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Venlafaxine

Medical and Pharmacy Editor:

Brand Name: Effexor, Effexor XR

Generic Name: Venlafaxine

Drug Class: Antidepressants, SSRIs

What Is Venlafaxine and How Does It Work?

Venlafaxine is used to treat depression, anxiety, panic attacks, and social anxiety disorder (social phobia). It may improve your mood and energy level and may help restore your interest in daily living. It may also decrease fear, anxiety, unwanted thoughts, and the number of panic attacks. Venlafaxine is known as a serotonin-norepinephrine reuptake inhibitor (SNRI). It works by helping to restore the balance of certain natural substances (serotonin and norepinephrine) in the brain.

Venlafaxine may also be used to treat hot flashes that occur with menopause.

Venlafaxine is available under the following different brand names: Effexor, and Effexor XR.

Dosages of Venlafaxine:

Adult Dosage Forms and Strengths

Tablet

  • 25 mg
  • 37.5 mg
  • 50 mg
  • 75 mg
  • 100 mg

Tablet, extended release

  • 37.5 mg
  • 75 mg
  • 150 mg
  • 225 mg

Capsule, extended release

  • 37.5 mg
  • 75 mg
  • 150 mg

Dosage Considerations – Should be Given as Follows:

Depression

Immediate release

  • 75 mg/day orally divided every 8-12 hours initially; may be increased by up to 75 mg/day not faster than every 4 days
  • Moderate: Up to 225 mg/day orally divided every 8-12 hours
  • Severe: Up to 375 mg/day orally divided every 8-12 hours

Extended release

  • 20 mg orally once/day initially; may increase by 10 mg once weekly, not to exceed 60 mg/day

Geriatric

Immediate release

  • 25-50 mg/day orally divided every 8-12 hours initially; may be increased as tolerated by up to 25 mg/day no faster than every 4 days
  • Moderate: Up to 225 mg/day orally divided every 8-12 hours
  • Severe: Up to 375 mg/day orally divided every 8-12 hours

Extended release

  • 37.5 mg orally once daily initially; may be increased by 37.5 mg/day every 4-7 days; not to exceed 225 mg/day
  • Pediatric (Off-label)
  • Children: 37.5 mg/day orally initially
  • Adolescents: 37.5-75 mg/day orally initially
  • Maintenance: Children, 75-150 mg/day; adolescents, 150-300 mg/day

Generalized Anxiety

  • Adult: Extended release: 37.5-75 mg orally once daily initially; may be increased by 75 mg/day every 4-7 days; not to exceed 225 mg/day
  • Geriatric: Extended release: 37.5 mg orally once daily initially; may be increased by 37.5 mg/day every 4 days; not to exceed 225 mg/day

Social Anxiety

  • Adult, Extended release: 75 mg orally once daily
  • Dosages greater than 75 mg/day not shown to be more effective
  • Geriatric, Extended release: 37.5 mg orally once daily; may be increased by 37.5 mg/day every 4 days

Anxiety, Pediatric (Off-label)

  • Children: 37.5 mg/day orally initially
  • Adolescents: 37.5-75 mg/day orally initially
  • Maintenance: Children, 75-150 mg/day; adolescents, 150-300 mg/day

Panic Disorder

  • Adult, Extended release: 37.5 mg orally once daily for 7 days, then 75 mg once daily; may be further increased by 75 mg/day every 7 days; not to exceed 225 mg/day
  • Geriatric, Extended release: 37.5 mg orally once daily for 7 days, then 75 mg once daily; may be further increased by 37.5 mg/day every 7 days; not to exceed 225 mg/day

Hot Flashes Due to Hormonal Chemotherapy (Off-label)

  • Immediate release: 37.5 mg BID or 75 mg once/day; alternatively may titrate up beginning with 37.5 mg once/day for 1 week then 75 mg daily
  • Extended release: 37.5-150 mg orally once daily for 4-12 weeks

Post-traumatic Stress Disorder (Off-label)

  • Extended release formulation: 37.5-300 mg/day

Attention Deficit Disorder

  • Adult: 18.75-75 mg/day; may increase to 150 mg/day after 4 weeks; doses up to 225 mg/day used
  • Children less than 40 kg: 12.5 mg/day orally initially; increase by 12.5 mg/week; not to exceed 50 mg/day divided twice daily
  • Children 40 kg or more: 12.5 mg/day orally initially; increase by 25 mg/week; not to exceed 75 mg/day divided three times daily

Neuropathic Pain (Off-label)

  • 75-225 mg/day orally; onset of relief may start in 1-2 weeks or take up to 6 weeks for full benefit

Administration

  • Take with food
  • If discontinuing therapy after 7 or more days, taper dosage

Dosing Modifications

  • Mild to severe renal impairment: Reduce dosage by 25-50%
  • Mild to moderate hepatic impairment: Reduce dosage by 50%
Medically Reviewed by a Doctor on 7/7/2017



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