Indicated for the treatment of major depressive disorder (MDD). Efficacy was established in three short-term (4, 8, and 12 weeks) and two long-term, maintenance trials.
Serotonin-Noradrenaline Reuptake Inhibitor; Antidepressant
The mechanism of the antidepressant action of venlafaxine in humans is believed to be associated with its potentiation of neurotransmitter activity in the CNS. Preclinical studies have shown that venlafaxine and its active metabolite, O-desmethylvenlafaxine (ODV), are potent inhibitors of neuronal serotonin and norepinephrine reuptake and weak inhibitors of dopamine reuptake. Venlafaxine and ODV have no significant affinity for muscarinic, histaminergic, or α-1 adrenergic receptors in vitro. Pharmacologic activity at these receptors is hypothesized to be associated with the various anticholinergic, sedative, and cardiovascular effects seen with other psychotropic drugs. Venlafaxine and ODV do not possess monoamine oxidase (MAO) inhibitory activity.
ORAL Depression: Adult: As conventional tablets: Initially, 75 mg daily in 2 or 3 divided doses, Increased to 150 mg daily after several wk if necessary, further increase may be made in increments of up to 75 mg, every 2-4 days. Max: 375 mg daily.
Venlafaxine should not be used concomitantly with MAOIs, Cimetidine inhibits the hepatic metabolism of Venlafaxine.
<18 yr. Lactation. Uncontrolled hypertension; high risk of serious ventricular arrhythmia. Moderate to severe renal or hepatic impairment. Conditions which may be worsened by increase in heart rate. History of Ml, bleeding disorder, epilepsy, hypomania or mania. Raised Intraocular pressure or risk at angleclosure glaucoma. May impair performance of skilled tasks, driving or machinery operation. Monitor BP & serum cholesterol regularly. Monitor closely during early therapy until depression improves due to increased risk of suicide. Avoid abrupt withdrawal. Withdraw gradually over at least 1-2 wk & monitor for withdrawal symptoms e.g. fatigue, headache, nausea, vomiting, palpitations. Discontinue if seizure develops or increase in seizure frequency. Elderly, pregnancy.
Nausea, vomiting, anorexia, dry mouth, constipation, orthostatic hypotension, tremour, sweating, rash, anxiety, dizziness, fatigue, headache, syncope, insomnia, somnolence, constipation, hyponatraemla, sexual dysfunction, dyspepsia, visual disturbances, mydriasis, increased cholesterol concentrations, increased LFT. Aggressive behaviour (especially at the start & when stoppplng therapy). Blood dyscrasias, Stevens-Johnson syndrome, hepatitis.
Studies have looked at nearly 700 babies born to women who took venlafaxine during early pregnancy or throughout the first trimester. These studies suggest that using venlafaxine during pregnancy is unlikely to increase the chance of birth defects above the 3-5% background population risk. Infants receive venlafaxine and its active metabolite in breastmilk, and the metabolite of the drug can be found in the plasma of most breastfed infants; however, concurrent side effects have rarely been reported.
Store below 30° C temperature & in dry place, protected from light. Keep out of the reach of children.
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