Venlafaxina

ATC code

N06AX16

Therapeutic class

Antidepressant (Serotonin-Norepinephrine Reuptake Inhibitor) · Serotonin-Norepinephrine Reuptake Inhibitor (SNRI)

Forms

extended-release capsule, immediate-release tablet

Brand names

Effexor (US) · Dislaven Retard (ES) · Efexor (FR)

Overall confidence

medium

Regulatory sources consulted

aemps-cima-ft-69149
CredibleMeds.org
Flockhart Table
Clinical Pharmacology Knowledge
RxNorm rxcui 39786 ↗

Approved indications

Treatment of major depressive episodes.
Prevention of recurrences of major depressive episodes.
Treatment of generalized anxiety disorder.
Treatment of social anxiety disorder (social phobia).
Treatment of panic disorder, with or without agoraphobia.

Contraindications

Absolute

Hypersensitivity to the active substance or to any of the excipients.
Concomitant treatment with irreversible monoamine oxidase inhibitors (MAOIs).

Clinical warnings

Boxed warning · Risk of suicidal thoughts and behavior, especially in children, adolescents, and young adults. — FDA
Major warning · Serotonin Syndrome: Increased risk with concomitant use of other serotonergic agents (triptans, other antidepressants, fentanyl, lithium, tramadol, etc.). — AEMPS SPC
Increase in blood pressure: Dose-related sustained increase in blood pressure has been observed. Blood pressure should be monitored regularly. — AEMPS SPC

Drug interactions

HighMonoamine Oxidase Inhibitors (MAOIs)N06AF
Mechanism: Synergistic increase in serotonin, norepinephrine, and dopamine levels, with a high risk of potentially fatal serotonin syndrome.
Recommendation: Contraindicated. Wait at least 14 days after stopping an irreversible MAOI before starting venlafaxine. Wait at least 7 days after stopping venlafaxine before starting an MAOI.
AEMPS SPC
HighLinezolidJ01XX08
Mechanism: Linezolid is a reversible, non-selective MAO inhibitor. Co-administration increases the risk of serotonin syndrome.
Recommendation: Contraindicated. If treatment is unavoidable, stop venlafaxine and monitor the patient closely.
AEMPS SPC

Adverse events

Common (≥1%)

nausea · dry mouth · headache · sweating · dizziness · insomnia · constipation · asthenia

Rare but serious

serotonin syndrome · hyponatremia · seizures · QT interval prolongation · hemorrhage · angle-closure glaucoma · rhabdomyolysis

Pregnancy and lactation

FDA category: C (US, deprecated)

Should not be used during pregnancy unless the expected benefit outweighs the potential risks. Use in the third trimester may cause neonatal withdrawal syndrome and/or persistent pulmonary hypertension of the newborn (PPHN). It is excreted in breast milk; a decision must be made whether to discontinue breastfeeding or discontinue therapy.