What is Effexor: How to use, Side Effects, Dosage

What is Effexor: How to use, Side Effects, Dosage

What is Effexor

Effexor(Venlafaxine) is used to treat depression, anxiety and panic disorder.

It is an antidepressant belongs to a group of drugs selected as selective norepinephrine reuptake inhibitors (SSNRIs). Venlafaxine affects the brain chemicals that may be unbalanced in those who have depression.

Compressed tablets containing venlafaxine hydrochloride, USP equivalent to 25 mg, 37.5 mg, 50 mg, 75 mg or 100 mg of venlafaxine base and inactive material: microcrystalline cellulose, lactose monohydrate, pregelatinized starch, sodium starch glycocoate, Red iron oxide, yellow iron oxide, colloidal silicon dioxide and magnesium lead acetate.

Venlafaxine hydrochloride is a white to white crystalline solid with a solubility of 572 mg / ml in water (iodine strength 0.2 mg with sodium chloride). The octanol distribution factor: water (0.2 M sodium chloride) is 0.43.

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 is used to treat depression. It may improve your mood and energy level, and may help restore your interest in daily living.

Please if you have any questions about Effexor, you can ask us by commenting below this text, we'll answer you as soon as possible.

How to use Effexor

Effexor should be taken with food. Try to take this medicine at the same time every day. Do not give a long-term capsule. To make the Effexor XR capsule long for dipping, you may open the capsule and cover the potatoes a little bit. Spread the whole mixture without chewing and never use it for the next use.

Dosage of Effexor

Oral Effexor Adult Dose for Depression:

Immediate release:

Initial dose: 37.5 mg twice daily or 25 mg three times a day

Maintenance dose: Daily increases in body weight up to 75 mg may occur at intervals of less than 4 days

Maximum dose: (Patients with depression): 225 mg per day

Maximum dose (severe depressed patients): 375 mg per day

The daily dose may be divided into 2 or 3 doses per day

Trial version:

Initial dose: 75 mg once daily

Maintenance dose: Daily increases in body weight up to 75 mg may occur at intervals of less than 4 days

Maximum dose (patients with depression): 225 mg per day

Maximum dose (severe depressed patients): 375 mg per day

Use: Major Depressive Disorders (MDD)

Adult dose of Effexor for anxiety:

Trial version:

Initial dose: 75 mg once daily

Maintenance dose: Increases in daily dose of 75 mg may increase at intervals of less than 4 days

Maximum dose: 225 mg per day

Uses: General Anxiety Disorder (GAD)

Treatment of Social Anxiety Disorder (SAD)

Effexor Oral Adult Dose for Panic Disorder:

Trial version:

Initial dose: 37.5 mg once daily

Maintenance dose: can increase the daily dose of 75 mg per day at intervals of less than 7 days.

Maximum dose: 225 mg per day

Use: Treating Pain Disorder (PD), with or without agoraphobia

The recommended dose for venlafaxine tablets is USP 75 mg / day, taken in two to three divided doses. Depending on the tolerance and the need for more clinical effects, the dose may be increased to 150 mg per day. If needed, the dose should be increased to 225 mg per day. When increasing the dose, no more than 75 mg per day should be made at intervals of less than 4 days. In the outpatient setting, there was no evidence of the beneficial effects of doses greater than 225 mg / day for patients with depression, but patients with depressed intensity responded to an average dose of 350 mg per day. Therefore, some patients, including depressed patients, may respond more to higher doses and up to a maximum of 375 mg per day, generally divided into three divided doses (instructions, commonly used in patients with associated illness).

Special crowd

Treating pregnant women in the third quarter

Infants exposed to venlafaxine tablets, USP, SNRI, or SSRIs, have developed long-term complications of long-term admission, respiratory support, and tubular nutrition late in the third trimester (see Tips). When treating pregnant women with Venlafaxine tablets, USP during the third trimester, the physician should consider the risks and benefits of potential treatment.

Consumption in patients with liver impairment

Regarding reduction in clearance and increased half-life of withdrawal of venlafaxine and ODV in patients with hepatic cirrhosis and liver and liver disorders in comparison with healthy subjects, it is recommended that the total daily dose be 50% In patients with mild to moderate hepatic impairment. Since there is a lot of variation in the incidence of cirrhosis among people, it may be necessary to reduce the dose by more than 50% and dosage fodder may be desirable in some patients.

Consumption in patients with renal impairment

Considering the reduction in clearance of venlafaxine and an increase in the half-life of the withdrawal of venlafaxine and ODV seen in patients with renal impairment (GFR = 10 to 70 ml / min), compare with normal (CLINICAL PHARMACOLOGY) The total daily dose in patients with mild to moderate hepatic impairment decreases by 25%. It is recommended that the total daily dose be reduced to 50% in hemodialysis patients. Because there are many changes in clearance between patients with renal impairment, dosage fomentation may be desirable in some patients.

Daily intake for elderly patients

For age for the elderly, the dose adjustment is not recommended. With any type of antidepressant medicine, you should be cautious in treating the elderly. When taking a dose, additional care should be taken when increasing the dose.

Preservative treatment

In general, it has been stipulated that acute accidents with major depressive disorder require several months or more of continuous drug therapy beyond the response to the acute part. In one study, in which patients received acute treatment with open-ended capsules after venlafaxine hydrochloride during the 8-week period, they randomly received placebo or the same dose of long-acting vralafacin hydrochloride capsules (75, 150 or 225 mg / day, qAM) 26 weeks of maintenance treatment During long-term stabilization phase, long-term efficacy has been shown. A long-term second-line study of the efficacy of Venlafaxine Tablet showed USP to maintain an antidepressant response in patients with recurrent depression that improved during the first 26 weeks of treatment and then randomly assigned to placebo tablets or venlafaxine, USP for periods up to 52 weeks with the same dose (100 to 200 mg per day in a proposed program) (see clinical trials). Based on this limited information, it is not known whether Venlafaxine Tablets, long USP / venlafaxine hydrochloride test capsules required for maintenance treatment, are equal to the dose required to reach the initial response. Patients should be re-examined periodically to determine the need for preservative treatment and appropriate dosage for such treatment.

Hang up Venlafaxine tablets, USP

Symptoms associated with the withdrawal of venlafaxine tablets, USP, other SNRIs and SSRIs have been reported (see the essential notes). Patients should discontinue these symptoms in the event of discontinuation of treatment. If possible, a gradual reduction of dose rather than a stop is recommended. If unacceptable symptoms occur after a dose reduction or after treatment discontinuation, then the previous dose is prescribed.

After that, the doctor may continue to reduce the dose, but with a gradual increase.

Replacement of a patient with one or more monoamine oxidase inhibitors (MAOIs) for the treatment of psychiatry.

Disorders

At least 14 days should be maintained between the discontinuation of methadone MAOI for treatment of mental disorders and the onset of treatment with venlafaxine tablets, USP. In contrast, at least 7 days after stopping the venlafaxine pill, the USP is allowed before the onset of a MAOI intended to treat psychiatric disorders.

Do not start with venlafaxine tablets, USP with other MAOls, such as lithizolide or methylene blue. Do not start the venlafaxine tablet; USP is used in patients who are given with lyticulosic or methylene blue, because they increase the risk of serotonin syndrome. In patients who need urgent treatment more than a psychiatric condition, other interventions, including hospitalization, should be considered.

In some cases, a patient currently taking venlafaxine tablets may require immediate treatment with either litzolide or methionine blue vein. If acceptable options are not available for the treatment of linear or intravenous methylen blue and potential benefits of treating lithizolide or methionine blue veins, the risk of serotonin syndrome in a particular patient, venlafaxine tablets, USP should be stopped quickly, and or Linzolide, aqueous methylene, can be given intravenously. The patient should check each of the priorities for symptoms of serotonin syndrome 7 days or up to 24 hours after the last dose of litzolide or methylene blue. Treatment with venlafaxine tablets, USP may be administered 24 hours after the last dose of litzolide or methylene blue.

The risk of using methylen blue with non-venous routes (such as oral pills or topical infusion) or intravenous doses of less than 1 mg / kg with venlafaxine tablets, USP is unknown. However, the doctor should be aware of the possibility of serotonin syndrome with such use.

Symptoms of overdose

Wyeth's letter states that the most commonly reported effects of Effexors over dose are heart rate, consciousness changes (sleepiness to the waist), seizure, vomiting and eye distortion.

The letter also notes that deaths, electrocardiogram changes (ECGs), slow heart rhythms, low blood pressure, dizziness, toxic chemical agents from dying muscle cells, and death of overactive Effexor liver cells have been reported. Is.

Effexor

Please if you have any questions about Effexor, you can ask us by commenting below this text, we'll answer you as soon as possible.

Side effects of Effexor

Report any new symptoms or worsening in your feeling to your doctor, such as: mood or behavioral changes, anxiety, panic attacks, drowsiness, or if you feel irritable, irritable, disturbed, hostile, aggressive, restless, have too much (mentally or physically) depression, or have your thoughts about suicide or harm yourself.

In case that:

Dark vision, tunnel vision, eye pain or swelling, or viewing aura around the lights;

Bruising bleeding or bleeding (nose bleeding, gingival bleeding), blood in urine or stool, coughing up blood

Cough, chest tightness, breathing problem;

Seizure

Low sodium level - headache, confusion, impatience, severe weakness, vomiting, loss of coordination, feeling of insecurity: or

Severe nervous system reaction - very stiff (rigid) muscles, high fever, sweating, confusion, rapid or uneven heartbeat, tremor, feeling like you may be erased.

Symptoms of serotonin syndrome include signs of serotonin syndrome, including: irritation, hallucinations, fever, sweating, chills, heart rate, muscle stiffness, shaking, coordination loss, nausea, vomiting or diarrhea.

The common side effects of Effexor may include:

Dizziness, drowsiness;

Anxiety, feeling nervous;

Sleep problems (insomnia);

Vision changes

Nausea, vomiting, diarrhea;

Change in weight or appetite;

Dry mouth, yawning

Sweating; or

Loss of libido, impotence, abnormal ejaculation or the problem of having orgasms.

This list is not the full list of side effects and others may occur.

This drug may increase serotonin and rarely create a very serious condition called serotonin / toxicity syndrome. If you also take medications that increase serotonin, the risk increases, so tell your doctor or pharmacist to see all the medications you are taking (see the section on drug interactions). If you experience some of the following symptoms, immediately help with heartbeat, hallucination, loss of coordination, severe dizziness, nausea / nausea / vomiting / diarrhea, muscle shaking, unknown fever, unusual disturbances.

Nausea, drowsiness, dizziness, dry mouth, constipation, loss of appetite, blurred vision, nervousness, low sleep, unusual sweating or yawning. If any of these effects persist or get worse, tell your doctor immediately.

Tell your doctor if any of these unexpected but serious symptoms are: easy bruising / bleeding, reduced sexual interest, changes in sexual ability, muscle cramps / weakness, shaking (shaking). This medicine may increase your blood pressure. Tell your doctor if your blood pressure is regularly checked and the results are very high.

In the case that any of these severely damaged deficiencies, shortness of breath, chest pain, severe headache / palpitations, black stools / bleeding, vomiting appear to be like coffee, eye pain / swelling / redness, students Expansive, vision changes (like seeing rainbows around the lights at night), seizures.

This allergic reaction is rare. However, if you notice signs of a severe allergic reaction, including itching, itching / swelling (especially face / tongue / throat), severe dizziness, difficulty breathing, see your doctor in a timely manner.

This is not a complete list of possible side effects. If you notice any other effects not listed above contact your doctor or pharmacist.

Drugs that may interact with Effexor

Ask your doctor before taking Effexor with a sleep pill, pain medication, relaxation of the muscle or medicine for anxiety, depression or seizure. Using this medication with other medications that causes drowsiness can make the effect worse

Many medications can interact with venlafaxine. All possible interactions are not listed here. Tell your doctor about all your current drugs and start and stop everything, especially:

Any other type of antidepressant

Cimetidine;

Saint John's yeast;

Tramadol;

Tryptophan (sometimes called L-Tryptophan);

Blood Drinks - Warfarin, Coumadine, Yanoton;

Medication for the treatment of mood disorders, thinking disorders, or mental illness - Bspron, Lithium and many others; or

Migraine headache medicines - Sumatriptan, Zulimperpentan and others.

This list is not complete and many other drugs can interact with venlafaxine. This includes prescription and over-the-counter prescriptions, vitamins and herbal products. Send a list of all your medicines to any health care provider that treats you.

Like other drugs, it is possible to interact with different mechanisms.

Co-administration of cimetidine and venlafaxine in a sustained study for both drugs led to the inhibition of the first metabolism in venlafaxine in 18 healthy individuals. Oral secretion of venlafaxine is reduced by about 43%, with a 60% increase in AUC and maximal drug concentration (Cmax). However, cimetidine synchronization has apparent effects on the pharmacokinetics of ODV, which is much more circulating, than venlafaxine. It is expected that the active physical activity of venlafaxine with ODV will only slightly increase and for most adults, dosage adjustment should not be necessary. However, for patients with pre-existing hypertension, and for elderly patients or patients with liver dysfunction, interaction with concomitant use of venlafaxine and cimetidine is not known and can potentially be higher. Therefore, it is recommended with such a patient.

Alcohol

Single dose of ethanol (0.5 g / kg) does not affect venlafaxine or ODV when Venlafaxine is taken at 150 mg / day in 15 healthy male patients. In addition, the administration of venlafaxine in a stable diet did not exceed the psychological and psychological effects of ethanol in these same individuals when not receiving venlafaxine.

Diazepam

Under stable conditions for venlafaxine, a daily dose of 150 mg per day, only a dose of 10 mg of diazepam does not appear to affect drug on venlafaxine or ODV in 18 healthy male patients. Venlafaxine also has no effect on the pharmacokinetics of diazepam or its active metabolite, desmethyldiazepam, or the psychosocial and psychological effects of diazepam.

Lithium

Sustained pharmacokinetics of venlafaxine, administered at 150 mg / day, were not affected if a dose of 600 mg of lithium oral was injected into 12 healthy men. Odesmethylvenlafaxine (ODV) was also not affected. Venlafaxine has no effect on lithium pharmacokinetics (also referred to as active CNS drugs).

Haloperidol

Venlafaxine reduced the dose of 2 mg haloperidol by 42% under steady-state conditions at 150 mg / day in 24 healthy subjects, resulting in an increase of 70% of the AUC of haloperidol per serving (CI / F). In addition, haloperidol C max increased by 88% when combined with venlafaxine, but the half-life of the trough (t½) was unchanged. The mechanism for explaining this finding is unknown.

The drug is highly dependent on the protein of the plasma

Venlafaxine is not very limited in plasma proteins; therefore, the administration of vanlafaxin tablets, the USP to the patient in the use of another drug that is highly protein-bound, should not increase the concentration of free drug.

Medications that cause homeostasis (eg, NSAIDs, aspirin and warfarin)

The release of serotonin by platelets plays an important role in homeostasis. Epidemiologic study of case control and coordination design. The association between the use of psychotropic drugs that inhibits sertotonin absorption and the onset of upper gastrointestinal bleeding has shown that simultaneous use of NSAIDs or aspirin may increase the risk of bleeding. Modified anticoagulant effects, including increased bleeding, have been reported when SSRIs and SNRI coarministered with warfarin. Patients who receive warfarin therapy should start or discontinue USP treatment when taking venlafaxine tablets.

Drugs that inhibit cytochrome P450 isozymes

In vitro and in vivo studies indicate that venlafaxine metabolizes to its active metabolite, ODV, by the CYP2D6, isozyme, which is responsible for the genetic polymorphism of the metabolism of many antidepressants. Therefore, there is potential for drug interactions between drugs that inhibit the metabolism of CYP2D6 and venlafaxine. However, although imipramine partially stops the metabolism of venlafaxine and increases plasma concentrations of venlafaxine and plasma ODV, the concentration of total active compounds (venlafaxine plus ODV) is not affected. In addition, in a clinical study that included extensive CYP2D6 metabolizers and its extensive concentration, the total concentration of active compounds (venlafaxine plus ODV) was similar in the two metabolizing groups. Therefore, no dose adjustment is required when venlafaxine is co-administered with CYP2D6 inhibitors.

Ketoconazole

A pharmacokinetic study with ketoconazole 100 mg b.i.d. With a single dose of venlafaxine 50 mg in extensive metabolites (EM; n = 14) and 25 mg in poor metabolisers (PM, n = 6), CYP2D6 resulted in increased plasma concentrations of both venlafaxine and O-desvenlafaxine (ODV) in Most of the following are administer.

Risperidone

Venlafaxine under stable conditions at 150 mg / day CYP2D6, a mediator of risperidone metabolism (administered as a single oral dose of 1 mg) inhibited its active metabolite, 9-hydroxyrisperidone, resulting in a 32% increase in rifasidone AUC. However, the synchronization of venlafaxine did not significantly alter the profile of total active profile (risperidone plus 9-hydroxyrisperidone).

CYP3A4

Venlafaxine does not inhibit CYP3A4. The finding in clinical studies of in vivo confirmed that venlafaxine did not inhibit several substrates of CYP3A4, including alprazolam, diazepam, and terfenadine.

Indinavir

In a study of nine healthy volunteers, venlafaxine, under steady-state conditions of 150 mg / day, resulted in a 28% reduction in AUC from 800 mg of single oral dose of indinavir and a 36% decrease in indinavir Cmax. Indinavir does not affect the drugs of venlafaxine and ODV. The clinical significance of this finding is unknown.

For whom Effexor might not be safe

Elderly adults may be more susceptible to side effects, especially vertigo, when standing up and bleeding. Elderly adults may most likely cause a type of salt imbalance (hyponatremia), especially if they are taking water tablets (diuretics). Colds and salt imbalances can increase the risk of falling.

Children may be more sensitive to side effects of this drug, especially loss of appetite and weight loss. Monitor weight and height in children taking this drug.

Can you use Effexor while pregnancy?

During pregnancy, this drug should only be taken when needed. It may be harmed to a baby. Also, babies born to mothers who have taken the drug for the last 3 months of pregnancy can rarely develop symptoms such as nourishment / respiration, seizure, muscle stiffness or permanent crying. If you notice any of these symptoms in your baby, tell your doctor immediately.

Warnings of Effexor

Clinical worsening and suicide risk

Major Depressive Disorders (MDDs) Both adults and children may experience depression and / or the emergence of suicidal thoughts and behaviors (suicide) or unusual changes in behavior, taking antidepressants. The risk may be up to recoverable time.

Continue to pay attention. Suicide is a known risk of depression and other psychiatric disorders, and these disorders are the strongest predictors of suicide. However, there is a long-standing concern that antidepressants may play an important role in depression and the emergence of suicide in some patients in the early stages of cure. Two-way analysis of placebo-controlled antiviral drugs (SSRIs and others) showed that these drugs are at risk of suicidal thoughts and behavior (suicide) in children, adolescents and young adults (18-24 years of age) with deep depression Disorder (MDD) and other mental disorders. Short-term studies did not show an increased risk of suicide with antidepressants compared with placebo in adults over the age of 24; in adults 65 years of age and older, they decreased with antidepressants.

The collected data from placebo-controlled trials in children and adolescents with MDD, obsessive-compulsive disorder (OCD) or other psychiatric disorders included a total of 24 short-term trials of 9 antidepressants in more than 4,400 patients. The analysis of collected drug control trials in adults with MDD or other psychiatric disorders included a total of 295 short-term trials (median duration 2 months) of 11 antidepressants in more than 77,000 patients. There were significant changes in the risk of drug suicide, but there was a tendency to increase in younger patients in almost all of the drugs studied. In most cases, the risk of suicide among different symptoms varies with the highest incidence of MDD. However, the difference in risk (medication versus placebo) was relatively stable among the age group and among the symptoms.

This medicine may cause dizziness or drowsiness or disrupt your vision. Alcohol or marijuana can cause your dizziness or sleepiness. Do not drive, use machines, or do anything that requires calm or sight until you can safely do it. Avoid alcoholic beverages. Talk to your doctor if you use marijuana.

At room temperature, keep it away from light and moisture. Do not save in the bathroom. Keep all medications away from children and pets.

Do not take medications from the toilet or drain them unless ordered to do so. After completing it, you will no longer need this product. Consult your local pharmacy or local waste disposal company to get the best advice.

Effexor

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