Effexor (Venlafaxine) Prescription

Generic Name: Venlafaxine

Brand Name: Effexor, Effexor XR, Efexor

Dosages: Tablets: 25 mg, 37.5mg, 50 mg, 75 mg, 100 mg
Capsules, extended-release: 37.5 mg, 75 mg, 150 mg

Buy Venlafaxine (generic Effexor) Without Prescription

Manufacturer: Protec
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Medical uses:

Effexor is an antidepressant, used to relieve symptoms of depression, generalized anxiety disorder, social anxiety disorder (social phobia) and panic disorder. Venlafaxine targets two neurotransmitter systems - serotonin and norepinephrine.

Effexor XR (venlafaxine) is an appropriate option for depression with anxiety; for deep, despairing clinical depression; after unsuccessful trials with SSRIs.

Persons vulnerable to nausea, those with hypertension or heart disease should keep off venlafaxine.

Contraindications:

• Not to be used with MAOIs or within 2 weeks of stopping MAOI therapy. MAOI should not be started until 2 weeks after discontinuing venlafaxine.

Dosage:

The response to Effexor is directly correlated with dose.

Depression
Adults (immediate-release): 75 mg/day in 2 or 3 divided doses. If no improvement, the dosage may be increased by adding up to 75 mg daily at intervals of at least 4 days (max, 375 mg/day).
Adults (XR extended-release): 75 mg once daily administered either in the morning or evening at approximately same time. Some patients may need to start at 37.5 mg/day for 4 to 7 days before increasing to 75 mg/day. Titrate to clinical effect, in increments of up to 75 mg daily at intervals of at least 4 days (max, 225 5 mg/day).

Generalized Anxiety Disorder, Social Phobia
Adults (XR extended-release): 75 mg once daily administered either in the morning or evening at approximately same time. Some patients may need to start at 37.5 mg/day for 4 to 7 days before increasing to 75 mg/day. Titrate to clinical effect, in increments of up to 75 mg/day at intervals of not less than 4 days (max, 225 mg/day).

Swallow the controlled-release capsule (Effexor XR) whole, without crushing or chewing.

It may take up to 4 weeks or more to notice the improvement in symptoms. Do not stop your prescription without first talking to your doctor. You may get severe withdrawal side effects if you stop taking antidepressant suddenly.

Dosage adjustment:

• Hepatic function impairment: Reduce total daily dose 50% in patients with moderate hepatic impairment.
• Renal function impairment: Reduce venlafaxine extended-release total daily dose 25% to 50% in patients with renal impairment (Ccr 10 to 70 mL/min). Reduce total daily dose of venlafaxine immediate-release 25% in patients with mild to moderate renal impairment. Reduce total daily dose 50% in patients undergoing hemodialysis. Withhold dose until hemodialysis is completed.

Effexor XR side effects:

• Central nervous system: headache (25% to 34%), insomnia (15% to 23%), asthenia (8% to 17%), somnolence (12% to 23%), nervousness (6% to 21%), tremor (4% to 10%), dizziness (11% to 20%), anxiety (6%), abnormal dreams (4%), yawning (3% to 5%), agitation (2%), chills (3%), hypertonia (3%), paresthesia (2% to 3%), twitching (1% to 2%), confusion (2%), depersonalization (1%).
• Gastrointestinal: nausea (21% to 58%), xerostomia (12% to 22%), anorexia (8% to 17%), constipation (8% to 15%), vomiting (3% to 6%), dyspepsia (5%), flatulence (3% to 4%), weight loss (1% to 4%).
• Genitourinary: abnormal ejaculation/orgasm (2% to 16%), impotence (4% to 10%), decreased libido (8%), urination impaired (2%).
• Cardiovascular: hypertension (3% to 13%), vasodilation (3% to 4%), palpitation (3%), tachycardia (2%), postural hypotension (1%).
• Dermatologic: sweating (11-15%), rash (3%), pruritus (1%), bruising, angioedema.
• Ocular: abnormal or blurred vision (4% to 6%), mydriasis (2%).
• Miscellaneous: tinnitus (2%).

Precautions:

Sustained hypertension: Venlafaxine is associated with dose-related increases in systolic and diastolic blood pressure (in 3% of patients receiving < 100 mg/day, and in up to 13% of patients receiving >300 mg/day). Sustained increases of supine diastolic blood pressure (SDBP) could have adverse consequences.

Pre-existing hypertension should be controlled before initiating venlafaxine. Monitor blood pressure regularly. If sustained increase in blood pressure noted, consider dose reduction or discontinuation of venlafaxine.

Serotonin syndrome: The development of a potentially life-threatening serotonin syndrome may occur during concurrent treatment with venlafaxine and other serotonergic drugs (including SSRIs, SNRIs and triptans) or drugs that impair serotonin metabolism (e.g., MAO inhibitors). Serotonin syndrome symptoms include mental status changes (e.g., agitation, hallucinations, coma), autonomic instability (e.g., tachycardia, labile blood pressure, hyperthermia), neuromuscular aberrations (e.g., hyperreflexia, incoordination) and/or gastrointestinal symptoms (e.g., nausea, vomiting diarrhea).

Children: Safety and efficacy not established. The studies suggest that Effexor may adversely affect weight and height.

Hazardous tasks: Has a low potential to impair cognitive or motor performance; caution operating hazardous machinery or driving.

Activation of mania or hypomania: May force a shift to mania or hypomania and unmask bipolar disorder.

Narrow-angle glaucoma: May cause mydriasis; use caution in patients with increased intraocular pressure or at risk of acute narrow-angle glaucoma.

Platelet aggregation: May impair platelet aggregation, resulting in bleeding.

Hyponatremia: Hyponatremia and the syndrome of inappropriate antidiuretic hormone secretion (SIADH) may occur with venlafaxine. This should be taken into consideration in patients who are volume-depleted, elderly, or taking diuretics.

Seizures: Use with caution in patients with a history of seizures or condition predisposing to seizures. Discontinue if seizures occur.

Drug Interactions:

• Buspirone: Concurrent use may result in serotonin syndrome.
• Cyproheptadine: Decreased pharmacologic effects of venlafaxine.
• Desipramine, haloperidol: Plasma levels of these drugs may be elevated by venlafaxine, increasing the risk of adverse effects.
• MAO inhibitors: MAO inhibitors have produced serious, even fatal, reactions when given concomitantly with venlafaxine. Do not use venlafaxine together with MAO inhibitors or within 14 days of MAO inhibitor use. Wait at least 7 days after stopping venlafaxine before using MAO inhibitors.
• Serotonergic drugs (e.g. meperidine, mirtazapine, sibutramine, antidepressants): Risk of serotonin syndrome.
• Selegiline: Concurrent use may predispose to serotonin syndrome.
• St. John's wort: Increased sedative effects.
• Warfarin: May increase PT, aPT, or INR with coadministration.

Pregnancy

Pregnancy Category C. Effexor did not cause malformations in offspring of rats or rabbits given doses up to 2.5 times (rat) or 4 times (rabbit) the maximum recommended human daily dose on a mg/m2 basis. However, in rats, there was a decrease in pup weight, an increase in stillborn pups, and an increase in pup deaths during the first 5 days of lactation, when dosing began during pregnancy and continued until weaning. The cause of these deaths is not known. These effects occurred at 2.5 times (mg/m2) the maximum human daily dose. The no effect dose for rat pup mortality was 0.25 times the human dose on a mg/m2 basis. There are no adequate studies in pregnant women. Because animal reproduction studies are not always predictive of human response, Venlafaxine should be used during pregnancy only if clearly needed.

Nursing Mothers
Effexor (Venlafaxine) and O-desmethylvenlafaxine have been reported to be excreted in human milk. Because of the potential for serious adverse reactions in nursing infants, a decision should be made whether to discontinue nursing or to discontinue Effexor.

Overdose:
Symptoms of overdose include altered consciousness (somnolence to coma), tachycardia, mydriasis, seizures, and vomiting. Predominantly occurs in combination with ethanol and/or other drug use. Most overdoses resolve with only supportive treatment, though ECG monitoring would be prudent considering the risk of arrhythmia. The risk of fatal outcome associated with overdose may be higher than that observed with SSRI-associated overdoses.

Price:
Venlafaxine, generic Effexor, is available without a prescription from your doctor. Pharmacies, listed above, let you buy the drug at affordable prices.

References:

• 1. U.S. Effexor XR (Venlafaxine) Prescribing Information