Drug Action:
Venlafaxine acts as a serotonin and noradrenaline reuptake inhibitor.
Indications and Dose:
Major Depression:
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- Immediate-Release Medicines:
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- Adult: Start with 75 mg daily in 2 divided doses, increase up to 375 mg daily as needed. Dose increases should occur at intervals of at least 2 weeks, with a maximum of 375 mg per day.
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- Modified-Release Medicines:
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- Adult: Start with 75 mg once daily, increase up to 375 mg once daily as needed. Dose increases should occur at intervals of at least 2 weeks, with a maximum of 375 mg per day.
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Generalized Anxiety Disorder (Using Modified-Release Medicines):
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- Adult: Start with 75 mg once daily, may increase up to 225 mg once daily. Increase doses at intervals of at least 2 weeks, with a maximum of 225 mg per day.
Social Anxiety Disorder (Using Modified-Release Medicines):
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- Adult: 75 mg once daily, increase if necessary up to 225 mg once daily. No evidence of greater efficacy at higher doses. Increase doses at intervals of at least 2 weeks, with a maximum of 225 mg per day.
Panic Disorder (Using Modified-Release Medicines):
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- Adult: Initially 37.5 mg once daily for 7 days, then increase to 75 mg once daily, up to a maximum of 225 mg once daily. Increase doses at intervals of at least 2 weeks.
Menopausal Symptoms in Women with Breast Cancer (Using Modified-Release Medicines):
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- Adult: Start with 37.5 mg once daily for one week, then increase to 75 mg once daily if necessary.
Unlicensed Use: Venlafaxine is sometimes used for menopausal symptoms, but this is not a licensed indication. Important Safety Information: There is a small increased risk of postpartum hemorrhage when used in the month before delivery, due to its effect on platelet function. Cautions: Use with caution in patients with uncontrolled hypertension, and those at high risk of cardiac arrhythmias, diabetes, heart disease, history of bleeding disorders, epilepsy, mania, or angle-closure glaucoma. Side Effects: Common side effects include anxiety, decreased appetite, constipation, dizziness, dry mouth, headache, nausea, and more. Uncommon side effects include alopecia, angioedema, hemorrhage, and more. Rare conditions like agranulocytosis, glaucoma, and neuroleptic malignant syndrome may occur.
Pregnancy and Breastfeeding:
- Pregnancy: Use only if the potential benefit outweighs the risk. There’s a risk of neonatal withdrawal symptoms if used near term.
- Breastfeeding: Venlafaxine is present in milk and should be avoided.
Hepatic and Renal Impairment:
- Hepatic: Use with caution; consider reducing the dose.
- Renal: Use with caution; halve the dose if eGFR is less than 30 mL/min/1.73 m².
Treatment Cessation: Gradual dose reduction is recommended to avoid withdrawal symptoms. Medicinal Forms: Venlafaxine is available in various forms, including oral suspension, solution, and modified-release tablets and capsules, from special-order manufacturers.
Modified-release Tablet:
- Venlafaxine, available in various strengths, is designed to release the medication slowly over time to provide a more consistent effect.
Brands and Varieties:
- Sunveniz XL (Sun Pharmaceutical Industries Europe B.V.)
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- Available in 75 mg and 150 mg strengths.
- Venladex XL (Dexcel-Pharma Ltd)
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- Offers 75 mg, 150 mg, and 225 mg tablets.
- Venlalic XL (Ethypharm UK Ltd)
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- Provides a range from 37.5 mg up to 300 mg.
- ViePax XL (Dexcel-Pharma Ltd)
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- Comes in 75 mg, 150 mg, and 225 mg dosages.
- Alventa XL (Consilient Health Ltd)
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- Available in 75 mg and 150 mg strengths.
- Efexor XL (Viatris UK Healthcare Ltd)
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- Available in 75 mg, 150 mg, and 225 mg capsules.
- Majoven XL (Bristol Laboratories Ltd)
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- Offers 37.5 mg, 75 mg, and 150 mg capsules.
- Politid XL (Accord Healthcare Ltd)
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- Comes in 75 mg and 150 mg capsules.
- Venaxx XL (Advanz Pharma)
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- Offers 75 mg and 150 mg capsules.
- Vencarm XL (Aspire Pharma Ltd)
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- Ranges from 37.5 mg to 225 mg capsules.
- Venlasov XL (Sovereign Medical Ltd)
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- Offers 75 mg and 150 mg capsules.
- Vensir XL (Morningside Healthcare Ltd)
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- Available in 75 mg, 150 mg, and 225 mg capsules.
- Venzip XL (Milpharm Ltd)
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- Provides 75 mg and 150 mg capsules.
Oral Solution:
- Venlafaxine Oral Solution:
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- Available as a sugar-free solution in two strengths, calculated per milliliter
to provide precise dosing flexibility.
Modified-Release Capsules of Venlafaxine: Product Overview
Venlafaxine (Non-proprietary)
- 75 mg Modified-Release Capsules
- 150 mg Modified-Release Capsules
- 225 mg Modified-Release Capsules
Alventa XL (Consilient Health Ltd)
- 75 mg Capsules
- 150 mg Capsules
Efexor XL (Viatris UK Healthcare Ltd)
- 75 mg Capsules
- 150 mg Capsules
- 225 mg Capsules
Majoven XL (Bristol Laboratories Ltd)
- 37.5 mg Capsules
- 75 mg Capsules
- 150 mg Capsules
Politid XL (Accord Healthcare Ltd)
- 75 mg Capsules
- 150 mg Capsules
Venaxx XL (Advanz Pharma)
- 75 mg Capsules
- 150 mg Capsules
Vencarm XL (Aspire Pharma Ltd)
- 37.5 mg Capsules
- 75 mg Capsules
- 150 mg Capsules
- 225 mg Capsules
Venlablue XL (Zentiva Pharma UK Ltd)
- 37.5 mg Capsules
- 75 mg Capsules
- 150 mg Capsules
Venlasov XL (Sovereign Medical Ltd)
- 75 mg Capsules
- 150 mg Capsules
Vensir XL (Morningside Healthcare Ltd)
- 75 mg Capsules
- 150 mg Capsules
- 225 mg Capsules
Venzip XL (Milpharm Ltd)
- 75 mg Capsules
- 150 mg Capsules