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Indications

BEERS REMS


Contraind./Precautions

Contraindicated in:

Use Cautiously in:

Adv. Reactions/Side Effects

CV: chest pain, hypertension, palpitations, tachycardia

Derm: ecchymoses, itching, photosensitivity, rash

EENT: rhinitis, visual disturbances, epistaxis, tinnitus

Endo: SIADH

GI: abdominal pain, altered taste, anorexia, constipation, diarrhea, dry mouth, dyspepsia, nausea, vomiting

GU: libido, delayed/absent orgasm, ejaculatory delay/failure, erectile dysfunction, urinary frequency, urinary retention

Hemat: BLEEDING

Metab: weight loss

Neuro: abnormal dreams, anxiety, dizziness, headache, insomnia, nervousness, paresthesia, weakness, abnormal thinking, agitation, confusion, depersonalization, drowsiness, emotional lability, NEUROLEPTIC MALIGNANT SYNDROME, SEIZURES, SUICIDAL THOUGHTS, twitching, worsening depression

Misc: chills, discontinuation syndrome, SEROTONIN SYNDROME, yawning

Interactions

Drug-drug:

Drug-Natural Products:

Availability

(Generic available)

Route/Dosage

Major Depressive Disorder

Renal Impairment

Hepatic Impairment

General Anxiety Disorder

Renal Impairment

Hepatic Impairment

Social Anxiety Disorder

Renal Impairment

Hepatic Impairment

Panic Disorder

Hepatic Impairment

Renal Impairment

US Brand Names

Effexor, Effexor XR

Action

  • Inhibits serotonin and norepinephrine reuptake in the CNS.
Therapeutic effects:
  • Decrease in depressive symptomatology, with fewer relapses/recurrences.
  • Decreased anxiety.Decrease in panic attacks.

Classifications

Therapeutic Classification: antidepressants, antianxiety agents

Pharmacologic Classification: selective serotonin and norepinephrine reuptake inhibitors-SSNRIs

Pharmacokinetics

Absorption: 92–100% absorbed after oral administration.

Distribution: Extensive distribution into body tissues.

Metabolism/Excretion: Extensively metabolized on first pass through the liver (primarily through the CYP2D6 isoenzyme); the CYP2D6 isoenzyme exhibits genetic polymorphism (7% of population may be poor metabolizers and may have significantly venlafaxine concentrations and an risk of adverse effects). One metabolite, O-desmethylvenlafaxine (ODV), has antidepressant activity. 5% of venlafaxine is excreted unchanged in urine; 30% of the active metabolite is excreted in urine.

Half-Life: Venlafaxine: 3–5 hr; ODV: 9–11 hr (both are in hepatic/renal impairment).

Time/Action Profile

(antidepressant action)

ROUTEONSETPEAKDURATION
POwithin 2 wk2–4 wkunknown



Patient/Family Teaching

Pronunciation

ven-la-FAX-een

Pill Image

venlafaxine_195-8941.jpg