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What is Venlafaxine
Venlafaxine is an oral serotonin norepinephrine reuptake inhibitor (SNRI) used in adults for treating major depression, generalized anxiety disorder, social anxiety disorder, and panic disorder.
Venlafaxine is effective for hot flashes due to menopause or breast cancer treatment and is commonly used off-label in women as an alternative to hormonal therapy for vasomotor symptom control. SNRIs are not approved for use in pediatric patients with depression; however, guidelines from the American Academy of Child and Adolescent Psychiatry (AACAP) recommend the use of antidepressants when nonpharmacologic treatment is insufficient or illness severity is high.
Due to limited data in treating pediatric depression, SNRIs are generally reserved for pediatric patients with documented antidepressant treatment failure or intolerability to a selective serotonin reuptake inhibitor (SSRI). Similar to other SNRIs, venlafaxine has been associated with increases in blood pressure and heart rate and caution is recommended when conditions are present that may be adversely affected by increased blood pressure or heart rate.
Product labels for all antidepressants contain a boxed warning related to an increased risk of suicidality in children, adolescents, and young adults during the initial stages of therapy when treating depression or other conditions; therefore, the necessity of pharmacologic therapy versus the potential risks should be carefully considered in these populations.
Brand Names
- Effexor
- Effexor XR
- Venlafaxine
Indications
- andropause
- depression
- diabetic neuropathy
- fibromyalgia
- generalized anxiety disorder (GAD)
- hot flashes
- menopause
- migraine prophylaxis
- obsessive-compulsive disorder (OCD)
- panic disorder
- premenstrual dysphoric disorder (PMDD)
- social phobia (social anxiety disorder)
Side Effects
- acne vulgaris
- agitation
- agranulocytosis
- akathisia
- akinesia
- alopecia
- amenorrhea
- amnesia
- anaphylactoid reactions
- anemia
- angina
- angioedema
- anorexia
- anuria
- anxiety
- aphasia
- aplastic anemia
- apnea
- arthralgia
- asthenia
- ataxia
- atrial fibrillation
- AV block
- bleeding
- blurred vision
- bone pain
- bradycardia
- breast discharge
- breast enlargement
- bundle-branch block
- cardiomyopathy
- cataracts
- cheilitis
- chest pain (unspecified)
- chills
- cholecystitis
- cholelithiasis
- colitis
- confusion
- conjunctivitis
- constipation
- contact dermatitis
- cough
- delirium
- depression
- diabetes mellitus
- diarrhea
- diplopia
- dizziness
- drowsiness
- Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)
- dysarthria
- dysgeusia
- dyskinesia
- dyspepsia
- dysphagia
- dysphonia
- dyspnea
- dystonic reaction
- ecchymosis
- edema
- ejaculation dysfunction
- elevated hepatic enzymes
- emotional lability
- eosinophilia
- eosinophilic pneumonia
- epistaxis
- eructation
- erythema multiforme
- esophagitis
- euphoria
- exfoliative dermatitis
- fever
- flank pain
- flatulence
- flushing
- galactorrhea
- gastritis
- GI bleeding
- GI obstruction
- gingivitis
- glossitis
- glycosuria
- goiter
- gout
- growth inhibition
- Guillain-Barre syndrome
- gynecomastia
- hallucinations
- headache
- heart failure
- hematemesis
- hemoptysis
- hemorrhoids
- hepatic failure
- hepatic necrosis
- hepatitis
- hirsutism
- hostility
- hypercalciuria
- hypercholesterolemia
- hyperesthesia
- hyperglycemia
- hyperhidrosis
- hyperkalemia
- hyperkinesis
- hyperlipidemia
- hyperphosphatemia
- hyperprolactinemia
- hyperreflexia
- hypersalivation
- hypertension
- hyperthyroidism
- hypertonia
- hyperuricemia
- hyperventilation
- hypoglycemia
- hypokalemia
- hyponatremia
- hypophosphatemia
- hyporeflexia
- hypotension
- hypothyroidism
- hypotonia
- hypoventilation
- hypoxia
- impotence (erectile dysfunction)
- impulse control symptoms
- increased urinary frequency
- infection
- insomnia
- jaundice
- laryngeal edema
- laryngitis
- laryngospasm
- leukocytosis
- leukopenia
- libido decrease
- lymphadenopathy
- lymphocytosis
- maculopapular rash
- mania
- mastalgia
- melena
- menorrhagia
- menstrual irregularity
- muscle cramps
- muscle paralysis
- myasthenia
- mydriasis
- myocardial infarction
- nausea
- neonatal abstinence syndrome
- nephrolithiasis
- neuritis
- neuroleptic malignant syndrome
- neuropathic pain
- neutropenia
- night sweats
- nocturia
- nystagmus
- ocular hypertension
- oliguria
- oral ulceration
- orgasm dysfunction
- orthostatic hypotension
- pallor
- pancreatitis
- pancytopenia
- paranoia
- paresis
- paresthesias
- parotitis
- peptic ulcer
- peripheral neuropathy
- peripheral vasoconstriction
- petechiae
- phlebitis
- photophobia
- photosensitivity
- platelet dysfunction
- polyuria
- priapism
- proctitis
- prolonged bleeding time
- prostatic hypertrophy
- prostatitis
- proteinuria
- pruritus
- psoriasis
- psychosis
- pulmonary embolism
- purpura
- QT prolongation
- rash
- renal failure (unspecified)
- restlessness
- rhabdomyolysis
- seizures
- serotonin syndrome
- SIADH
- sinus tachycardia
- spontaneous fetal abortion
- steatosis
- Stevens-Johnson syndrome
- stomatitis
- stroke
- suicidal ideation
- supraventricular tachycardia (SVT)
- syncope
- synovitis
- tardive dyskinesia
- teeth grinding (bruxism)
- tendon rupture
- thrombocytopenia
- tongue discoloration
- torsade de pointes
- torticollis
- toxic epidermal necrolysis
- tremor
- trismus
- urinary incontinence
- urinary retention
- urinary urgency
- urticaria
- vaginal bleeding
- vaginitis
- ventricular fibrillation
- ventricular tachycardia
- vertigo
- vomiting
- weakness
- weight loss
- withdrawal
- xerophthalmia
- xerosis
- xerostomia
- yawning
Monitoring Parameters
- blood pressure
- serum cholesterol
Contraindications
- abrupt discontinuation
- alcoholism
- anticoagulant therapy
- bipolar disorder
- bleeding
- bradycardia
- breast-feeding
- cardiac arrhythmias
- cardiac disease
- cerebrovascular disease
- children
- closed-angle glaucoma
- coronary artery disease
- dehydration
- desvenlafaxine hypersensitivity
- diabetes mellitus
- dialysis
- driving or operating machinery
- eclampsia
- electroconvulsive therapy (ECT)
- eosinophilic pneumonia
- females
- geriatric
- growth inhibition
- heart failure
- hepatic disease
- hypertension
- hypocalcemia
- hypokalemia
- hypomagnesemia
- hyponatremia
- hypovolemia
- increased intraocular pressure
- long QT syndrome
- malnutrition
- mania
- MAOI therapy
- myocardial infarction
- neonates
- obstetric delivery
- pregnancy
- QT prolongation
- renal disease
- renal failure
- renal impairment
- seizure disorder
- seizures
- suicidal ideation
- thrombolytic therapy
- thyroid disease
- venlafaxine hypersensitivity
Interactions
- Abciximab
- Acetaminophen; Aspirin, ASA; Caffeine
- Acetaminophen; Butalbital; Caffeine; Codeine
- Acetaminophen; Caffeine; Dihydrocodeine
- Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
- Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
- Acetaminophen; Codeine
- Acetaminophen; Dextromethorphan
- Acetaminophen; Dextromethorphan; Doxylamine
- Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
- Acetaminophen; Dextromethorphan; Phenylephrine
- Acetaminophen; Dextromethorphan; Pseudoephedrine
- Acetaminophen; Hydrocodone
- Acetaminophen; Pentazocine
- Acetaminophen; Tramadol
- Aclidinium; Formoterol
- Albuterol
- Albuterol; Ipratropium
- Alfuzosin
- Aminosalicylate sodium, Aminosalicylic acid
- Amiodarone
- Amitriptyline
- Amitriptyline; Chlordiazepoxide
- Amlodipine; Celecoxib
- Amoxicillin; Clarithromycin; Lansoprazole
- Amoxicillin; Clarithromycin; Omeprazole
- Amphetamine; Dextroamphetamine Salts
- Anagrelide
- Antithrombin III
- Apixaban
- Apomorphine
- Aprepitant, Fosaprepitant
- Arformoterol
- Argatroban
- Aripiprazole
- Arsenic Trioxide
- Artemether; Lumefantrine
- Asenapine
- Aspirin, ASA
- Aspirin, ASA; Butalbital; Caffeine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Aspirin, ASA; Caffeine; Dihydrocodeine
- Aspirin, ASA; Caffeine; Orphenadrine
- Aspirin, ASA; Carisoprodol
- Aspirin, ASA; Carisoprodol; Codeine
- Aspirin, ASA; Citric Acid; Sodium Bicarbonate
- Aspirin, ASA; Dipyridamole
- Aspirin, ASA; Omeprazole
- Aspirin, ASA; Oxycodone
- Aspirin, ASA; Pravastatin
- Atazanavir; Cobicistat
- Atomoxetine
- Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Azithromycin
- Bedaquiline
- Benzhydrocodone; Acetaminophen
- Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Benzphetamine
- Betrixaban
- Bismuth Subcitrate Potassium; Metronidazole; Tetracycline
- Bismuth Subsalicylate
- Bismuth Subsalicylate; Metronidazole; Tetracycline
- Bivalirudin
- Boceprevir
- Brompheniramine; Dextromethorphan; Guaifenesin
- Brompheniramine; Guaifenesin; Hydrocodone
- Brompheniramine; Hydrocodone; Pseudoephedrine
- Budesonide; Formoterol
- Buprenorphine
- Buprenorphine; Naloxone
- Buspirone
- Carbinoxamine; Dextromethorphan; Pseudoephedrine
- Carbinoxamine; Hydrocodone; Phenylephrine
- Carbinoxamine; Hydrocodone; Pseudoephedrine
- Celecoxib
- Ceritinib
- Cevimeline
- Chloroquine
- Chlorpheniramine; Codeine
- Chlorpheniramine; Dextromethorphan
- Chlorpheniramine; Dextromethorphan; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
- Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Hydrocodone
- Chlorpheniramine; Hydrocodone; Phenylephrine
- Chlorpheniramine; Hydrocodone; Pseudoephedrine
- Chlorpromazine
- Choline Salicylate; Magnesium Salicylate
- Cilostazol
- Cimetidine
- Cinacalcet
- Ciprofloxacin
- Cisapride
- Citalopram
- Clarithromycin
- Clofazimine
- Clomipramine
- Clopidogrel
- Clozapine
- Cobicistat
- Cocaine
- Codeine
- Codeine; Guaifenesin
- Codeine; Phenylephrine; Promethazine
- Codeine; Promethazine
- Crizotinib
- Cyclobenzaprine
- Cyproheptadine
- Dabigatran
- Dacomitinib
- Dalteparin
- Danaparoid
- Darunavir; Cobicistat
- Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
- Dasatinib
- Degarelix
- Delavirdine
- Desipramine
- Desirudin
- Desvenlafaxine
- Deutetrabenazine
- Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
- Dexmethylphenidate
- Dextromethorphan
- Dextromethorphan; Diphenhydramine; Phenylephrine
- Dextromethorphan; Guaifenesin
- Dextromethorphan; Guaifenesin; Phenylephrine
- Dextromethorphan; Guaifenesin; Potassium Guaiacolsulfonate
- Dextromethorphan; Guaifenesin; Pseudoephedrine
- Dextromethorphan; Promethazine
- Dextromethorphan; Quinidine
- Diclofenac
- Diclofenac; Misoprostol
- Diflunisal
- Dihydrocodeine; Guaifenesin; Pseudoephedrine
- Diphenhydramine; Hydrocodone; Phenylephrine
- Diphenhydramine; Ibuprofen
- Diphenhydramine; Naproxen
- Dipyridamole
- Disopyramide
- Diuretics
- Dofetilide
- Dolasetron
- Dolutegravir; Rilpivirine
- Donepezil
- Donepezil; Memantine
- Doxepin
- Dronedarone
- Droperidol
- Duloxetine
- Edoxaban
- Efavirenz
- Efavirenz; Emtricitabine; Tenofovir
- Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
- Elbasvir; Grazoprevir
- Eliglustat
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Emtricitabine; Rilpivirine; Tenofovir alafenamide
- Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
- Encorafenib
- Enoxaparin
- Entrectinib
- Eptifibatide
- Ergot alkaloids
- Eribulin
- Erythromycin
- Erythromycin; Sulfisoxazole
- Escitalopram
- Esomeprazole; Naproxen
- Etodolac
- Everolimus
- Ezogabine
- Famotidine; Ibuprofen
- Fedratinib
- Fenoprofen
- Fentanyl
- Fingolimod
- Flecainide
- Fluconazole
- Fluoxetine
- Fluoxetine; Olanzapine
- Fluphenazine
- Flurbiprofen
- Fluticasone; Salmeterol
- Fluticasone; Umeclidinium; Vilanterol
- Fluticasone; Vilanterol
- Fluvoxamine
- Fondaparinux
- Formoterol
- Formoterol; Mometasone
- Foscarnet
- Gemifloxacin
- Gemtuzumab Ozogamicin
- Gilteritinib
- Givosiran
- Glasdegib
- Glycopyrrolate; Formoterol
- Goserelin
- Granisetron
- Guaifenesin; Hydrocodone
- Guaifenesin; Hydrocodone; Pseudoephedrine
- Halogenated Anesthetics
- Haloperidol
- Heparin
- Histrelin
- Homatropine; Hydrocodone
- Hydrochlorothiazide, HCTZ; Metoprolol
- Hydrocodone
- Hydrocodone; Ibuprofen
- Hydrocodone; Phenylephrine
- Hydrocodone; Potassium Guaiacolsulfonate
- Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
- Hydrocodone; Pseudoephedrine
- Hydroxychloroquine
- Hydroxyzine
- Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
- Ibuprofen
- Ibuprofen; Oxycodone
- Ibuprofen; Pseudoephedrine
- Ibutilide
- Idelalisib
- Iloperidone
- Imatinib
- Imipramine
- Indacaterol
- Indacaterol; Glycopyrrolate
- Indinavir
- Indomethacin
- Inotuzumab Ozogamicin
- Iobenguane I 131
- Isavuconazonium
- Isoniazid, INH
- Isoniazid, INH; Pyrazinamide, PZA; Rifampin
- Isoniazid, INH; Rifampin
- Itraconazole
- Ivosidenib
- Ketoconazole
- Ketoprofen
- Ketorolac
- Lansoprazole; Naproxen
- Lapatinib
- Lasmiditan
- Lefamulin
- Lenvatinib
- Lepirudin
- Letermovir
- Leuprolide
- Leuprolide; Norethindrone
- Levalbuterol
- Levobupivacaine
- Levofloxacin
- Levomilnacipran
- Linezolid
- Lisdexamfetamine
- Lithium
- Lofexidine
- Long-acting beta-agonists
- Loperamide
- Loperamide; Simethicone
- Lopinavir; Ritonavir
- Lorcaserin
- Macimorelin
- Magnesium Salicylate
- Maprotiline
- Meclofenamate Sodium
- Mefenamic Acid
- Mefloquine
- Meloxicam
- Meperidine
- Meperidine; Promethazine
- Mesoridazine
- Metaproterenol
- Methadone
- Methamphetamine
- Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
- Methylene Blue
- Methylphenidate
- Metoprolol
- Metronidazole
- Midostaurin
- Mifepristone
- Milnacipran
- Mirabegron
- Mirtazapine
- Mitotane
- Monoamine oxidase inhibitors
- Morphine
- Morphine; Naltrexone
- Moxifloxacin
- Nabumetone
- Naproxen
- Naproxen; Pseudoephedrine
- Naproxen; Sumatriptan
- Nefazodone
- Netupitant, Fosnetupitant; Palonosetron
- Nilotinib
- Nonsteroidal antiinflammatory drugs
- Norfloxacin
- Nortriptyline
- Octreotide
- Ofloxacin
- Olanzapine
- Olodaterol
- Ondansetron
- Oritavancin
- Osilodrostat
- Osimertinib
- Oxaliplatin
- Oxaprozin
- Ozanimod
- Paliperidone
- Palonosetron
- Panobinostat
- Paroxetine
- Pasireotide
- Pazopanib
- Peginterferon Alfa-2b
- Pentamidine
- Pentazocine
- Pentazocine; Naloxone
- Pentosan
- Perphenazine
- Perphenazine; Amitriptyline
- Phentermine
- Phentermine; Topiramate
- Phenylephrine; Promethazine
- Pimavanserin
- Pimozide
- Pirbuterol
- Piroxicam
- Pitolisant
- Posaconazole
- Prasugrel
- Primaquine
- Procainamide
- Procarbazine
- Prochlorperazine
- Promethazine
- Propafenone
- Protriptyline
- Quetiapine
- Quinidine
- Quinine
- Ranolazine
- Rasagiline
- Remifentanil
- Ribociclib
- Ribociclib; Letrozole
- Rilpivirine
- Risperidone
- Rivaroxaban
- Rofecoxib
- Rolapitant
- Romidepsin
- Safinamide
- Salicylates
- Salmeterol
- Salsalate
- Saquinavir
- Selpercatinib
- Serotonin-Receptor Agonists
- Sertraline
- Short-acting beta-agonists
- Sibutramine
- Siponimod
- Solifenacin
- Solriamfetol
- Sorafenib
- Sotalol
- St. John’s Wort, Hypericum perforatum
- Sulindac
- Sunitinib
- Tacrolimus
- Tamoxifen
- Tapentadol
- Tedizolid
- Telaprevir
- Telavancin
- Telithromycin
- Telotristat Ethyl
- Terbinafine
- Terbutaline
- Tetrabenazine
- Thiethylperazine
- Thioridazine
- Thrombolytic Agents
- Ticagrelor
- Ticlopidine
- Tinzaparin
- Tiotropium; Olodaterol
- Tirofiban
- Tolmetin
- Tolterodine
- Toremifene
- Tramadol
- Trazodone
- Tricyclic antidepressants
- Trifluoperazine
- Trimipramine
- Triptorelin
- Umeclidinium; Vilanterol
- Valdecoxib
- Valerian, Valeriana officinalis
- Vandetanib
- Vardenafil
- Vemurafenib
- Vilazodone
- Vorapaxar
- Voriconazole
- Vorinostat
- Vortioxetine
- Warfarin
- Ziprasidone
- Zolpidem
