Venlafaxine Hydrochloride (Antidepressant) Flashcards
What is the brand name of venlafaxine hydrochloride?
Effexor and Effexor XR
What strength tablets of Effexor are available?
25 mg, 37.5 mg, 50 mg, 75 mg, 100 mg
What strength extended release tablets of Effexor XR are available?
37.5 mg, 75 mg, 150 mg, 225 mg
I what strength extended release capsules are available of Effexor XR?
37.5 mg, 75 mg, 150 mg
What are the FDA approved indications for venlafaxine hydrochloride?
For the treatment of depression, generalized anxiety disorder (XR), social anxiety disorder (XR)
What dose of venlafaxine hydrochloride is used for the treatment of depression?
Start with 75 mg per day administered in a single dose (XR) or 2 to 3 divided toast (tablets), taken with food. The dose may be increased to 150 mg per day. If needed, the dose should be further increased up to 225 mg per day. When increasing the dose, increments of up to 75 mg per day should be made at intervals of no less than four days. Certain patients, including some more severely depressed patients, may respond to higher doses, up to a maximum of 375 mg per day.
What dose a Effexor XR is used for the treatment of generalized anxiety disorder?
Start with 37.5 mg per day. Maintenance dosage is usually 75 to 225 mg per day.
What dose of venlafaxine hydrochloride is used for the treatment of social anxiety disorder?
Start with 75 mg once a day. Maintenance dose range is 75 to 225 mg per day.
What adjustments should be made to venlafaxine dosing in patients with hepatic and renal impairments?
Hepatic: Reduce the total daily dose by 50% and patient with moderate hepatic impairment.
Renal: reduce the total daily dose by 25% and patient with mild to moderate renal impairment.
What should the providers monitor when their patients are taking venlafaxine hydrochloride?
Blood pressure, sodium, Intensive Outpatient Treatment
What is the mechanism of action of venlafaxine hydrochloride?
The mechanism of action of venlafaxine is believed to be associated with this potentiation of neurotransmitter activity in the CNS.
What are the drug interactions of Effexor?
Venlafaxine in combination with MAO inhibitor’s has resulted in serious, sometimes fatal reactions. The use of other CNS active drugs, including anti-histamines, should be approached with caution. Coadministration with aspirin or an NSAID may increase the risk of upper G.I. bleed.
What are the contraindications to venlafaxine hydrochloride?
- It is recommended that venlafaxine not be used in combination with an MAOI, or within 14 days of discontinuing treatment with an MAOI. At least one week should be allowed after stopping venlafaxine before starting an MAOI.
- Antidepressants increase suicidal thoughts and actions and children, adolescents, and young adults.
- Use with caution in patients with pre-existing hypertension. For patients who experience a sustained increase in blood pressure while receiving venlafaxine, either dose reduction or discontinuation should be considered.
- As with all antidepressants, caution should be used in patients with a history of mania.
- Venlafaxine should be used cautiously in patients with a history of seizures.
- In patients with renal impairment or cirrhosis of the liver, the clearances to venlafaxine and it’s active metabolite or decreased, that’s prolonging the elimination half lives of these substances.
- In patients who have received extended-release forms for six weeks or more should have their dose tapered over at least a two week period if therapy is discontinued.
- Not indicated for use in pediatric patients.
- Pregnancy Category C
What are the adverse effects of Effexor?
The most common adverse effects include nausea, dry mouth, anorexia, constipation, drowsiness, insomnia, dizziness, nervousness, abnormal ejaculation, sweating, impotence, decreased libido, and yawning
What should the pharmacist tell the patient counseling them on the use of venlafaxine?
- Avoid alcohol while taking this medication.
- Patient should be advised to inform their physician if they are taking, or plan to take, any prescription or OTC drugs since there’s potential for interactions.
- Swallow capsules whole, do not crush, chew, dissolve, or divide.
- Pay close attention to any changes, especially sudden changes, and mood behaviors, thoughts, or feelings. Antidepressants may increase suicidal thoughts or actions. - Continued therapy of up to two weeks may be needed to show noticeable improvement.
