Venlafaxine

Venlafaxine should be taken once daily with food, either in the morning or in the evening. Swallow the capsules whole. Do not crush, chew, or split the capsules.

Depression: The recommended dose of venlafaxine for people with depression is 75 mg once daily. For some people, the doctor may recommend starting with a lower dose of 37.5 mg daily for the first 4 to 7 days of treatment so they can get used to the medication. The dose can then be increased to 75 mg daily. If the expected benefit does not occur after a few weeks, your doctor may gradually increase the dose to a maximum of 225 mg daily, until improvement is seen.

Generalized anxiety disorder (GAD): For people with GAD, the recommended starting dose of venlafaxine is 37.5 mg once daily for 4 to 7 days. Your doctor may gradually increase the dose to a maximum of 225 mg daily, based on your response to the medication.

Social anxiety disorder (social phobia): The usual recommended starting dose of venlafaxine is 75 mg once daily. For some people, the doctor may recommend starting with a lower dose of 37.5 mg daily for the first 4 to 7 days of treatment so they can get used to the medication. The dose can then be increased to 75 mg daily. Your doctor may gradually increase the dose based on your response to the medication, to a maximum of 225 mg daily.

Panic disorder (panic attacks): For people with panic attacks, the recommended starting dose of venlafaxine extended release is 37.5 mg once daily for 7 days. The dose can then be increased to 75 mg daily. Your doctor may gradually increase the dose based on your response to the medication to a maximum of 225 mg daily.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important that Teva Venlafaxine Xr be taken exactly as prescribed by your doctor. If you miss a dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store Teva Venlafaxine Xr at room temperature, protect it from moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

In addition to its desired action, this medication may cause some adverse effects, notably: it may decrease your appetite; it may cause dryness of the mouth; it may cause dizziness - use caution when getting up from a lying or sitting position and use caution if driving; it may cause either drowsiness or excitability - use caution until you know how you will react; it may cause nausea or, rarely, vomiting. Each person may react differently to a treatment. If you think this medication may be causing adverse effects (including those described here, or others), talk to your health care professional. He or she can help you to determine whether or not the medication is the source of the problem.

37.5 mg
Each extended-release, hard gelatin capsule, with a grey cap and peach-coloured body, filled with white-to-off-white pellets, imprinted with "37.5" on the body and "N" on the cap, contains 37.5 mg of venlafaxine HCl. Nonmedicinal ingredients: antifoam DC 1510, black iron oxide, D&C Yellow No. 10, dibutyl sebacate, ethylcellulose, FD&C Yellow No. 6, gelatin, polyethylene glycol, povidone, shellac, soya lecithin, starch, sucrose, talc, and titanium dioxide.

75 mg
Each extended-release, hard gelatin capsule, with peach cap and peach-coloured body, filled with white-to-off-white pellets, imprinted with "75" on the body and "N" on the cap, contains 75 mg of venlafaxine HCl. Nonmedicinal ingredients: antifoam DC 1510, black iron oxide, dibutyl sebacate, D&C Yellow No. 10, ethylcellulose, FD&C Yellow No. 6, polyethylene glycol, povidone, shellac, soya lecithin, starch, sucrose, talc, gelatin, and titanium dioxide.

150 mg
Each extended-release, hard gelatin capsule, with a dark orange cap and dark orange body, filled with white-to-off-white pellets, imprinted "150" on the body and "N" on the cap, contains 150 mg of venlafaxine HCl. Nonmedicinal ingredients: antifoam DC 1510, black iron oxide, dibutyl sebacate, ethylcellulose, FD&C Yellow No. 6, polyethylene glycol, povidone, shellac, soya lecithin, starch, sucrose, talc, gelatin, and titanium dioxide.

Do not take venlafaxine if you:

• are allergic to venlafaxine or any ingredients of the medication
• are currently taking an MAO inhibitor (e.g., Phenelzine, Tranylcypromine), have taken one in the last 14 days, or will start treatment with one in the next 14 days

There may be an interaction between venlafaxine and any of the following:

• Acalabrutinib
• alcohol
• alpha-agonists (e.g., Clonidine, methyldopa)
• alpha/beta-agonists (e.g., Epinephrine, norepinephrine)
• amphetamines (e.g., Dextroamphetamine, Lisdexamfetamine)
• anticoagulants (e.g., Apixaban, Edoxaban, dabigatran, Rivaroxaban, Warfarin)
• antihistamines (e.g., cetirizine, doxylamine, Diphenhydramine, Hydroxyzine, Loratadine)
• antiplatelet medications (e.g., acetylsalicylic acid [Asa], Clopidogrel)
• antipsychotics (e.g., Chlorpromazine, Clozapine, Haloperidol, Olanzapine, Quetiapine, Risperidone)
• "azole" antifungals (e.g., itraconazole, ketoconazole, Voriconazole)
• barbiturates (e.g., butalbital, Phenobarbital)
• Bromocriptine
• Bupropion
• Buspirone
• Carbamazepine
• Celecoxib
• Crizotinib
• Cyclobenzaprine
• Dasatinib
• dexmethylphenidate
• Dextromethorphan
• ergot alkaloids (e.g., ergotamine, Dihydroergotamine)
• glucosamine
• grapefruit juice
• Heparin
• Linezolid
• lithium
• low molecular weight heparins (e.g., Dalteparin, Enoxaparin, Tinzaparin)
• Methadone
• methylene blue
• Methylphenidate
• Metoclopramide
• Mirtazapine
• monoamine oxidase inhibitors (M.O.S. e.g., Moclobemide, phenelzine, Rasagiline, Selegiline, tranylcypromine)
• multivitamins with minerals
• narcotic pain relievers (e.g., Codeine, Fentanyl, Morphine, Oxycodone)
• nonsteroidal anti-inflammatory drugs (NSAIDs; e.g., Ibuprofen, Indomethacin, Naproxen)
• Obinutuzumab
• Pentoxifylline
• Phenytoin
• primidone
• Propafenone
• Pseudoephedrine
• rivaroxaban
• Safinamide
• St. John's wort
• selective serotonin reuptake inhibitors (SSRIs; e.g., Citalopram, Fluoxetine, Sertraline)
• other serotonin / norepinephrine reuptake inhibitors (SNRIs; e.g., Desvenlafaxine, Duloxetine)
• serotonin antagonists (anti-emetic medications; e.g., Granisetron, Ondansetron)
• Tramadol
• Trazodone
• tricyclic antidepressants (e.g., Amitriptyline, Desipramine, Imipramine)
• "triptan" migraine medications (e.g., sumatriptan, rizatriptan, Zolmitriptan)
• Tryptophan supplements
• vitamin E

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Teva Venlafaxine Xr. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Teva Venlafaxine Xr.

Allergic reactions: In rare cases, some people may develop an allergic reaction to Teva Venlafaxine Xr. Signs of an allergic reaction include a severe rash, swollen face, or difficulty breathing. If these occur, get immediate medical attention.

Behaviour changes or suicidal behaviour: Some people taking Teva Venlafaxine Xr experience erratic or aggressive behaviour, agitation, depressed mood, or they may have thoughts of harming themselves or others. If you experience any mood or behaviour changes, or if your friends or family observe any of these changes while you are taking Teva Venlafaxine Xr, stop taking Teva Venlafaxine Xr and contact your doctor immediately.

Bleeding disorders: Venlafaxine may increase bruising and bleeding from cuts may take longer to stop. If you have a bleeding disorder or a history of bleeding problems, discuss with your doctor how Teva Venlafaxine Xr may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Teva Venlafaxine Xr, and whether any special monitoring is needed.

Blood pressure: Treatment with venlafaxine has been associated with increases in blood pressure. Your doctor may monitor your blood pressure while you are taking venlafaxine. Rarely, some people may experience a large increase in blood pressure. This extremely high blood pressure can cause rapid or irregular heartbeat, chest pain, dizziness, feeling overly tired, blurred vision, and symptoms of severe headache upon awakening that is mainly in the back of the head and neck region. If any of these symptoms occur, contact your doctor immediately.

Bone health and Osteoporosis: Recent studies have shown that there may be an increased risk of bone fractures (breaks) with the use of venlafaxine and other antidepressants. People with osteoporosis or those with risk factors for developing osteoporosis, may be more likely to experience a fracture. If you have osteoporosis or are at risk for developing osteoporosis, discuss with your doctor how Teva Venlafaxine Xr may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Teva Venlafaxine Xr, and whether any special monitoring is needed.

Cholesterol: Venlafaxine can cause higher blood cholesterol levels. If you are at risk of developing High Cholesterol or you have high cholesterol levels before starting venlafaxine, discuss with your doctor how Teva Venlafaxine Xr may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Teva Venlafaxine Xr, and whether any special monitoring is needed.

Drowsiness/reduced alertness: Venlafaxine may cause drowsiness or dizziness, affecting your ability to drive or operate machinery. Avoid these and other hazardous tasks until you have determined how Teva Venlafaxine Xr affects you.

Glaucoma: Teva Venlafaxine Xr may cause the symptoms of glaucoma (increased pressure in the eye) to become worse. If you have glaucoma, discuss with your doctor how Teva Venlafaxine Xr may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Teva Venlafaxine Xr, and whether any special monitoring is needed. Report any changes in vision to your doctor as soon as possible while you are taking Teva Venlafaxine Xr.

Heart disease: If you have heart disease, discuss with your doctor how Teva Venlafaxine Xr may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Teva Venlafaxine Xr, and whether any special monitoring is needed. Venlafaxine may cause increased blood pressure or increased cholesterol levels.

Kidney function: Kidney Disease or reduced kidney function may cause Teva Venlafaxine Xr to build up in the body, causing side effects. If you have kidney disease or reduced kidney function, discuss with your doctor how Teva Venlafaxine Xr may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Teva Venlafaxine Xr, and whether any special monitoring is needed.

Liver function: Liver disease or reduced liver function may cause Teva Venlafaxine Xr to build up in the body, causing side effects. If you have liver problems, discuss with your doctor how Teva Venlafaxine Xr may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Teva Venlafaxine Xr, and whether any special monitoring is needed. Your doctor may want to test your liver function regularly with blood tests while you are taking Teva Venlafaxine Xr.

If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.

Mania/hypomania: Venlafaxine may cause activation of mania or hypomania. People with a history of bipolar disorder should be closely monitored by their doctor while taking Teva Venlafaxine Xr.

Neuroleptic malignant syndrome (NMS): Venlafaxine can rarely cause a potentially fatal syndrome known as neuroleptic malignant syndrome (NMS). If you notice the symptoms of NMS such as high fever, muscle stiffness, confusion or loss of consciousness, sweating, racing or irregular heartbeat, or fainting, get immediate medical attention.

Seizures: If you have a history of seizures, discuss with your doctor how Teva Venlafaxine Xr may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Teva Venlafaxine Xr, and whether any special monitoring is needed.

Serotonin syndrome: Teva Venlafaxine Xr may cause a potentially life-threatening condition called serotonin syndrome, especially when used with other medications that increase serotonin levels (e.g., Sumatriptan, Rizatriptan). If you experience symptoms of serotonin syndrome such as agitation, hallucinations, fast heart rate, fever, lack of coordination, nausea, vomiting, and diarrhea, get immediate medical attention.

Stopping the medication: Stopping Teva Venlafaxine Xr suddenly may lead to side effects. If you are thinking of stopping Teva Venlafaxine Xr, check with your doctor first. When stopping venlafaxine treatment after more than one week, it is recommended that the dose of the medication be reduced gradually to prevent symptoms such as anxiety, agitation, confusion, diarrhea, dizziness, dry mouth, fatigue, headache, nausea, loss of appetite, nervousness, sleep disturbances, sweating, and vomiting.

Pregnancy: Newborns whose mothers take medications such as venlafaxine during the third trimester of pregnancy may experience complications that require prolonged hospitalization. These complications normally resolve over time.

Teva Venlafaxine Xr should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Teva Venlafaxine Xr, contact your doctor immediately.

Breast-feeding: Teva Venlafaxine Xr passes into breast milk. If you are a breast-feeding mother and are taking venlafaxine, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of Teva Venlafaxine Xr have not been established for children under 18 years old. There have been reports that using this and similar medications for children below the age of 18 may cause behavioural and emotional changes, such as suicidal thoughts and behaviour.

Seniors: Seniors may be more sensitive to the side effects of Teva Venlafaxine Xr.

This medication is typically used only once a day. However, your pharmacist may have suggested a different schedule that is more appropriate for you. Take it regularly and continuously to maintain its beneficial effects. Important: Follow the instructions on the label. Do not use more of this product, or more often, than prescribed. It is not advisable to stop using this product suddenly, particularly if you have been on it for several weeks. If you are considering stopping the medication, talk to your pharmacist first. The capsule of this medication should not be opened, crushed or chewed. If you forget a dose, simply skip it and then take the next dose at the regularly scheduled time. This medication may irritate the stomach, and should be taken with food. It is best to avoid coffee, spicy food or alcohol. Consuming alcohol may intensify the effect of this product. If you choose to drink alcohol, do so in moderation. Talk to your health care professional to find out exactly how much alcohol you can drink.