Venlafaxine Hydrochloride is a serotonin and norepinephrine reuptake inhibitor (SNRI) indicated for the treatment of:

• Major Depressive Disorder (MDD)
• Generalized Anxiety Disorder (GAD)
• Social Anxiety Disorder (SAD)
• Panic Disorder (PD)

The antidepressant effect of venlafaxine is believed to be associated with enhancement of neurotransmitter activity in the central nervous system (CNS). Venlafaxine and its active metabolite O-desmethylvenlafaxine (ODV) are potent inhibitors of serotonin and norepinephrine reuptake, and weak inhibitors of dopamine reuptake. They show no significant affinity for muscarinic, histaminergic, or α1-adrenergic receptors in vitro. These receptor activities are typically associated with anticholinergic, sedative, and cardiovascular effects seen with other psychotropic drugs. Venlafaxine and ODV do not inhibit monoamine oxidase (MAO).

Depression: Initially 75 mg daily in 2 divided doses. Can be increased if necessary after several weeks to 150 mg daily in 2 divided doses.

Severely depressed or hospitalized patients: Initially 150 mg daily in 2 divided doses. Can be increased if necessary in steps of up to 75 mg every 2-3 days to max. 376 mg daily then gradually reduced.

Generalised anxiety disorder: 75 mg daily as a single dose.”

Venlafaxine should not be used concomitantly with MAO inhibitors (MAOIs). Cimetidine may inhibit the hepatic metabolism of venlafaxine, increasing its levels.

Hypersensitivity to venlafaxine hydrochloride or any excipients, Severe hepatic impairment, Severe renal impairment, Pregnancy and breastfeeding.

Most commonly reported side effects include nausea, headache, insomnia, dry mouth, dizziness, constipation, sweating, nervousness, and asthenia. Orthostatic hypotension may occur occasionally. Other reported effects include anorexia, dyspepsia, abdominal pain, anxiety, sexual dysfunction, visual disturbances, vasodilation, vomiting, tremor, chills, palpitations, agitation, rashes, seizures, and hypertension.

Use with caution in patients with a history of myocardial infarction or unstable heart disease. Blood pressure monitoring is recommended if the dose exceeds 200 mg daily. Caution is advised in patients with epilepsy, mania, hepatic or renal impairment. Abrupt withdrawal should be avoided; if treatment is used for more than 1 week, discontinuation should be done gradually over at least 1 week. Use with caution in patients with glaucoma.

Use with caution in patients with: History of myocardial infarction or unstable cardiac disease, Seizure disorders, Hypomania or mania, Increased intraocular pressure or risk of acute narrow-angle glaucoma, Increased risk of bleeding, Renal or hepatic impairment. Gradual dose reduction is recommended instead of abrupt withdrawal. Caution is required during pregnancy and lactation. Patients should be advised that the medicine may impair the ability to drive or operate machinery.

Serotonin-norepinephrine reuptake inhibitor (SNRI)

Store below 30°C in a dry place, protected from light. Keep out of reach of children.