venlafaxine
Venlafaxine is an antidepressant used to treat mental health conditions like depression, generalized anxiety disorder, social anxiety disorder, and panic disorder. It comes in two forms: extended-release, which is taken once a day, and immediate-release, which is taken in split doses throughout the day. This medication can interact with many things, including other medications and alcohol. Possible side effects can include nausea, weight changes, and sexual problems. It can also cause withdrawal symptoms if you stop taking it suddenly.
What is Venlafaxine?
What is Venlafaxine used for?
- Depression
- Generalized anxiety disorder - extended-release capsules only
- Social anxiety disorder - extended-release capsules and tablets only
- Panic disorder - extended-release capsules only
How Venlafaxine works
Venlafaxine is a serotonin and norepinephrine reuptake inhibitor (SNRI). It raises certain chemicals in your brain, like serotonin and norepinephrine, which can improve your mood and reduce anxiety. By balancing these chemicals, it helps to make you feel better.
Drug facts
Side effects of Venlafaxine
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
Extended-release:
- Nausea (29-31%)
- Trouble sleeping (17-23%)
- Dizziness (16-20%)
- Loss of appetite (10-20%)
- Drowsiness (15-17%)
- Dry mouth (12-17%)
- Abnormal ejaculation (10-16%)
- Sweating (11-14%)
- Weakness (8-13%)
Immediate-release:
- Nausea (37%)
- Headache (25%)
- Drowsiness (23%)
- Dry mouth (22%)
- Dizziness (19%)
- Trouble sleeping (18%)
- Constipation (15%)
- Nervousness (13%)
- Weakness (12%)
- Sweating (12%)
- Abnormal ejaculation (12%)
- Loss of appetite (11%)
Less Common Side Effects
- Vomiting
- Lower sex drive
- Tremor
- Changes in vision
- Yawning
- Stomach pain
- Diarrhea
- Weight loss
- Abnormal dreams
- Agitation
- Rash
- Infection
- Chest pain
- Indigestion
- Passing gas
- Confusion
- Tingling sensation
- Urinary problems
Venlafaxine serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Suicidal thoughts and behaviors: suicide attempts, new or worsening anxiety or depression, trouble sleeping, restlessness, acting aggressive or violent, dangerously impulsive
- Serotonin syndrome: sweating, shivering, tremor, fast heartbeat, nausea, confusion, agitation, fever
- Bleeding problems: easy bruising or bleeding, blood in urine or stools
- Allergic reaction: rash, hives, swelling, difficulty breathing
- Low sodium levels: weakness, confusion, problems with memory, headache, fainting, unable to concentrate, hallucinations
- Lung problems: shortness of breath, cough, chest discomfort
- Seizure
More on Venlafaxine side effects
The following Venlafaxine side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Lack or loss of strength
severe headache
sweating
Less common
Blurred vision
fast or irregular heartbeat
mood or mental changes
ringing or buzzing in the ears
suicidal thoughts
Rare
Actions that are out of control
convulsions
high fever
irritability
itching or skin rash
lightheadedness or fainting, especially when getting up suddenly from a sitting or lying position
menstrual changes
nervousness
problems with urinating or holding urine
severe muscle stiffness
talking, feeling, and acting with excitement that you cannot control
trouble breathing
unusually pale skin
Incidence not known
Agitation
bloody, black, or tarry stools
bloody stool or urine
dark urine
decreased frequency or amount of urine
drowsiness
general feeling of tiredness or weakness
headache
increased thirst
light-colored stools
muscle cramps, spasms, or pain
nausea or vomiting
nosebleeds
overactive reflexes
poor coordination
red or purple spots on the skin
restlessness
shivering
stomach pain on the upper right side
swelling of the face, lower legs, ankles, hands, or fingers
trembling or shaking that is hard to control
twitching
unusual bruising
unusual tiredness or weakness
vomiting of blood or material that looks like coffee grounds
yellow eyes or skin
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Abnormal dreams
chills
decrease in sexual desire or ability
increased sweating
loss of appetite
stuffy or runny nose
tingling, burning, or prickly sensations
trouble sleeping
vomiting
Less common
Change in taste
muscle tension
yawning
Incidence not known
Night sweats
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Venlafaxine
Pros
- Can treat multiple mental health conditions
- Affects two chemicals in the brain that impact your mood
- Lower risk of weight gain compared to other antidepressants
- Comes in both immediate-release and extended-release versions
Cons
- Might raise your blood pressure, especially at higher doses
- Interacts with many medications
- Can take up to 4 to 8 weeks before you feel the full effect
- High risk of causing withdrawal symptoms if suddenly stopped
Pharmacist tips for Venlafaxine
- Take all your doses of venlafaxine with food to help reduce nausea, a common side effect of this medication.
- Take venlafaxine extended-release tablet or capsule once a day either in the morning or in the evening at about the same time each day. S
- If you're taking venlafaxine extended-release tablet, swallow it whole with water. Don't crush, cut, or chew the tablet since doing so can affect how well it works in your body.
- If you're taking venlafaxine extended-release capsules, you can swallow them whole or open the capsule if you have trouble swallowing. To do this, sprinkle all the contents from the capsule onto a spoonful of applesauce and swallow it right away without chewing.
- If you're swallowing venlafaxine extended-release capsules whole, you might notice the shell of the capsule in your stool. This is normal, and your body has already absorbed the proper amount of medication.
- Venlafaxine works in the brain and affects certain chemicals. Over time, your brain gets used to the medication. If you suddenly stop taking it, you might experience withdrawal symptoms like nausea, vomiting, tiredness, muscle aches, and trouble sleeping. To stop safely, work with your mental health provider to gradually lower the dose.
- Venlafaxine can take some time to start working. Many people see benefits within 1 to 2 weeks, but it can take 6 to 8 weeks for full effects. Over time, you should notice improvements in your mood and anxiety as you continue taking the medication.
- Venlafaxine can cause dizziness or drowsiness. Don't drive or operate heavy machinery until you know how this medication affects you.
- Venlafaxine interacts with many medications, and some interactions can be serious. For example, taking it with other antidepressants, MAO inhibitors, or opioids can lead to a dangerous condition called serotonin syndrome. Be sure to inform your mental health provider and pharmacist about all the medications you're taking.
- Avoid alcohol while taking venlafaxine because it can cause more dizziness. This can affect the way you do regular activities.
- Like other antidepressants, venlafaxine has been linked to suicidal thoughts and behavior, particularly in children, teenagers, and young adults. You or your loved ones should report any worsening of your mood or behavior to your mental health provider, especially when starting the medication or during changes in your dose.
Common questions about Venlafaxine
It depends on the form of Venlafaxine you're taking and what condition it's being used to treat. If an extended-release version is used for generalized anxiety disorder, depression, or panic disorder, the maximum dose is 225 mg per day. But if you're taking the extended-release capsules for social anxiety disorder, you shouldn't take more than 75 mg per day because higher doses don't provide additional benefit. For the immediate-release version, the maximum daily dose is 375 mg, split up into two or three doses throughout the day. Work with your mental health provider to find the best dose for managing your symptoms.
Weight gain isn't a common side effect of Venlafaxine. In fact, it more often causes weight loss in some people. If you notice changes in your body weight while taking this medication, speak with your mental health provider.
No, Venlafaxine isn't a selective serotonin reuptake inhibitor (SSRI); instead, it's a serotonin and norepinephrine reuptake inhibitor (SNRI). Though both drug classes work to boost serotonin levels in the brain, SNRIs like Venlafaxine also raise norepinephrine levels to help regulate your mood. Speak to your prescriber to learn about more key differences between SSRIs and SNRIs.
This can depend on many things, like your dose of Venlafaxine, other medications you're taking, and any other medical conditions you have. In general, side effects like nausea and dizziness often go away on their own as your body adjusts to the medication. But other side effects, like dry mouth, tend to stay around as you continue to take the medication. Speak with your prescriber if you have questions about how long side effects from Venlafaxine can last.
Antidepressants like Venlafaxine generally take a few weeks to start working. And it can take a month or two before you to feel the full effects. As you take this medication, you'll work with your prescriber closely to find the right dose for you.
It's possible for SNRIs like Venlafaxine to cause sexual side effects like erectile dysfunction. Talk to your prescriber if you have any questions about how to manage this side effect.
The extended-release version of Venlafaxine lasts longer in the body compared to the immediate-release version. For this reason, people taking the immediate-release version need to take 2 or 3 doses throughout the day since it wears off quicker. Also, the immediate-release version is only approved for depression, while the extended-release version can be used for depression, generalized anxiety, panic disorder (capsules only), and social anxiety disorder (capsules only). Ask your prescriber if you have questions comparing these two types of the same medication.
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Risks and warnings for Venlafaxine
Venlafaxine can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Suicidal thoughts and behavior
- Risk factors: Age 24 or younger
Venlafaxine can raise your risk of having suicidal thoughts or behavior. Watch for symptoms like new or worsening depression, suicidal thoughts or behavior, aggression, or agitation, especially during the first few months of treatment or when the dose changes. Though the risk is higher for people ages 24 and younger, it can happen to anyone. Let your mental health provider know right away if you or your loved ones notice any unusual changes in your mood or behavior while taking this medication.
Serotonin syndrome
- Risk factors: Taking other medications that can affect the serotonin levels in your brain
Serotonin syndrome is a rare, but potentially life-threatening condition where there's too much serotonin in the brain. Serotonin is one of the chemicals in your brain responsible for your mood. Your risk goes up if you use venlafaxine with other medications that affect serotonin levels (e.g., other antidepressants, lithium (Lithobid), tramadol (Ultram), triptans, mirtazapine (Remeron), St. John's wort). Symptoms include fast heart rate, sweating, muscle stiffness or spasms, fever, and confusion. Tell your prescriber or get medical help right away if you have any of these symptoms.
High blood pressure
- Risk factors: History of high blood pressure | Certain heart conditions | Taking a high dose of venlafaxine
Venlafaxine can raise your blood pressure. Your prescriber will check your blood pressure before starting this medication, and regularly during treatment. If you're currently taking medication for high blood pressure, continue taking it as prescribed. You might want to check your blood pressure at home and keep a log to share with your healthcare team.
Higher bleeding risk
- Risk factors: Taking certain blood-thinning medications | Taking NSAIDs
Venlafaxine can raise your risk of bleeding or bruising, especially if you're also taking aspirin, NSAIDs (like ibuprofen (Advil, Motrin)), or certain blood thinners. Tell your prescriber about any bruising that doesn't get better, black-colored stools, pink or red urine, or unusual bleeding from your nose or gums. If you're taking blood thinners, your prescriber might need to change your dose.
Mania
- Risk factors: Personal or family history of bipolar disorder
Sometimes, depression is the first symptom of bipolar disorder. Treating someone with bipolar disorder with an antidepressant, like venlafaxine, alone can cause a manic episode. Symptoms of a manic episode include great excitement, euphoria, delusions, and overactivity. This is more likely to happen if you or someone in your family has had bipolar disorder. Your mental health provider should make sure that you don't have bipolar disorder before starting this medication because venlafaxine isn't approved to treat bipolar disorder. Talk to your prescriber right away if you notice unusual changes in your behavior.
Glaucoma
- Risk factors: History of glaucoma
Antidepressants like venlafaxine can cause your pupils to dilate (widen), which can block the flow of fluid in the eye and lead to high eye pressure. This is particularly important for people with a history of glaucoma. Symptoms can include sudden eye pain, headache with blurry vision, nausea, and vomiting. Speak to your prescriber if you have a history of glaucoma to learn more of this potential side effect.
Withdrawal
- Risk factors: Stopping venlafaxine suddenly | Taking a high dose before stopping | History of having withdrawal symptoms after stopping an antidepressant
Stopping venlafaxine suddenly can cause withdrawal symptoms such as nausea, anxiety, agitation, flu-like symptoms, trouble sleeping, and dizziness. These symptoms usually appear within 3 days of stopping the medication and typically go away within 1 to 2 weeks. For this reason, it's important to work with your mental health provider to gradually lower your dose to prevent these symptoms.
Seizures
- Risk factors: History of seizures
Some people taking venlafaxine have experienced seizures. Tell your prescriber if you have a history of seizures before starting this medication. If you develop any seizures, stop using this medication and tell your prescriber right away.
Low sodium levels
- Risk factors: Older adult | Taking a water pill | Low fluids in the body
Rarely, venlafaxine can cause low sodium levels in the body. The risk is higher if you're an older adult, taking a diuretic (water pill), or have low fluids in your body. Get medical attention if you experience headaches, trouble concentrating, problems with your memory, confusion, weakness, or if you feel unsteady.
Lung problems and pneumonia
Although rare, venlafaxine has been linked to lung problems and pneumonia. Tell your prescriber or get medical help if you experience shortness of breath, cough, or discomfort in your chest.
Sexual problems
Venlafaxine can cause sexual side effects. In males, this might include issues like abnormal ejaculation, low sex drive, or erectile dysfunction. In females, it can lead to a lower sex drive or orgasm problems. Speak with your prescriber if you experience this side effect. They might have some recommendations to help you with this potential side effect.
Venlafaxine dosage
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 100mg | 60 tablets | $15.00 | $0.25 |
| 37.5mg | 30 tablets | $8.89 | $0.30 |
| 50mg | 60 tablets | $14.93 | $0.25 |
| 75mg | 90 tablets | $18.24 | $0.20 |
| 25mg | 30 tablets | $11.38 | $0.38 |
Typical dosage for Venlafaxine
- Depression: The typical starting dose is 75 mg by mouth daily, split up into 2 or 3 doses throughout the day. After 4 days, your prescriber might raise your dose if you're tolerating the medication. The maximum daily dose is 375 mg.
- Depression: The typical starting dose is 37.5 mg to 75 mg by mouth once a day. After 4 days, your prescriber might raise your dose if you're tolerating the medication. The maximum daily dose is 225 mg.
- Generalized anxiety disorder: The typical starting dose is 37.5 mg to 75 mg by mouth once a day. After 4 days, your prescriber might raise your dose if you're tolerating the medication. The maximum daily dose is 225 mg.
- Social anxiety disorder: The typical dose is 75 mg by mouth once a day. This is the maximum dose you should take for social anxiety because higher doses don't provide more benefit.
- Panic disorder: The typical starting dose is 37.5 mg by mouth once a day for 1 week. After a week, your prescriber might raise your dose to 75 mg by mouth once a day. The maximum daily dose is 225 mg a day.
- Depression: The typical starting dose is 37.5 mg to 75 mg by mouth once a day. After 4 days, your prescriber might raise your dose if you're tolerating the medication. The maximum daily dose is 225 mg.
- Social anxiety disorder: The typical dose is 75 mg by mouth once a day. This is the maximum dose you should take for social anxiety because higher doses don't provide more benefit.
More on Venlafaxine dosage
Interactions between Venlafaxine and other drugs
More on Venlafaxine interactions
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Bepridil
- Bromopride
- Cisapride
- Dronedarone
- Furazolidone
- Iproniazid
- Isocarboxazid
- Linezolid
- Mesoridazine
- Methylene Blue
- Metoclopramide
- Moclobemide
- Nialamide
- Pargyline
- Phenelzine
- Pimozide
- Piperaquine
- Procarbazine
- Rasagiline
- Safinamide
- Saquinavir
- Selegiline
- Sparfloxacin
- Terfenadine
- Thioridazine
- Toloxatone
- Tranylcypromine
- Trifluoperazine
- Ziprasidone
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Aceclofenac
- Acemetacin
- Acenocoumarol
- Alfentanil
- Almotriptan
- Amiodarone
- Amisulpride
- Amitriptyline
- Amoxapine
- Amoxicillin
- Amphetamine
- Amtolmetin Guacil
- Anagrelide
- Ancrod
- Anisindione
- Antithrombin III Human
- Apixaban
- Apomorphine
- Argatroban
- Aripiprazole
- Aripiprazole Lauroxil
- Arsenic Trioxide
- Aspirin
- Atazanavir
- Bemiparin
- Benzhydrocodone
- Benzphetamine
- Bivalirudin
- Bromfenac
- Bufexamac
- Buprenorphine
- Bupropion
- Buserelin
- Butorphanol
- Celecoxib
- Ceritinib
- Chloroquine
- Choline Salicylate
- Cilostazol
- Clarithromycin
- Clofazimine
- Clomipramine
- Clonixin
- Clopidogrel
- Clozapine
- Codeine
- Crizotinib
- Cyclobenzaprine
- Dabigatran Etexilate
- Dabrafenib
- Dalteparin
- Danaparoid
- Darunavir
- Dasatinib
- Defibrotide
- Degarelix
- Delamanid
- Dermatan Sulfate
- Desipramine
- Desirudin
- Deslorelin
- Desvenlafaxine
- Deutetrabenazine
- Dexfenfluramine
- Dexibuprofen
- Dexketoprofen
- Dextroamphetamine
- Dextromethorphan
- Dibenzepin
- Diclofenac
- Dicumarol
- Diflunisal
- Dihydrocodeine
- Dipyridamole
- Dipyrone
- Dolasetron
- Domperidone
- Donepezil
- Dothiepin
- Doxepin
- Droxicam
- Duloxetine
- Edoxaban
- Efavirenz
- Eletriptan
- Encorafenib
- Enoxaparin
- Entacapone
- Entrectinib
- Epoprostenol
- Eptifibatide
- Escitalopram
- Etodolac
- Etofenamate
- Etoricoxib
- Felbinac
- Fenfluramine
- Fenoprofen
- Fentanyl
- Fepradinol
- Feprazone
- Fingolimod
- Floctafenine
- Fluconazole
- Flufenamic Acid
- Fluoxetine
- Flurbiprofen
- Fondaparinux
- Formoterol
- Foscarnet
- Fostemsavir
- Frovatriptan
- Givosiran
- Glasdegib
- Gonadorelin
- Goserelin
- Granisetron
- Haloperidol
- Heparin
- Histrelin
- Hydrocodone
- Hydromorphone
- Hydroxychloroquine
- Hydroxyzine
- Ibuprofen
- Iloprost
- Imipramine
- Indomethacin
- Inotuzumab Ozogamicin
- Iobenguane I 123
- Iobenguane I 131
- Itraconazole
- Ivabradine
- Ivosidenib
- Jujube
- Ketoconazole
- Ketoprofen
- Ketorolac
- Lamifiban
- Lasmiditan
- Lefamulin
- Lenvatinib
- Lepirudin
- Levofloxacin
- Levomilnacipran
- Levorphanol
- Lexipafant
- Lisdexamfetamine
- Lithium
- Lofexidine
- Lorcaserin
- Lornoxicam
- Loxoprofen
- Lumiracoxib
- Macimorelin
- Meclofenamate
- Mefenamic Acid
- Meloxicam
- Meperidine
- Metaxalone
- Methadone
- Methamphetamine
- Metronidazole
- Milnacipran
- Mirtazapine
- Morniflumate
- Morphine
- Morphine Sulfate Liposome
- Moxifloxacin
- Nabumetone
- Nafarelin
- Nalbuphine
- Naproxen
- Naratriptan
- Nefazodone
- Nelfinavir
- Nepafenac
- Niflumic Acid
- Nilotinib
- Nimesulide
- Nimesulide Beta Cyclodextrin
- Nortriptyline
- Ondansetron
- Osilodrostat
- Osimertinib
- Oxaliplatin
- Oxaprozin
- Oxycodone
- Oxymorphone
- Oxyphenbutazone
- Ozanimod
- Palonosetron
- Panobinostat
- Parecoxib
- Paroxetine
- Pasireotide
- Pazopanib
- Pentazocine
- Pentosan Polysulfate Sodium
- Phenindione
- Phenprocoumon
- Phenylbutazone
- Piketoprofen
- Pimavanserin
- Piroxicam
- Pitolisant
- Ponesimod
- Posaconazole
- Pranoprofen
- Proglumetacin
- Propyphenazone
- Proquazone
- Protein C
- Protriptyline
- Quetiapine
- Remifentanil
- Ribociclib
- Ritonavir
- Rivaroxaban
- Rizatriptan
- Rofecoxib
- Salicylic Acid
- Salsalate
- Selpercatinib
- Sertraline
- Sevoflurane
- Sibrafiban
- Sibutramine
- Siponimod
- Sodium Salicylate
- Solifenacin
- Sotalol
- Sufentanil
- Sulfinpyrazone
- Sulindac
- Sulodexide
- Sulpiride
- Sumatriptan
- Sunitinib
- Tacrolimus
- Tapentadol
- Telithromycin
- Tenoxicam
- Tiaprofenic Acid
- Ticlopidine
- Tinzaparin
- Tirofiban
- Tolfenamic Acid
- Tolmetin
- Toremifene
- Tramadol
- Trazodone
- Triclabendazole
- Trimipramine
- Triptorelin
- Valdecoxib
- Vandetanib
- Vemurafenib
- Vilazodone
- Vinflunine
- Voclosporin
- Vortioxetine
- Warfarin
- Xemilofiban
- Zolmitriptan
- Zuclopenthixol
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Ginkgo
- Metoprolol
- St John's Wort
- Zolpidem
How much does Venlafaxine cost?
$8.89
Venlafaxine contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Venlafaxine will not be safe for you to take.
- Taking MAOIs currently or within 14 days before starting venlafaxine
- Taking with linezolid or intravenous methylene blue
What are alternatives to Venlafaxine?
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