section name header

Pronunciation ⬇

ven-la-FAX-een

Classifications ⬆ ⬇

Therapeutic Classification: antidepressants, antianxiety agents

Pharmacologic Classification: selective serotonin and norepinephrine reuptake inhibitors-SSNRIs

Indications ⬆ ⬇

REMS

Unlabeled Use:

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.

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



Contraind./Precautions ⬆ ⬇

Contraindicated in:

Use Cautiously in:

Adv. Reactions/Side Effects ⬆ ⬇

CV: chest pain, hypertension, palpitations, tachycardia

Derm: ecchymoses, itching, photosensitivity, skin rash

EENT: rhinitis, visual disturbances, epistaxis, tinnitus

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

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

Hemat: BLEEDING

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:

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

Availability ⬆ ⬇

(Generic available)

Assessment ⬆ ⬇

Lab Test Considerations:

Implementation ⬆ ⬇

Patient/Family Teaching ⬆ ⬇

Evaluation/Desired Outcomes ⬆ ⬇

US Brand Names ⬆ ⬇

Effexor, Effexor XR

Pill Image

venlafaxine_195-8941.jpg

Code ⬆

NDC Code