Medications such as venlafaxine may increase the risk of suicidal thoughts and actions. This increase was found in children, teenagers, and young adults (less than 24 years of age). The risk may be more likely with the first few months of treatment and when the dose is increased.
Call your doctor right away if you experience any of the following symptoms: new or worsening depression; thinking about harming or killing yourself, or planning or trying to do so; extreme worry; agitation; panic attacks; difficulty falling asleep or staying asleep; aggressive behavior; irritability; acting without thinking; severe restlessness; and frenzied abnormal excitement. Be sure that your family or caregiver knows which symptoms may be serious so they can call the doctor if you are unable to do so.
The doctor or pharmacist will give you the Medication Guide. Read the information carefully and ask your doctor or pharmacist if you have any questions. You also can obtain the Medication Guide from https://www.fda.gov/Drugs/DrugSafety/ucm085729.htm .Talk to your doctor about the risks of taking venlafaxine.
Why is this medicine prescribed?
Venlafaxine is used to treat depression, generalized anxiety disorder (GAD; excessive worrying that is difficult to control), social anxiety disorder (extreme fear of interacting with others or performing in front of others that interferes with normal life), and panic disorder (sudden, unexpected attacks of extreme fear and worry about these attacks). Venlafaxine is in a class of medications called selective serotonin and norepinephrine reuptake inhibitors (SNRIs). It works by increasing the amounts of serotonin and norepinephrine, natural substances in the brain that help maintain mental balance.
Are there other uses for this medicine?
Venlafaxine is also sometimes used to treat hot flashes (hot flushes; sudden strong feelings of heat and sweating) in women who have experienced menopause ('change of life'; the end of monthly menstrual periods) or who are taking medication to treat breast cancer. Talk to your doctor or pharmacist about the risks of using venlafaxine to treat your condition.
This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.
How should this medicine be used?
Venlafaxine comes as a tablet or extended-release capsule to take by mouth. Take the tablet two or three times a day with food. Take the extended-release capsule once daily in the morning or evening with food. Take venlafaxine at around the same time(s) every day.
Take venlafaxine exactly as directed. Do not take more or less of it or take it more often or for a longer period of time than prescribed by your doctor.
Swallow the extended-release capsule whole; do not split, chew, or crush it, or place it in water. If you cannot swallow the extended-release capsule, you may carefully open the capsule and sprinkle the entire contents on a spoonful of applesauce. Swallow (without chewing) this mixture immediately after preparation. Then drink a glass of water to make sure that you have swallowed all of the medication.
Your doctor will probably start you on a low dose of venlafaxine and gradually increase your dose, not more often than once every 4 to 7 days.
It may take several weeks or longer for you to feel the full benefit of this medication. Do not stop taking venlafaxine without talking to your doctor. Your doctor will probably decrease your dose gradually. If you suddenly stop taking venlafaxine, you may experience withdrawal symptoms such as agitation; anxiety; tiredness; confusion; mood changes; headache; dizziness; irritability; frenzied or abnormal excitement; lack of coordination; trouble falling asleep or staying asleep; nightmares; nausea; vomiting; loss of appetite; diarrhea; dry mouth; sweating; uncontrollable shaking of a part of the body; ringing in the ears; blurred vision; seizures; or burning, tingling, numbness, or electric shock-like feelings in any part of the body. Tell your doctor if you experience any of these symptoms.
What special precautions should I follow?
Before taking venlafaxine,
- tell your doctor or pharmacist if you are allergic to this drug, any part of this drug, or any other drugs, foods or substances. Tell your doctor or pharmacist about the allergy and what symptoms you had.
- tell your doctor or pharmacist if you are taking the following medications or have stopped taking them within the past two weeks: monoamine oxidase (MAO) inhibitor, such as isocarboxazid , linezolid, methylene blue, phenelzine, selegiline, and tranylcypromine. If you stop taking venlafaxine, your doctor will tell you that you should wait at least 7 days before you start to take an MAO inhibitor.
- some medications should not be taken with venlafaxine. Other medications may cause dosing changes or extra monitoring when taken with venlafaxine. Make sure you have discussed any medications you are currently taking or plan to take before starting venlafaxine with your doctor and pharmacist. Before starting, stopping, or changing any medications while taking venlafaxine, please get the advice of your doctor or pharmacist.
- the following nonprescription or herbal products may interact with venlafaxine: St. John's wort; tryptophan; cimetidine (Tagamet®). Be sure to let your doctor and pharmacist know that you are taking these medications before you start taking venlafaxine. Do not start any of these medications while taking venlafaxine without discussing with your healthcare provider.
- tell your doctor if you drink or have ever drunk large amounts of alcohol or use or have ever used street drugs or overused prescription medications. Also tell your doctor if you have recently had a heart attack and if you have or have ever had high blood pressure, high blood cholesterol seizures, glaucoma (increased pressure in the eye that may cause loss of sight), or heart, kidney, liver, or thyroid disease.
- tell your doctor if you are pregnant, especially if you are in the last few months of your pregnancy, or if you plan to become pregnant or are breast-feeding. If you become pregnant while taking venlafaxine, call your doctor.
- you should know that this medication may make you drowsy and may affect your judgment, thinking, and movements. Do not drive a car or operate machinery until you know how this medication affects you.
- you should know that venlafaxine may cause angle-closure glaucoma (a condition where the fluid is suddenly blocked and unable to flow out of the eye causing a quick, severe increase in eye pressure which may lead to a loss of vision). Talk to your doctor about having an eye examination before you start taking this medication. If you have nausea, eye pain, changes in vision, such as seeing colored rings around lights, and swelling or redness in or around the eye, call your doctor or get emergency medical treatment right away.
- talk to your doctor about the safe use of alcoholic beverages during your treatment with venlafaxine. Alcohol can make the side effects of venlafaxine worse
What special dietary instructions should I follow?
Unless your doctor tells you otherwise, continue your normal diet.
What should I do if I forget to take a dose?
Take the missed dose as soon as you remember it. However, if it is almost time for your next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are taking the extended-release capsules, do not take more than one dose per day.
What should I do in case of overdose?
In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help . If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.
Symptoms of overdose may include:
- dizziness
- nausea
- vomiting
- burning, tingling, or numbness of the hands and feet
- hot and cold spells
- sleepiness
- seizures
- fast, slow, or irregular heartbeat
- coma (loss of consciousness for a period of time)
What side effects can this medicine cause?
Venlafaxine may cause side effects. Call your doctor if any of the following symptoms are severe or do not go away:
- drowsiness
- nausea
- dry mouth
- loss of appetite
- sweating
- sexual problems in males; decreased sex drive, inability to get or keep an erection, or delayed or absent ejaculation
- sexual problems in females; decreased sex drive, or delayed orgasm or unable to have an orgasm
Some side effects can be serious. If you experience any of the following symptoms or those listed in the IMPORTANT WARNING or SPECIAL PRECAUTIONS sections, call your doctor immediately:
- rash; hives; itching; difficulty breathing or swallowing
- fast, pounding, or irregular heartbeat
- difficulty breathing, cough, chest pain
- seizures
- unusual bruising or bleeding
- fever, sweating, confusion, fast or irregular heartbeat, severe muscle stiffness or twitching, nausea, vomiting, or diarrhea
- hallucinations (seeing things or hearing voices that do not exist)
- coma (loss of consciousness for a period of time)
Venlafaxine may cause other side effects. Call your doctor if you have any unusual problems while you are taking this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online ( https://www.fda.gov/Safety/MedWatch ) or by phone ( 1-800-332-1088).What should I know about storage and disposal of this medication?
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).
Keep all medication out of sight and reach of children as many containers are not child-resistant. Always lock safety caps. Place the medication in a safe location – one that is up and away and out of their sight and reach. https://www.upandaway.org Dispose of unneeded medications in a way so that pets, children, and other people cannot take them. Do not flush this medication down the toilet. Use a medicine take-back program. Talk to your pharmacist about take-back programs in your community. Visit the FDA's Safe Disposal of Medicines website https://goo.gl/c4Rm4p for more information.What other information should I know?
Keep all appointments with your doctor.
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.
Keep a written list of all of the prescription and nonprescription (over-the-counter) medicines, vitamins, minerals, and dietary supplements you are taking. Bring this list with you each time you visit a doctor or if you are admitted to the hospital. You should carry the list with you in case of emergencies.