Effexor

Generic Name: Venlafaxine
Brand Name: Effexor

Indications
Effexor (venlafaxine hydrochloride) is indicated for the treatment of major depressive disorder.

Dosage and Administration
Effexor is available for oral administration as 25mg, 37.5mg, 50mg, 75mg and 100mg tablets.
Normal Dosage: The recommended starting dose for Effexor is 75 mg/day, administered in two or three divided doses, taken with food. Depending on tolerability and the need for further clinical effect, the dose may be increased to 150 mg/day. If needed, the dose should be further increased up to 225 mg/day . When increasing the dose, increments of up to 75 mg/day should be made at intervals of no less than 4 days.
Overdose: Overdose symptoms may include dizziness, sleepiness, nausea, and numbness or tingling in your hands or feet.

Drug Description
Effexor (venlafaxine hydrochloride) is a structurally novel antidepressant for oral administration. It is designated (R/S)-1-[2-(dimethylamino) -1-(4-methoxy phenyl) ethyl] cyclohexanol hydrochloride or (±)-1-[α-[(dimethylamino) methyl]-p-methoxy benzyl] cyclohexanol hydrochloride and has the empirical formula of C17H27NO2 HCl. Its molecular weight is 313.87.
The structural formula is shown below.

Side Effects
Get emergency medical help if you have any of these signs of an allergic reaction: skin rash or hives; difficulty in 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);
• nausea, vomiting, diarrhea, fever, fast heartbeat; hallucinations, loss of coordination, fainting, coma;
• seizure (convulsions);
• extreme thirst with headache, nausea, vomiting, and weakness; or
• 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;
• tremor or chills; or
• 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.

Precautions

• Avoid drinking alcohol, which can increase some of the side effects of venlafaxine.
• 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 venlafaxine.
• Venlafaxine 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.
• Do not take this medication if you are allergic to venlafaxine, or if you are also using a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate). You must wait at least 14 days after stopping an MAOI before you can take venlafaxine. After you stop taking venlafaxine, you must wait at least 7 days before you start taking an MAOI.
  
• Before taking venlafaxine, 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;
• a bleeding or blood clotting disorder; or
• high cholesterol.
• You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Tell your doctor if you have worsening symptoms of depression or suicidal thoughts during the first several weeks of treatment, or whenever your dose is changed.
• Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.
• FDA pregnancy category C. Venlafaxine 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.
• Venlafaxine 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.
• Do not give this medication to anyone under 18 years old without the advice of a doctor.

Drug Interactions
Before taking venlafaxine, 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) or risperidone (Risperdal);
almotriptan (Axert), frovatriptan (Frova), sumatriptan (Imitrex), naratriptan (Amerge), rizatriptan (Maxalt), or zolmitriptan (Zomig); or
any other antidepressants such as 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), or trimipramine (Surmontil).
If you are using any of these drugs, you may not be able to use venlafaxine, or you may need dosage adjustments or special tests during treatment.
There may be other drugs not listed that can affect venlafaxine. 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.

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