What is the most important information I should know about venlafaxine?

Do not use venlafaxine within 7 days before or 14 days after you have used an MAO inhibitor, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine.

Some young people have thoughts about suicide when first taking an antidepressant. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor.

What is venlafaxine?

Venlafaxine is a selective serotonin and norepinephrine reuptake inhibitor (SNRIs) antidepressant. Venlafaxine affects chemicals in the brain that may be unbalanced in people with depression.

Venlafaxine is used to treat major depressive disorder, anxiety, and panic disorder.

Venlafaxine may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before taking venlafaxine?

Do not use venlafaxine within 7 days before or 14 days after you have used an MAO inhibitor, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine. A dangerous drug interaction could occur.

Some medicines can interact with venlafaxine and cause a serious condition called serotonin syndrome. Be sure your doctor knows if you also take stimulant medicine, opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. Ask your doctor before making any changes in how or when you take your medications.

Tell your doctor if you have ever had:

• bipolar disorder (manic depression);
• cirrhosis or other liver disease;
• kidney disease;
• heart disease, high blood pressure, high cholesterol;
• diabetes;
• narrow-angle glaucoma;
• a thyroid disorder;
• a history of seizures;
• a bleeding or blood clotting disorder;
• low levels of sodium in your blood; or
• if you are switching to venlafaxine from another antidepressant.

Some young people have thoughts about suicide when first taking an antidepressant. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Venlafaxine may cause serious lung problems in a newborn if the mother takes the medicine late in pregnancy (during the third trimester). However, you may have a relapse of depression if you stop taking your antidepressant. Tell your doctor right away if you become pregnant. Do not start or stop taking venlafaxine during pregnancy without your doctor's advice.

How should I take venlafaxine?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

If you cannot swallow a capsule whole, open it and sprinkle the medicine into a spoonful of applesauce. Swallow the mixture right away without chewing. Do not save it for later use.

Your blood pressure will need to be checked often.

This medicine may affect a drug-screening urine test and you may have false results. Tell the laboratory staff that you use venlafaxine.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

What should I avoid while taking venlafaxine?

Ask your doctor before taking a nonsteroidal anti-inflammatory drug (NSAID) such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib (Celebrex), diclofenac, indomethacin, meloxicam, and others. Using an NSAID with venlafaxine may cause you to bruise or bleed easily.

What are the possible side effects of venlafaxine?

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

• blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights;
• easy bruising or bleeding (nosebleeds, bleeding gums), blood in your urine or stools, coughing up blood;
• cough, chest tightness, trouble breathing;
• a seizure (convulsions);
• low sodium level --headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady; or
• severe nervous system reaction --very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, feeling like you might pass out.

Common side effects may include:

• dizziness, drowsiness,
• anxiety, feeling nervous;
• sleep problems (insomnia);
• vision changes;
• nausea, vomiting, diarrhea;
• changes in weight or appetite;
• dry mouth, yawning;
• increased sweating; or
• decreased sex drive, impotence, abnormal ejaculation, difficulty having an orgasm.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect venlafaxine?

Tell your doctor about all your current medicines. Many drugs can affect venlafaxine, especially:

• any other antidepressant;
• cimetidine;
• St. John's wort;
• tramadol;
• tryptophan (sometimes called L-tryptophan);
• a blood thinner --warfarin, Coumadin, Jantoven;
• medicine to treat mood disorders, thought disorders, or mental illness --buspirone, lithium, and many others; or
• migraine headache medicine --sumatriptan, zolmitriptan, and others.

This list is not complete and many other drugs may affect venlafaxine. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Where can I get more information?

Your pharmacist can provide more information about venlafaxine.