Effexor XR

Effexor XR is a prescription medication used to treat adults with major depressive disorder, panic disorder, and anxiety. It belongs to a class of drugs called serotonin norepinephrine reuptake inhibitors (SNRIs). These work by increasing serotonin and norepinephrine levels, which are natural substances in the brain that help maintain mental balance.

Effexor XR is available as an extended-release capsule and is usually taken once a day, with food. Capsules should be taken whole; do not divide, crush, chew, or dissolve capsules.

Common side effects of Effexor XR include dry mouth, insomnia, loss of appetite, and dizziness. Do not drive or operate heavy machinery until you know how Effexor XR will affect you.

Effexor XR is a prescription medication used to treat adults with depression, anxiety disorders, and panic disorder.

• Wyeth Pharmaceuticals Company, a subsidiary of Pfizer Inc.

Effexor XR may cause serious side effects. See "Drug Precautions".

Common side effects include:

• unusual dreams
• sexual problems
• loss of appetite, constipation, diarrhea, nausea or vomiting, or dry mouth
• feeling tired, fatigued or overly sleepy
• change in sleep habits, problems sleeping
• yawning
• tremor or shaking
• dizziness, blurred vision
• sweating
• feeling anxious, nervous or jittery
• headache
• increase in heart rate

This is not a complete list of Effexor XR side effects. Ask your doctor or pharmacist for more information.

Tell your doctor about all the medicines you are taking including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you are taking:

• MAOIs such as isocarboxazid and phenelzine 
• Alcohol 
• Fluoxetine 
• Citalopram 
• Sertraline 
• Amitriptyline 
• Doxepin 
• Lithium 
• Tramadol 
• Indinavir 
• Ketoconazole 
• Cimetidine

This is not a complete list of Effexor XR drug interactions. Ask your doctor or pharmacist for more information.

1. Suicidal thoughts or actions:

• Effexor XR and other antidepressant medicines may increase suicidal thoughts or actions in some children, teenagers, or young adults within the first few months of treatment or when the dose is changed.
• Depression or other serious mental illnesses are the most important causes of suicidal thoughts or actions.
• Watch for these changes and call your healthcare provider right away if you notice:
  • New or sudden changes in mood, behavior, actions, thoughts, or feelings, especially if severe.
  • Pay particular attention to such changes when Effexor XR is started or when the dose is changed.
  
  Keep all follow-up visits with your healthcare provider and call between visits if you are worried about symptoms.
  
  Call your healthcare provider right away if you have any of the following symptoms, or call 911 if an emergency, especially if they are new, worse, or worry you:
  • attempts to commit suicide
  • acting on dangerous impulses
  • acting aggressive or violent
  • thoughts about suicide or dying
  • new or worse depression
  • new or worse anxiety or panic attacks
  • feeling agitated, restless, angry or irritable
  • trouble sleeping
  • an increase in activity or talking more than what is normal for you
  • other unusual changes in behavior or mood
  • Visual problems (eye pain, changes in vision, swelling or redness in or around the eye). Only some people are at risk for these problems. You may want to undergo an eye examination to see if you are at risk and receive preventative treatment if you are.

Call your healthcare provider right away if you have any of the following symptoms, or call 911 if an emergency. Effexor XR may be associated with these serious side effects:

2. Serotonin Syndrome: This condition can be life-threatening and may include:

• agitation, hallucinations, coma or other changes in mental status
• coordination problems or muscle twitching (overactive reflexes)
• racing heartbeat, high or low blood pressure
• sweating or fever
• nausea, vomiting, or diarrhea
• muscle rigidity

3. Changes in blood pressure. Effexor XR may increase your blood pressure. Control high blood pressure before starting treatment and monitor blood pressure regularly

4. Enlarged pupils (mydriasis).

5. Anxiety and insomnia.

6. Changes in appetite or weight.

7. Manic/hypomanic episodes:

• greatly increased energy
• severe trouble sleeping
• racing thoughts
• reckless behavior
• unusually grand ideas
• excessive happiness or irritability
• talking more or faster than usual

8. Low salt (sodium) levels in the blood. Elderly people may be at greater risk for this. (Symptoms may include headache, weakness or feeling unsteady, confusion, problems concentrating or thinking or memory problems)

9. Seizures or convulsions.

10. Abnormal bleeding: Effexor XR and other antidepressant medicines may increase your risk of bleeding or bruising, especially if you take the blood thinner warfarin (Coumadin, Jantoven), a non-steroidal anti-inflammatory drug (NSAIDs, like ibuprofen or naproxen), or aspirin.

11. Elevated cholesterol.

12. Lung disease and pneumonia: Effexor XR may cause rare lung problems. Symptoms include:

• worsening shortness of breath
• cough
• chest discomfort

13. Severe allergic reactions:

• trouble breathing
• swelling of the face, tongue, eyes or mouth
• rash, itchy welts (hives) or blisters, alone or with fever or joint pain.

Do not stop Effexor XR without first talking to your healthcare provider. Stopping Effexor XR too quickly or changing from another antidepressant too quickly may cause serious symptoms including:

• anxiety, irritability
• feeling tired, restless or problems sleeping
• headache, sweating, dizziness
• electric shock-like sensations, shaking, confusion, nightmares
• vomiting, nausea, diarrhea

Do not take Effexor XR if:

• you have a history of mania, seizures, or kidney problems
• have uncontrolled angle-closure glaucoma
• take a Monoamine Oxidase Inhibitor (MAOI). Ask your healthcare provider or pharmacist if you are not sure if you take an MAOI, including the antibiotic linezolid.
  • Do not take an MAOI within 7 days of stopping Effexor XR unless directed to do so by your physician.
  • Do not start Effexor XR if you stopped taking an MAOI in the last 2 weeks unless directed to do so by your physician.

Effexor XR may make you drowsy. Do not drive or operate heavy machinery until you know how this medication affects you. Do not drink alcohol while using Effexor XR.

Medicines can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of Effexor XR there are no specific foods that you must exclude from your diet when receiving Effexor XR.

Before receiving this medication, tell your doctor about all your medical conditions especially:

• have heart problems
• have diabetes
• have liver problems
• have kidney problems
• have thyroid problems
• have or had seizures or convulsions
• have bipolar disorder or mania
• have low sodium levels in your blood
• have high blood pressure
• have high cholesterol
• have or had bleeding problems
• are pregnant or plan to become pregnant. It is not known if Effexor XR will harm your unborn baby. Talk to your healthcare provider about the benefits and risks of treating depression during pregnancy
• are breast-feeding or plan to breast-feed. Some Effexor XR may pass into your breast milk. Talk to your healthcare provider about the best way to feed your baby while taking Effexor XR.

Tell your doctor about all the medicines you take or are planning to take including prescription and non-prescription medicines, vitamins, and herbal supplements.

Tell your doctor if you are pregnant, planning to become pregnant or breastfeeding.

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

This medication falls into category C. In animal studies, pregnant animals were given this medication and had some babies born with problems. No well-controlled studies have been done in humans. Therefore, this medication may be used if the potential benefits to the mother outweigh the potential risks to the unborn child.

Tell your doctor if you are breastfeeding or planning to breastfeed. Effexor XR may be excreted in human breast milk and may harm your nursing baby.

Take Effexor XR exactly as prescribed. Your healthcare provider may need to change the dose of Effexor XR until it is the right dose for you.

• Effexor XR is to be taken with food.
• If you miss a dose of Effexor XR, take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and take your next dose at the regular time. Do not take two doses of Effexor XR at the same time.
• If you take too much Effexor XR, call your healthcare provider or poison control center right away, or get emergency treatment.
• When switching from another antidepressant to Effexor XR your doctor may want to lower the dose of the initial antidepressant first to avoid side effects

Take Effexor XR exactly as your doctor prescribes it. Follow the directions on your prescription label carefully. The dose will depend on several factors including the condition being treated, response to the medicine, and how well the medicine is tolerated.

The recommended target dose for Effexor XR is 75 mg/day. 

The usual starting dose range is 37.5 mg- 75 mg per day. 

The recommended maximum daily dose is 225 mg for patients being treated for major depressive disorder, generalized anxiety disorder, and panic disorder. 

The recommended maximum daily dose is 75 mg for patients being treated for social anxiety disorder.

If you take too much Effexor XR call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away.

If Effexor XR is administered by a healthcare provider in a medical setting, it is unlikely that an overdose will occur. However, if overdose is suspected, seek emergency medical attention.

• Store at controlled room temperature.
• Keep all medications out of the reach of children.

WARNING: SUICIDAL THOUGHTS AND BEHAVIORS

Antidepressants increased the risk of suicidal thoughts and behavior in children, adolescents, and young adults in short-term studies. These studies did not show an increase in the risk of suicidal thoughts and behavior with antidepressant use in patients over age 24; there was a reduction in risk with antidepressant use in patients aged 65 and older.

In patients of all ages who are started on antidepressant therapy monitor closely for clinical worsening and emergence of suicidal thoughts and behaviors. Advise families and caregivers of the need for close observation and communication with the prescriber.