Venlafaxine (generic for Effexor®)

Venlafaxine is FDA approved for the treatment of:

• Major depressive disorder (MDD) or depression

• Generalized anxiety disorder (GAD)

• Social anxiety disorder (SAD)

• Panic disorder (PD)

Venlafaxine may be used off-label for:

• Fibromyalgia

• Diabetic neuropathy

• Migraine prevention

• Post-traumatic stress disorder (PTSD)

• Obsessive-compulsive disorder (OCD)

• Hot flashes

Venlafaxine is the generic equivalent of Effexor®. Venlafaxine also comes in extended-release capsules (and tablets) and is the generic equivalent of Effexor® XR.

By law, a generic drug must be the same as its brand name counterpart in terms of active ingredient, dosage, safety, effectiveness, strength, stability, and quality. A generic may, however, differ in its inactive ingredients (i.e. flavoring, fillers, and preservatives).

Venlafaxine (Effexor®) does come with serious warnings. These include:

• Increased risk of suicidal thoughts or actions*

• Serotonin syndrome—a rare, but potentially life-threatening condition that occurs when there’s too much serotonin in the brain

• Withdrawal symptoms—abrupt discontinuation of treatment can cause nausea, anxiety, confusion, and headache.

• Liver problems, liver damage

• Risk of bleeding

• Manic episodes or hypomania in patients with bipolar disorder

• Seizures

• High blood pressure or changes in blood pressure—must be monitored periodically

• Severe skin reactions

• Glaucoma

• Changes in blood sugar

• Risk of falls in older patients

If any of the above concern you, speak with your doctor or pharmacist about your perceived risk and other treatment options that exist.

*This warning is a boxed warning. A boxed warning is the most serious type of medication warning assigned by the FDA.

Venlafaxine is an SNRI (serotonin-norepinephrine reuptake inhibitor). It works by blocking the brain’s absorption of norepinephrine and serotonin, “feed good” chemicals in your brain. The end result? An increased level of norepinephrine and serotonin in your brain, which is thought to improve mood and pain.

The most common side effects of venlafaxine include:

• Nausea

• Dry mouth, blurred vision

• Drowsiness, sleepiness

• Fatigue

• Constipation

• Decreased appetite

• Sweating

• Sexual problems

• Weight loss, weight gain

• Small increases in heart rate

• Loss of appetite

• Trouble sleeping

Side effects may improve over time as your body adjusts to the medicine.

This list doesn’t represent all possible side effects (or serious side effects) of venlafaxine. If you’re experiencing any ongoing, bothersome adverse effects(s), tell your healthcare provider right away.

If you’d like to learn more, speak with your doctor or pharmacist. The Food and Drug Administration (FDA) also has a helpful medication guide for venlafaxine here.

Venlafaxine can interact with some medicines and supplements. It’s always recommended to give both your doctor and pharmacy an updated list of everything you’re taking, so drug interactions can be identified.

Some medicines and supplements venlafaxine can interact with include:

• SSRIs (selective serotonin reuptake inhibitors): citalopram, sertraline, fluoxetine, paroxetine

• Monoamine oxidase inhibitors (MAOIs): selegiline, phenelzine, linezolid, methylene blue, tranylcypromine, isocarboxazid

• SNRIs (serotonin and norepinephrine reuptake inhibitors): desvenlafaxine, duloxetine, milnacipran

• Triptans: sumatriptan, eletriptan, naratriptan

• Arrhythmia medications: propafenone, flecainide

• Alcohol

• NSAIDs (nonsteroidal anti-inflammatory drugs): aspirin, ibuprofen

• Warfarin

• Tramadol

• Cimetidine

• St. John’s Wort

• Ciprofloxacin

• Weight loss medications

This list doesn’t represent all the drugs that may not be safe to take with venlafaxine. If you’re unsure whether a certain drug or supplement can be taken with venlafaxine, speak with your doctor or pharmacist. The FDA also has a helpful medication guide for venlafaxine here.

If you accidentally miss your dose of venlafaxine, take the dose as soon as you remember. If it’s almost time for your next dose (within 2 hours), skip the missed dose and take your next dose at the usual time. Don't take 2 doses at the same time or extra doses.

It’s important to avoid missing doses of this drug, as even one missed dose can lead to withdrawal symptoms

Venlafaxine should be taken with food.

Take the extended-release version once a day at the same time each day. Don’t crush or chew the pill. If you have difficulty swallowing pills, the capsule may be opened and contents can be sprinkle and swallowed with a spoonful of applesauce.

During pregnancy: Based on animal data, venlafaxine may cause fetal harm if taken during pregnancy.

While breastfeeding: Venlafaxine passes into breastmilk and is detectable in infants.

It’s important to treat mental health-related conditions when pregnant or nursing, as untreated depression, anxiety, or other mental illnesses can harm both you and baby. Always let your provider know if you’re pregnant or breastfeeding, so you can discuss alternative treatment options.

It’s recommended to avoid or limit the use of alcohol when taking venlafaxine. Liver failure has been reported in patients taking venlafaxine and the risk is much higher for patients with substantial alcohol use.