Efexor XR Tablets Venlafaxine 75MG, 150 MG, Uses Side Effects Benefits Price

What Are Efexor XR Venlafaxine Tablets Uses & Side Effects?

Efexor XR Tablets is the brand name of a very famous well-known medication named Venlafaxine. Venlafaxine HCL is mainly considered an effective and fast-acting oral antidepressant with a novel structure. Moreover the generic drug Venlafaxine is designated as (+/-)-1-[a-[(dimethylamino)methyl]-p-methoxybenzyl] cyclohexanol. It is chemically unrelated to other available antidepressant agents. But actions are similar to tricyclic antidepressants like amitriptyline. Therefore it is prescribed by healthcare providers doctors or pharmacists as an antidepressant.

You must also understand that the name “XR” in the product name stands for “Extended Released”. This means that this medication will release slowly in humans over time which surely provides the patients a long-lasting relief from the symptoms they have. Do not use it without the instructions of your doctor or pharmacist and do not exceed the dose recommended by your healthcare provider to avoid any type of undesirable side effects.

What Are The Main Venlafaxine Tablets Uses & Indications?

• Treatment of depression, including depression with associated anxiety
• Treatment of anxiety or generalized anxiety disorder, including long-term treatment
• For prevention of relapse and prevention of recurrence of depression
• Treatment of social anxiety disorder, including long-term treatment
• Treatment of panic disorder, including long-term treatment

What Is Venlafaxine Tablets Dosage And Method Of Administration?

The following are representative Efexor XR Dosage recommendations. Meanwhile, It is recommended that Venlafaxine Capsules are taken with food at approximately the same time each day. swallowing the tablet whole with fluid, without crushing, dividing, or chewing it. Another option is to sprinkle the medication on a spoonful of applesauce, which should be swallowed immediately without chewing and followed by a glass of water to ensure all pellets are swallowed. Following these instructions will help ensure the medication is effective and safe. However, with the exception of patients with a social anxiety disorder (SAD) patients not responding to the Efexor XR 75MG /day dose may benefit from a dose increase in increments of up to Efexor 75 /day to a maximum of Efexor XR 225 mg/ day. Meanwhile, Extended release of the medicine dose increase can be made at intervals of 2 weeks or more but not less than 4 days. If a patient is currently taking Venlafaxine immediate-release tablets, they may be switched to Venlafaxine extended-release capsules at an equivalent daily dose. For instance, if a patient is taking 37.5mg of immediate-release Venlafaxine twice a day, they may switch to taking 75mg of extended-release Venlafaxine once a day. However, it’s important to note that individual dosage adjustments may be needed, and patients should always follow their healthcare provider’s instructions when switching between medication formulations.

• Major Depressive Disorder

The recommended starting Venlafaxine Dose extended-release capsule is Efexor 75 mg given once daily. Patients not responding to the initial doses may benefit from a dose increase to a maximum of 225 mg/day. While the recommended dose of this tablet immediate-release tablet in moderately depressed patients is up to 225 mg/ day more severely depressed patients in one study responded to a mean dose of 350 mg/day range of 150 to 375 mg/day.

• Generalized Anxiety Disorder

The recommended starting dose of Venlafaxine extended-release capsules is Efexor XR 75 mg given once daily. Patients not responding to the dose may benefit from a dose increase to a maximum of 225 mg/day.

• Social Anxiety Disorder

The recommended dose of venlafaxine extended-release capsules is 75 mg given once daily. There is no evidence that higher doses confer any additional benefit.

• Panic Disorder

It recommended that an Efexor XR Tablets dose of 37-5 mg/day of Venlafaxine extended-release capsule be used for 7 days. The dose should then be increased to  75 mg/day. Patients not responding to the Efexor 75 mg/day dose may benefit from a dose increase to a maximum of 225 mg. per day.

• Discontinuing Of The Medicine

Efexor XR Tablets Dose tapering is recommended whenever possible when discontinuing Venlafaxine therapy. In a clinical trial with venlafaxine extended-release capsules, tapering was achieved by reducing the daily dose by 75 mg at 1 weeks intervals. The period required for tapering may depend on the dose, duration of therapy, and the individual patient.

• Use In Patients With Renal Impairment

Patients with renal impairment, as defined by a glomerular filtration rate (GFR) between 10 and 70 ml/min, should have their entire daily dose of Venlafaxine decreased by 25% to 50%. Hemodialysis patients, on the other hand, should have their everyday dose of Venlafaxine tablets lowered by 50%. Since clearance may differ among these patients, it may be required to personalize the dosage. It’s necessary to consult with a healthcare provider to decide the proper dose for patients with renal impairment.

• Use in Patients with Hepatic Impairment

The total daily dose should be reduced by 50% in patients with mild to moderate hepatic impairment. Reductions of more than 50% may be appropriate for some patients. Because of individual variability in clearance in these patients, individualization of dosage may be desirable.

• Use in Children and Adolescent

There is insufficient experience with the use of Venlafaxine in patients younger than 18 years of age.

• Use in Older Age Patients

No specific dosage adjustments of venlafaxine are recommended based on patient age.

What Are The Contraindications To Using This Medicine?

Most importantly, Venlafaxine should not be assumed by patients who have a hypersensitivity to the medicine or any of its ingredients. Additionally, it should not be used in combination with monoamine oxidase inhibitors (MAOIs). If a patient has been using an MAOI, Venlafaxine should not be started until at least 14 days after discontinuation of the MAOI therapy. However, a quicker interval may be relevant if the MAOI is reversible. Prior to starting any MAOI therapy, Venlafaxine should be suspended for at least 7 days. It’s important to be mindful of potential interactions with other medications or substances and to confer with a healthcare provider.

Are There Any Warnings And Precautions For Its Use?

• Suicide /Suicide Thoughts or Clinical Worsening

All patients treated with Efexor XR Tablets should be monitored appropriately and observed closely for clinical worsening and suicidality. Patients, their families, and their caregivers should be encouraged to be alert to the emergence of anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia (psychomotor restlessness) hypomania, mania, other unusual changes in behavior, worsening of depression, and suicidal ideation. Especially when initiating therapy or during any changes in dosage regimen. The risk of suicide attempt must be considered, especially in depressed patients, and the smallest quantity of drug consistent with good patient management, should be provided to reduce the risk of overdose Undesirable Effects. Suicide is a known risk of depression and certain other psychiatric disorders, and these disorders themselves are strong predictors of suicide. Pooled analyses of short-term placebo-controlled trials of antidepressant medicine (selective serotonin reuptake inhibitors (SSRIs) and others showed that these medicines increase the risk of suicidality in children, adolescents, and young adults (ages 18-24 years) with major depression and other psychiatric disorder. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults older than years of age. There was a reduction in the risk of suicidality with antidepressants compared to placebo in adults aged 65 years and older.

• Bone Fractures

Epidemiological studies show an increased risk of bone fracture in patients receiving to this risk is not fully understood.

Is It Safe To Use In Children and Adolescents?

Efficacy in patients younger than 18 years of age have not been established. Regular measurement of weight and blood pressure is recommended if  Venlafaxine is used in children and adolescents. Discontinuation of the medication treatment increase in blood pressure. Measurement of serum cholesterol levels should be considered during long-term treatment of serum children and adolescents. Safety in children younger than 6 years of age has not been evaluated.

• NMS Like Reactions

As with other serotonergic agents serotonin syndrome, a potentially life-threatening condition or NMS-like reactions may occur with this medical treatment. Particularity with concomitant use of other serotonergic drugs including SSRls, SNRls, triptans, fentanyl, dextromethorphan, trama-dol, tapentadol, meperidine, methadone, pentazocine 211, with drugs that impair metabolism of serotonin including MAOls, e.g. methylene blue, or with antipsychotics. Or other dopamine antagonists 24,25,26. Symptoms of serotonin syndrome may include mental status changes (e.g.agitation, hallucinations, and coma), autonomic instability (e.g tachycardia, labile blood pressure, and hyperthermia, neuromuscular aberrations(e.g. hyperreflexia, incoordination ), and gastrointestinal symptoms (e.g. nausea, vomiting, and diarrhea) 25 Serotonin syndrome, muscle rigidity, autonomic instability with possible rapid fluctuation of vital signs, and mental status changes. If concomitant treatment with Venlafaxine and other agents that may affect the serotonergic and dopaminergic nerrotrans matter systems is clinically warranted. Careful observation of the patients is advised, particularly during treatment initiation and dose increases. The concomitant use of Venlafaxine with serotonin such as tryptophan supplements is not recommended.

• Angle Closure Glaucoma

Mydriasis may occur in association with Venlafaxine. It is recommended that patients with raised intra-ocular pressure or patients at risk for acute narrow-angle glaucoma (angle closure glaucoma ) be closely monitored.

• Cardiovascular System

Venlafaxine has not been evaluated in patients with a recent history of myocardial interaction or unstable heart disease. Therefore, it should be used with caution in these patients. However, Dose-related increases in blood pressure have been reported in some patients treated with it. Therefore, Cases of elevated blood pressure requiring immediate treatment have been reported in post-marketing experience. Most importantly, the measurement of blood pressure is recommended for patients receiving this. Meanwhile, Pre-existing hypertension should be controlled before treatment with it. On the other hand, Caution should be exercised in patients whose underlying conditions might compromise by increased in blood pressure. Furthermore, Increases in heart rate can occur, particularly with higher doses. So, Caution should be exercised in patients whose underlying conditions might be compromised by increases in heart rate. Meanwhile, Cases of QTc prolongation, Torsade de Pointes (TdP), ventricular tachycardia, and sudden death have been reported during the post-marketing use of venlafaxine. The majority of reports occurred in association with overdose or in patients with other risk factors for QTc prolongation TdP. Therefore it should be used with caution in patients with risk factors QTc prolongation.

• Convulsions

However, Convulsions may occur with venlafaxine therapy. But, As with all antidepressants, it should be introduced with caution in patients with antidepressants. So, the medication should be introduced with caution in patients with a history of convulsions.

• Mania / Hypomania

Mania /hypomania may occur in a small proportion of patients with mood disorders who have received antidepressants, including venlafaxine. Meanwhile, as with other antidepressants, it should be used cautiously in patients with a history or family history of confusion and two-minded disorder.

• Aggression

Most importantly, Aggression may occur in a small proportion of patients who have received antidepressants. Including the treatment, dose reduction, or discontinuation. However, As with other antidepressants, it should be used cautiously in patients with a history of aggression.

• Hyponatremia

On the other hand, Cases of hyponatremia and the syndrome of inappropriate antidiuretic hormone (SIADH) secretion may occur with venlafaxine. But, Usually in volume-depleted or dehydrated patients. On the other hand, older age patients, patients taking diuretics,s and patients who are otherwise volume-depleted may be at greater risk for this event.

• Bleeding

Most importantly, Drugs that inhibit uptake may lead to abnormalities of platelet aggregation. Therefore reports of bleeding abnormalities with venlafaxine range from skin and mucous membrane bleeding and gastrointestinal hemorrhage 45 to life-threatening hemorrhage. 46, 47,48,49,211.  However, As with other SRls, venafaxine should use cautiously in patients predisposed to bleeding, including patients on anticoagulants and platelet inhibitors.

• Weight Loss

The safety and efficacy of venlafaxine therapy in combination with weight loss agents, including phentermine, have not been established. So, Co-administration of this medicine and weight loss agents is not recommended. On the other hand, it does not indicate weight loss alone or in combination with other products.

• Serum Cholesterol

Clinically release increases in serum cholesterol were recorded in 5.3 venlafaxine-treated patients and 0.0% of placebo-treated patients treated for at least 3 months in placebo-controlled clinical trials. Meanwhile, the Measurement of serum cholesterol levels should be considered during long-term treatment.

What Are Its Drug Interactions To Take Care of?

• Monoamine Oxidase Inhibitors

Furthermore, Severe adverse reactions have been reported in patients who have recently discontinued a MAOl and started on venlafaxine or have recently had its therapy discontinued prior to initiation of a MAol. However, These reactions have including tremors, myoclonus, diaphoresis, nausea, vomiting, flushing, dizziness, and hyperthermia with features resembling NMS, seizures, and death.

• CNS Active Drugs

On the other hand, the risk of using it in combination with other CNS-active drugs has not been systematically evaluated. Consequently, caution is advised when this medicine is taken in combination with other CNS-active drugs.

• Serotonin Syndrome

As with other serotonergic agents, serotonin syndrome, a potentially life-threatening condition, may occur with its treatment, particularly with concomitant use of other agents that may affect the serotonergic neurotransmitter system including triptans, SSRls, other SNRl, lithium sibutramine, fentanyl and its analogs trama dol, dextromethorphan, tapentadol, meperidine, methadone, pentazocine, or SL john,s Wort(Hypericum perforatum), with drugs that impair metabolism of serotonin such as MAOls, including linezolid (an antibiotic which is a reversible nonselective MAO) and methylene blue, or with serotonin precursors such as tryptophan supplements. Meanwhile, If concomitant treatment with this product and an SSRl, as SNRl or a 5 hydroxytryptamine receptor agonist (triptan) is clinically warranted, careful observation of the patients is advised, particularly during treatment initiation and dose increase. Therefore, the concomitant use of venlafaxine with serotonin precursors (such as tryptophan supplements) is not recommended.

• Drugs That Prolong the QT Interval

Meanwhile, the risk of QT c prolongation and ventricular arrhythmias (e.g. TdP) increased with concomitant use of other drugs.  Which prolongs the QTc interval (e.g some antipsychotics and antibiotics ).

Indinavir

Further, A pharmacokinetic study with indinavir has shown a 28 decrease in area under the concentration versus time curve and a 36 decrease in Cmax for indinavir did not affect the pharmacokinetics of venlafaxine and o desmethyl venlafaxine (ODV). The clinical significance of this interaction is unknown.

Ethanol

Meanwhile, it has been shown not to increase the impairment of mental and motor skills caused by ethanol. However, as with all CNS active drugs, patients should be advised to avoid alcohol consumption while taking this product.

• Haloperidol

Furthermore, a pharmacokinetic study with haloperidol has shown a 42 decrease in total oral clearance a  70 increase in AUC, and an 88 increase in cmax. But no change in half-life. 60  The should be taken into account in patients treated with haloperidol and this medicine concomitantly.

• Cimetidine

At a steady state, cimetidine has been shown to inhibit first-pass metabolism of this. However, cimetidine had no effect on the pharmacokinetics of ODV. Meanwhile, The overall pharmacological activity of venlafaxine plus ODV is expected to increase only slightly in most patients. 61 in older age and in patients with hepatic dysfunction, this interaction may be more pronounced.

• Imipramine

Meanwhile, it did not affect the pharmacokinetics of imipramine and 2  OH imipramine. However, desipramine AUC, Cmax, and Cmin increased by about 35 in the presence of this drug and did not affect the pharmacokinetics of venlafaxine and ODV. Therefore, This should take into account in patients treated with imipramine and venlafaxine concomitantly.

• Ketoconazole

A pharmacokinetics study with ketoconazole in extensive metabolizers and poor metabolizers of CYP2D6 resulted in higher plasma concentrations of both venlafaxine and ODV in subjects following the administration of ketoconazole. Meanwhile, it increases by 26 in EM subjects and 48 in PM subjects. On the other hand, Cmax values for ODV increased by 14 and 29 in EM and PM subjects, respectively. Therefore, it increased by 21 in EM subjects and 70 in PM subjects. AUC values for ODV increased by 23 and 33 in EM and PM subjects, respectively.

• Metoprolol

Most importantly, concomitant administration of the medicine (50 mg every 8 hours for 5 days) and metoprolol (100 mg every 24 hours for 5 days) to healthy volunteers in a pharmacokinetic interaction study for both drugs resulted in increased plasma concentrations of metoprolol by approximately 30 -40 without altering the plasma concentrations of its active metabolite, hydroxy metoprolol. Moreover, Venlafaxine appeared to reduce the blood pressure-lowering effect of metoprolol in this study of healthy volunteers. Meanwhile, the clinical relevance of this finding in hypertensive patients is unknown. Metoprolol did not alter the pharmacokinetic profile of this or its active metabolite, ODV. 65 Caution should be exercised with co-administration of this medicine and metoprolol.

• Risperidone

On the other hand, it increased risperidone AUC 32 but did not significantly alter the pharmacokinetic profile of the total active moiety (risperidone plus 9 hydroxy risperidone). 66 The clinical significance of this interaction is unknown.

• Diazepam

However, Diazepam does not appear to affect the pharmacokinetics of either this medication or ODV. venlafaxine has no effects on the pharmacokinetics and pharmacodynamics of diazepam and its active metabolite, desmethydiazepam.

• Lithium

Meanwhile, the steady-state pharmacokinetics of venlafaxine and ODV were not affected when lithium co-administered. However, it has no effect on the pharmacokinetics of lithium.

• Eletroconvulsive Therapy

Therefore no clinical data establishing the benefit of electroconvulsive therapy combined with Effexor XR Tablets treatment.

• Drug Laboratory Test Interactions

False positive urine immunoassay screening tests for PCP and amphetamine have been reported in patients taking it. Meanwhile, this is due to the lack of specificity of the screening tests. On the other hand, False positive test results may be expected for several days following discontinuation of this medical therapy. Meanwhile, Confirmatory tests, such as gas chromatography /mass spectrometry, will distinguish venlafaxine from PCP and amphetamine.

Is It Safe To Use Efexor XR During In Pregnancy And Lactation For Women?

Most importantly, to know that the safety of Venlafaxine In Pregnancy has not been established. Meanwhile, During Pregnancy must be administered only if the expected benefits outweigh the possible risks. However, If it is used until or shortly before birth, discontinuation effects in the newborn should be considered. 82 Some neonates exposed to this late in the third trimester have developed complications requiring tube feeding, respiratory support, or prolonged hospitalization. Such complications can arise immediately upon delivery. Meanwhile, when the tab was administered orally to pregnant rats throughout gestation and lactation. A decrease in pup weight, an increase in stillborn pups, and an increase in pup deaths during the first 5 days of lactation. However, when dosing began during pregnancy and continued until weaning. 85 The cause of these deaths is not known. Meanwhile, These effects occurred at 10 times the human daily dose (on an mg/kg basis ) or 2.5 times (on an mg/m2 basis ) the human daily dose of 375 mg. However, the no-effect dose for rat pup mortality is 1.4 times the human dose, on an mg/kg basis, or 0.25 times the human dose, on an mg/32 basis. Meanwhile, Venlafaxine and ODV are excreted in human milk. Therefore a decision should be made whether to baby-feed or discontinue this medication.

What Are The Effects On the Ability To Drive And Machines?

Effexor XR Tablets did not affect psychomotor, cognitive, or complex behavior performance in healthy volunteers. However, any psychoactive drug may impair judgment, thinking, and motor skills. Therefore patients should be cautioned about their ability to drive or operate hazardous machinery.

How Much Efexor XR Side Effects May Appear?

• Blood And Lymphatic System Side Effects
• Agranulocytosis
• Aplastic anemia
• Pancytopenia
• Neutropenia
• Thrombocytopenia

Immune System Disorders

• Anaphylactic reaction

Endocrine Disorders

• Inappropriate antidiuretic hormone secretion
• Blood prolactin increased

Psychiatric Disorders

• Delirium
• Confusional state
• Mania
• Hypomania
• Depersonalization
• Hallucination
• Insomnia
• Abnormal dreams
• Nervousness
• Libido decreased
• Agitation
• Anorgasmia
• Abnormal orgasm
• Bruxism
• Apathy

Nervous System Disorders

• Neuroleptic malignant syndrome
• Serotonin syndrome
• Akathisia
• Syncope
• Convulsion
• Headache
• Dizziness
• Sedation
• Tremor
• Paraesthesia
• Dysgeusia
• Myoclonus
• Balance disorder
• Coordination abnormal
• Dyskinesia
• Dystonia
• Tardive dyskinesia

Eye Disorders

• Angle-closure glaucoma
• Visual impairment
• Accommodation disorder
• Mydriasis

Vascular Disorders

• Hypertension
• Orthostatic hypotension
• Hypotension
• Hot flush

Respiratory, Thoracic, And Mediastinal Disorders

• Dyspnoea, Interstitial lung disease
• Pulmonary eosinophilia
• Yawing

Gastrointestinal Disorders

• Gastrointestinal hemorrhage
• Pancreatitis
• Diarrhoea
• Vomiting
• Nausea
• Dry mouth
• Constipation

Hepatobiliary Disorders

• Hepatitis
• Liver function test abnormal

Skin And Subcutaneous Tissue Disorders

• Stevens-Johnson Syndrome
• Toxic epidermal necrosis
• Angioedema
• Erythema multiforme
• Rash
• Hyperhidrosis
• Pruritus
• Night sweats
• Urticaria
• Alopecia
• Ecchymosis
• Photosensitivity reaction

Musculoskeletal And Connective Tissue Disorders

• Rhabdomyolysis
• Hypertonia

Renal And Urinary Disorders

• Urinary hesitation
• Pollakiuria
• Urinary retention
• Urinary incontinence

Reproductive System And Chest Disorders

• Ejaculation disorder
• Metrorrhagia
• Menorrhagia

General Disorders And Administration Site Conditions

• Fatigue
• Asthenia
• Chills
• Mucosal hemorrhage

Investigations

• Bleeding time prolonged
• Weight Decreased
• Weight increased
• Blood cholesterol increased

Meanwhile, the following symptoms were reported in association with abrupt discontinuation or dose reduction, or tapering of treatment:

• Hypomania
• Anxiety
• Agitation
• Nervousness
• Confusion
• Insomnia or other sleep disturbances
• Fatigue
• Somnolence
• Paraesthesia
• Dizziness
• Convulsion
• Vertigo
• Headache
• Flu-like symptoms
• Tinnitus
• Impaired coordination and balance
• Tremor
• Sweating
• Dry mouth
• Anorexia
• Diarrhoea
• Nausea
• Vomiting

However, In premarketing studies, the majority of discontinuation reactions were mild and resolved without treatment.

What Type Of Side Effects Are Shown In Pediatric Patients?

In general, the adverse reaction profile of Venlafaxine (in placebo-controlled clinical trials) in children and adolescents (aged 6 to 17) was similar to that seen in adults. As with adults, decreased appetite, weight loss, increased blood pressure, and increased serum cholesterol were observed. On the other hand, In pediatric clinical trials, the adverse reaction of suicidal ideation was observed.  Also increased reports of hostility and, especially in major depressive disorder, self-harm. Particularly the following adverse reaction observed in pediatric patients.

• Abdominal pain
• Agitation
• Dyspepsia
• Ecchymosis
• Epistaxis
• Myalgia.

What Are The Overdose Symptoms & Treatment Of This Medicine?

In post-marketing experience, the overdosage with this product has been reported predominantly in combination with alcohol and other drugs. The most commonly reported events in overdose include tachycardia, changes in levels of consciousness (ranging from somnolence to coma), mydriasis, convulsion, and vomiting. Other events reported include electrocardiographic changes (e.g. prolongation of QT interval, bundle branch block, QRS prolongation), venlafaxine tachycardia, bradycardia, hypotension, vertigo, and death. Meanwhile, Published retrospective studies report that Venlafaxine Overdose may be associated with an increased risk of fatal outcomes compared to that observed with SSRI antidepressant products. But at lower than that for tricyclic antidepressants. Epidemiological studies have shown that treated patients have a higher burden of suicide risk factors than SSRl-treated patients. However, The extent to which the finding of an increased risk of fatal outcomes can be attributed to the toxicity of venlafaxine in overdose, as opposed to some characteristics of venlafaxine-treated patients, is not clear. Prescriptions for this medicine should be written for the smallest quantity of drug consistent with good patient management in order to reduce the risk of overdose.

Storage Instructions

Most importantly, protect the drug from sunlight and heat. On the other hand, Store the tablets in well-closed containers. Most importantly always remember to keep all your medicine out of the reach of the children.

Other Medical Information: Presage Injection 5000 I.U. Uses, Dosage, Side Effects Benefits Formula Ingredients Price

Efexor Xr (Venlafaxine) 75MG, 150MG Tablets Capsules Price Details

• Price In Pakistan: 499 PKR
• Price In India: 425 INR
• Price In USA: 3 USD
• Price In UAE Dubai: 5 AED