swallow the controlled-release capsule (Effexor XR) whole, without crushing or chewing. To make the medication easier to swallow, you may open the capsule and sprinkle the medicine into a small amount of applesauce. Swallow all of the mixture without chewing, and do not save any for later use.

Try to take Effexor at the same time each day. It may take 4 weeks or more for your symptoms improve. For best results, keep using the medication as directed. Do not stop using Effexor without first talking to your doctor. You may have unpleasant side effects if you stop taking this medication suddenly.

Store Effexor at room temperature away from moisture and heat.

Do not take this medication if you are allergic to Effexor, or if you are also using a monoamine oxidase inhibitor (MAOI) such as:

• Isocarboxazid (Marplan®)
• Phenelzine (Nardil®)
• Rasagiline (Azilect®)
• Selegiline (Eldepryl®, Emsam®)
• Tranylcypromine (Parnate®)

You must wait at least 14 days after stopping an MAOI before you can take Effexor. After you stop taking Effexor, you must wait at least 7 days before you start taking an MAOI.

Before taking Effexor, tell your doctor if you are allergic to any medications, or if you have:

• Bipolar disorder (manic depression)
• Cirrhosis or other liver disease
• Kidney disease
• High blood pressure
• Glaucoma
• Seizures or epilepsy
• Bleeding or blood clotting disorder
• High cholesterol

If you have any of the conditions listed above, you may not be able to take Effexor, or you may need a dosage adjustment or special monitoring during treatment.

You may have suicidal thoughts or behavior when you first start taking an antidepressant, especially if you are under 18 years old. Watch for worsening symptoms of depression or suicidal thoughts. Your doctor should check you at regular visits during the first 12 weeks of treatment, or whenever your dose is changed.

In addition to you watching for changes in your own symptoms, your family or caregivers should be alert to changes in your mood or symptoms.

Contact your doctor if you have any of the following side effects, especially if they are new symptoms or if they get worse:

• mood changes
• anxiety
• panic attacks
• trouble sleeping
• irritability
• agitation
• aggressiveness
• severe restlessness
• mania (mental and/ or physical hyperactivity)
• thoughts of suicide or hurting yourself

Effexor may be harmful to an unborn baby, and may cause problems in a newborn baby if the mother takes the medication late in pregnancy (during the third trimester). Tell your doctor if you are pregnant or plan to become pregnant during treatment. Effexor can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Older adults may be more sensitive to the side effects of this medication. Do not give this medication to anyone under 18 years old without the advice of a doctor.

Take the missed dose as soon as you remember. However, if it is almost time for the next regularly scheduled dose, skip the missed dose and take the next one as directed. Do not take extra medicine to make up the missed dose.

Seek emergency medical attention if you think you have taken too much of this medication. An overdose of Effexor can be fatal, especially if taken together with alcohol.

Symptoms of a Effexor overdose may include:

• dizziness
• sleepiness
• nausea
• numbness or tingling in your hands or feet

Avoid drinking alcohol, which can some of the side effects of Effexor. Using too much of this medicine in addition to drinking alcohol can cause death.

Avoid using other medicines that make you sleepy such as:

• cold medicine
• pain medication
• muscle relaxers
• medicine for seizures
• other medication for depression or anxiety

They can add to sleepiness caused by Effexor.

Effexor can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Side Effects

Get emergency medical help if you have any of these signs of an allergic reaction:

• skin rash or hives
• difficulty breathing
• swelling of your face, lips, tongue, or throat

Contact your doctor promptly if you have any of the following side effects, especially if they are new symptoms or if they get worse:

• Mood changes
• Anxiety, panic attacks
• Trouble sleeping
• Irritability, agitation, aggressiveness
• Severe restlessness
• Mania (mental and/ or physical hyperactivity)
• Thoughts of suicide or hurting yourself

Call your doctor at once if you have any of these SERIOUS side effects:

• Increased blood pressure (severe headache, blurred vision)
• Restlessness, overactive reflexes
• Nausea, vomiting, diarrhea
• Fever, fast heartbeat
• Hallucinations
• Loss of coordination, fainting
• Coma
• Seizure (convulsions)
• Extreme thirst with headache, nausea, vomiting, and weakness
• Easy bruising or bleeding

Other less serious side effects are more likely to occur, such as:

• Drowsiness, dizziness, nervousness, or anxiety
• Dry mouth, increased sweating
• Nausea, vomiting, diarrhea, constipation
• Decreased sex drive, impotence, or difficulty having an orgasm
• Headache, blurred vision
• Sleep problems (insomnia)
• Tremor or chills
• Changes in appetite or weight

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

Before taking Effexor, tell your doctor if you are using any of the following medicines:

• Cimetidine (Tagamet®, Tagamet HB®)
• Warfarin (Coumadin®)
• Ketoconazole (Nizoral®)
• Tryptophan (sometimes called L-tryptophan®)
• Haloperidol (Haldol®)
• Risperidone (Risperdal®)
• Almotriptan (Axert®)
• Frovatriptan (Frova®)
• Sumatriptan (Imitrex®)
• Naratriptan (Amerge®)
• Rizatriptan (Maxaltv)
• Zolmitriptan (Zomig®)
• Amitriptyline (Elavil®)
• Amoxapine (Ascendin®)
• Citalopram (Celexa®)
• Clomipramine (Anafranil®)
• Desipramine (Norpramin®)
• Escitalopram (Lexapro®)
• Fluoxetine (Prozac®)
• Fluvoxamine (Luvox®)
• Imipramine (Tofranil®)
• Nortriptyline (Pamelor®)
• Paroxetine (Paxil®)
• Protriptyline (Vivactil®)
• Sertraline (Zoloft®)
• Trimipramine (Surmontil®)

If you are using any of these drugs, you may not be able to use Effexor, or you may need dosage adjustments or special tests during treatment.

There may be other drugs not listed that can affect Effexor. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.