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venlafaxine hydrochloride
Efexor‡, Effexor, Effexor XR

Pregnancy Risk Category C

How supplied
Capsules (extended-release):
37.5 mg, 75 mg, 150 mg
Tablets:
25 mg, 37.5 mg, 50 mg, 75 mg, 100 mg

Action
Blocks reuptake of norepinephrine and serotonin into neurons in the CNS.

Indications & dosage
Depression--

Adults:
initially, 75 mg P.O. daily in two or three divided doses with food. Dosage increased as tolerated and needed in increments of 75 mg/day at intervals of no less than 4 days. For moderately depressed outpatients, usual maximum dose is 225 mg/day; in certain severely depressed patients, dose may be as high as 375 mg/day. For extended-release capsules, 75 mg P.O. daily in a single dose. For some patients it may be desirable to start at 37.5 mg P.O. daily for 4 to 7 days before increasing to 75 mg daily. Dosage may be increased at increments of 75 mg/day q 4 days to maximum of 225 mg/day.
Adjust-a-dose:
For renally impaired patients, reduce total daily dose by 25%. For patients undergoing hemodialysis, reduce total daily dose by 50% and withhold dose until dialysis is completed. For patients with hepatic impairment, reduce total daily dose by 50%.

Adverse reactions
CNS:
headache, somnolence, dizziness, nervousness, insomnia, anxiety, tremor, abnormal dreams, paresthesia, agitation, asthenia.
CV:
hypertension, tachycardia, vasodilation.
EENT:
blurred vision.
GI:
nausea, constipation, vomiting, dry mouth, anorexia, diarrhea, dyspepsia, flatulence, vomiting.
GU:
abnormal ejaculation, impotence, urinary frequency, impaired urination.
Metabolic:
weight loss.
Skin:
diaphoresis, rash.
Other:
yawning, chills, infection.

Interactions
Drug-drug.
MAO inhibitors: may precipitate a syndrome similar to neuroleptic malignant syndrome (myoclonus, hyperthermia, seizures, and death). Avoid concomitant use.
Drug-herb.
Yohimbe: additive stimulation. Use together cautiously.

Effects on diagnostic tests
None reported.

Contraindications
Contraindicated in patients with hypersensitivity to drug or within 14 days of MAO inhibitor therapy.

Nursing considerations

Patient teaching

*Liquid contains alcohol. **May contain tartrazine.  †Canada  ‡Australia  §U.K.  OTCOver the counter
Reactions may be common, uncommon, life-threatening, or COMMON AND LIFE-THREATENING

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