Skip to main content

Venlafaxine

Generic name: venlafaxine [ VEN-la-fax-een ]
Brand names: Effexor XR, Effexor
Dosage forms: oral capsule, extended release (150 mg; 37.5 mg; 75 mg); oral tablet (100 mg; 25 mg; 37.5 mg; 50 mg; 75 mg); oral tablet, extended release (150 mg; 225 mg; 37.5 mg; 75 mg)
Drug class: Serotonin-norepinephrine reuptake inhibitors

Medically reviewed by Sophia Entringer, PharmD. Last updated on Aug 2, 2021.

What is venlafaxine?

Venlafaxine is an antidepressant belonging to a group of drugs called selective serotonin and norepinephrine reuptake inhibitors (SSNRIs). Venlafaxine affects chemicals in the brain that may be unbalanced in people with depression.

Venlafaxine is a prescription medicine used to treat major depressive disorder, anxiety, and panic disorder.

Warnings

You should not take venlafaxine if you have uncontrolled narrow-angle glaucoma.

Do not use venlafaxine within 7 days before or 14 days after you have used an MAO inhibitor, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, or tranylcypromine.

Some young people have thoughts about suicide when first taking an antidepressant. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor, such as: mood or behavioral changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Do not stop using venlafaxine without first talking to your doctor.

Do not give this medicine to anyone younger than 18 years old without the advice of a doctor. Venlafaxine is not FDA approved for use in children.

Before taking this medicine

You should not take this medicine if you are allergic to venlafaxine or desvenlafaxine (Pristiq), or if you have uncontrolled narrow-angle glaucoma.

Do not use venlafaxine within 7 days before or 14 days after you have used an MAO inhibitor, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, or tranylcypromine. A dangerous drug interaction could occur.

Tell your doctor if you also take stimulant medicine, opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. An interaction with venlafaxine could cause a serious condition called serotonin syndrome.

To make sure venlafaxine is safe for you, tell your doctor if you have ever had:

Some young people have thoughts about suicide when first taking an antidepressant. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Venlafaxine is not approved for use by anyone younger than 18 years old.

Taking this medicine during pregnancy could harm the baby, but stopping the medicine may not be safe for you. Do not start or stop venlafaxine without asking your doctor.

Do not breastfeed.

How should I take venlafaxine?

Take venlafaxine exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets.

Take with food at the same time each day.

Swallow the extended-release capsule or tablet whole and do not crush, chew, break, or open it.

If you cannot swallow a capsule whole, open it and mix the medicine with applesauce. Swallow the mixture right away without chewing.

Do not stop using venlafaxine suddenly, or you could have unpleasant symptoms (such as agitation, confusion, tingling or electric shock feelings). Ask your doctor how to safely stop using this medicine.

Your symptoms may not improve for several weeks.

Your blood pressure will need to be checked often.

This medicine may cause false results on a drug-screening urine test. Tell the laboratory staff that you use venlafaxine.

Store at room temperature away from moisture and heat.

Dosing information

Usual Adult Dose for Depression:

Immediate release:
-Initial dose: 37.5 mg orally twice a day OR 25 mg orally 3 times a day
-Maintenance dose: 75 to 150 mg orally per day, given in divided doses
-Maximum dose:
---Moderately depressed outpatients: 225 mg/day
---Severely depressed inpatients: 375 mg/day

Extended release:
-Initial dose: 75 mg orally once a day
-Maintenance dose: 75 to 225 mg orally once a day
-Maximum dose:
---Moderately depressed outpatients: 225 mg/day
---Severely depressed inpatients: 375 mg/day

Comments:
-The daily dosage of immediate-release formulations may be divided into 2 or 3 doses/day.
-Healthcare providers should consider initial extended release doses of 37.5 mg orally once a day for 4 to 7 days (before increasing the dose to 75 mg/day) in patients who may require additional time to adjust to the drug.
-Doses may be increased in daily increments of up to 75 mg orally at intervals of no less than 4 days.
-Patients should be periodically reassessed for the continued need of maintenance treatment and for the appropriate dose of treatment.
-Use of doses exceeding 225 mg/day is limited.

Use: Treatment of major depressive disorder (MDD)

Usual Adult Dose for Generalized Anxiety Disorder:

Extended release:
-Initial dose: 75 mg orally once a day
-Maintenance dose: 75 to 225 mg orally once a day
-Maximum dose: 225 mg/day

Comments:
-Healthcare providers should consider initial extended release doses of 37.5 mg orally once a day for 4 to 7 days (before increasing the dose to 75 mg/day) in patients who may require additional time to adjust to the drug.
-Doses may be increased in daily increments of up to 75 mg orally at intervals of no less than 4 days.

Use: Treatment of generalized anxiety disorder (GAD)

Usual Adult Dose for Social Anxiety Disorder:

Extended release: 75 mg orally once a day

Comment: There is no evidence that doses greater than 75 mg/day confer additional benefit.

Uses:
-Treatment of social anxiety disorder (SAD)
-Treatment of social phobia

Usual Adult Dose for Panic Disorder:

Extended release:
-Initial dose: 37.5 mg orally once a day for 7 days, then 75 mg orally once a day thereafter
-Maintenance dose: 75 to 225 mg orally once a day
-Maximum dose: 225 mg/day

Comment: Doses may be increased in daily increments of 75 mg orally at intervals of no less than 7 days.

Use: Treatment of Panic Disorder (PD), with or without agoraphobia

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking venlafaxine?

Do not drink alcohol.

Ask your doctor before taking a nonsteroidal anti-inflammatory drug (NSAID) such as aspirin, ibuprofen, naproxen, Advil, Aleve, Motrin, and others. Using an NSAID with venlafaxine may cause you to bruise or bleed easily.

Avoid driving or hazardous activity until you know how venlafaxine will affect you. Your reactions could be impaired.

Venlafaxine side effects

Get emergency medical help if you have signs of an allergic reaction to venlafaxine: skin rash or hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have:

  • blurred vision, eye pain or redness, seeing halos around lights;

  • cough, chest tightness, trouble breathing;

  • a seizure (convulsions);

  • unusual bleeding - nosebleeds, bleeding gums, abnormal vaginal bleeding, any bleeding that will not stop;

  • low blood sodium - headache, confusion, problems with thinking or memory, weakness, feeling unsteady; or

  • severe nervous system reaction - very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, feeling like you might pass out.

Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea

Common side effects of venlafaxine may include:

  • headache, dizziness, drowsiness, tiredness;
  • feeling anxious, nervous, or jittery;
  • sleep problems, unusual dreams;
  • tremors;
  • fast heartbeats;
  • blurred vision;
  • nausea, vomiting, diarrhea, constipation;
  • changes in weight or appetite;
  • dry mouth, yawning;
  • increased sweating; or
  • sexual problems.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect venlafaxine?

Using venlafaxine with other drugs that make you drowsy can worsen this effect. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety or seizures.

Tell your doctor about all your current medicines. Many drugs can interact with venlafaxine, especially:

This list is not complete and many other drugs may interact with venlafaxine. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Frequently asked questions

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use venlafaxine only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.