Effexor 25mg Tablets

Venlafaxine and its active metabolite, O-desmethylvenlafaxine (ODV), are potent inhibitors of neuronal serotonin and norepinephrine reuptake and weak inhibitors of dopamine reuptake. The antidepressant and anxiolytic effects are believed to be associated with the potentiation of neurotransmitter activity in the central nervous system.

Urgent Side Effects: Seek Medical Help Right Away

Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek medical attention immediately:

Signs of an allergic reaction: rash, hives, itching, red, swollen, blistered, or peeling skin (with or without fever), wheezing, tightness in the chest or throat, trouble breathing, swallowing, or talking, unusual hoarseness, or swelling of the mouth, face, lips, tongue, or throat
Signs of low sodium levels: headache, difficulty focusing, memory problems, confusion, weakness, seizures, or changes in balance
Signs of bleeding: vomiting or coughing up blood, vomit that resembles coffee grounds, blood in the urine, black, red, or tarry stools, bleeding from the gums, abnormal vaginal bleeding, unexplained bruises or bruises that enlarge, or uncontrolled bleeding
Signs of high blood pressure: severe headache or dizziness, fainting, or changes in vision
Seizures
Chest pain or pressure
Shortness of breath
Cough
Bone pain
Sexual problems, including decreased libido, difficulty achieving orgasm, ejaculation problems, or erectile dysfunction

A potentially life-threatening condition called serotonin syndrome may occur, especially if you are taking other medications. Seek medical help immediately if you experience:
Agitation
Changes in balance
Confusion
Hallucinations
Fever
Abnormal or rapid heartbeat
Flushing
Muscle twitching or stiffness
Seizures
Shivering or shaking
Excessive sweating
Severe diarrhea, nausea, or vomiting
Severe headache

Other Possible Side Effects

Most medications can cause side effects, but many people experience none or only mild symptoms. If you are bothered by any of the following side effects or if they persist, contact your doctor or seek medical attention:

Difficulty sleeping
Feeling nervous, anxious, or excitable
Anxiety
Weight loss
Dizziness, drowsiness, fatigue, or weakness
Shakiness
Headache
Excessive sweating
Constipation, diarrhea, nausea, vomiting, or decreased appetite
Gas
Dry mouth
Vivid or unusual dreams
Yawning

This list is not exhaustive, and you may experience other side effects. If you have questions or concerns, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.

Before Taking This Medication: Important Information to Share with Your Doctor

It is essential to inform your doctor about the following conditions and situations to ensure safe treatment:

Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Describe the allergic reactions you have experienced.
If you have high blood pressure, as this medication may affect your condition.
If you have narrow-angle glaucoma, a condition that affects the eyes.
If you are taking a weight loss drug, as this may interact with the medication.
* If you are taking or have recently taken certain medications, including:
+ Linezolid or methylene blue, as these can cause serious interactions.
+ Certain drugs for depression or Parkinson's disease, such as isocarboxazid, phenelzine, tranylcypromine, selegiline, or rasagiline, within the last 14 days. This is crucial because combining these medications can lead to very high blood pressure.

This list is not exhaustive, and it is crucial to disclose all your medications, including prescription and over-the-counter drugs, natural products, and vitamins, as well as any health problems you have. Your doctor and pharmacist need this information to assess the safety of taking this medication with your other treatments and health conditions. Never start, stop, or change the dose of any medication without consulting your doctor first.

It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. This will help ensure your safety and prevent any potential interactions with other treatments.

Before engaging in activities that require your full attention, such as driving, wait until you understand how this medication affects you. This will help you avoid accidents and ensure your safety.

Do not abruptly stop taking this medication without consulting your doctor, as this may increase your risk of experiencing side effects, some of which can be severe and long-lasting. If you need to discontinue this medication, your doctor will provide guidance on how to gradually stop taking it. Be sure to discuss any new or worsening symptoms with your doctor.

Regular blood pressure checks are crucial while taking this medication, as it may cause high blood pressure. Follow your doctor's instructions for monitoring your blood pressure.

It is recommended that you avoid consuming alcohol while taking this medication. Additionally, consult your doctor before using marijuana, cannabis, or any prescription or over-the-counter medications that may cause drowsiness.

This medication may increase your risk of bleeding, which can be life-threatening in some cases. Discuss this risk with your doctor.

If you have bipolar disorder, be aware that this medication may trigger manic episodes. Contact your doctor immediately if you experience symptoms of a manic episode.

Some individuals may be at a higher risk of developing eye problems while taking this medication. Your doctor may recommend an eye exam to assess your risk. If you experience eye pain, changes in vision, or swelling and redness in or around the eye, seek medical attention promptly.

This medication may cause low blood sodium levels, which can be fatal in severe cases. Discuss this risk with your doctor.

High cholesterol has been reported in some individuals taking this medication. If you have concerns, consult your doctor.

This medication may affect the results of certain laboratory tests. Inform all your healthcare providers and laboratory personnel that you are taking this medication.

If you are 65 or older, use this medication with caution, as you may be more susceptible to side effects.

In some cases, this medication may affect growth in children and adolescents. Regular growth checks may be necessary. Discuss this with your doctor.

If you are pregnant, planning to become pregnant, or breastfeeding, inform your doctor. You will need to discuss the potential benefits and risks of taking this medication during pregnancy or breastfeeding. Taking this medication in mid to late pregnancy may increase the risk of health problems for both the mother (such as postpartum bleeding) and the newborn.

• Monoamine Oxidase Inhibitors (MAOIs) (concurrent use or within 14 days of discontinuing MAOI or venlafaxine due to risk of serotonin syndrome)
• Linezolid (reversible non-selective MAOI)
• Methylene blue (reversible non-selective MAOI)

• Other serotonergic drugs (e.g., SSRIs, SNRIs, triptans, fentanyl, tramadol, tryptophan, buspirone, St. John's Wort) - increased risk of serotonin syndrome
• Drugs that prolong the QT interval (e.g., Class IA and III antiarrhythmics, antipsychotics, macrolide antibiotics) - theoretical risk of QT prolongation
• Anticoagulants/Antiplatelets (e.g., warfarin, aspirin, NSAIDs) - increased risk of bleeding
• CYP2D6 inhibitors (e.g., quinidine, fluoxetine, paroxetine) - may increase venlafaxine levels and ODV levels (less pronounced effect on ODV)
• CNS depressants (e.g., alcohol, benzodiazepines, opioids) - additive CNS depression

• Cimetidine (may inhibit first-pass metabolism of venlafaxine, particularly in poor CYP2D6 metabolizers)
• Ketoconazole (CYP3A4 inhibitor, may increase venlafaxine and ODV levels)
• Metoprolol (venlafaxine may increase metoprolol AUC and Cmax)
• Haloperidol (venlafaxine may increase haloperidol AUC and Cmax)
• Imipramine/Desipramine (venlafaxine may increase plasma levels of imipramine and desipramine)

• Not specifically categorized as minor, but general caution with drugs affecting blood pressure or heart rate.

• Worsening depression
• Suicidal thoughts or behavior
• Unusual changes in behavior (e.g., agitation, irritability, hostility, impulsivity)
• Anxiety
• Panic attacks
• Insomnia
• Akathisia (restlessness)
• Hypomania or mania
• Serotonin syndrome symptoms (e.g., agitation, hallucinations, delirium, tachycardia, labile blood pressure, hyperthermia, hyperreflexia, incoordination, nausea, vomiting, diarrhea)
• Bleeding (e.g., bruising, petechiae, GI bleeding)
• Symptoms of hyponatremia (e.g., headache, confusion, weakness, seizures)
• New or worsening visual problems (e.g., eye pain, blurred vision, halos around lights)

Use during pregnancy should be considered only if the potential benefit justifies the potential risk to the fetus. Exposure during late pregnancy may lead to complications in the neonate requiring prolonged hospitalization, respiratory support, and tube feeding. These complications can arise immediately upon delivery and are consistent with a direct toxic effect of SSRIs/SNRIs or, possibly, a drug discontinuation syndrome.

Venlafaxine and its active metabolite (ODV) are excreted into breast milk. The decision to breastfeed should consider the developmental and health benefits of breastfeeding, the mother’s clinical need for venlafaxine, and any potential adverse effects on the breastfed infant from venlafaxine or from the underlying maternal condition. Monitor infants for sedation, poor feeding, and poor weight gain.

Not approved for use in pediatric patients for MDD due to increased risk of suicidality. Safety and efficacy have not been established. Use in other pediatric indications is off-label and generally not recommended.

Use with caution in elderly patients due to increased risk of hyponatremia/SIADH, falls, and potential for greater sensitivity to side effects (e.g., dizziness, orthostatic hypotension). Lower starting doses and slower titration may be appropriate. Monitor renal function.

• Venlafaxine is an SNRI, meaning it affects both serotonin and norepinephrine. At lower doses, it primarily acts as an SSRI; at higher doses, norepinephrine reuptake inhibition becomes more prominent.
• Extended-release (XR) formulation is generally preferred due to once-daily dosing and potentially better tolerability compared to immediate-release (IR) due to more stable plasma levels.
• Discontinuation syndrome is common and can be severe if venlafaxine is stopped abruptly. Tapering should be slow and gradual, typically over several weeks to months, depending on dose and duration of treatment.
• Monitor blood pressure regularly, especially during dose escalation, as venlafaxine can cause sustained hypertension in a dose-dependent manner.
• Be vigilant for symptoms of serotonin syndrome, especially when co-administered with other serotonergic agents.
• The 25mg tablet is an immediate-release formulation, typically used for initial titration or in divided doses. Most patients are transitioned to higher doses or the XR formulation.

• Other SNRIs (e.g., Duloxetine, Desvenlafaxine, Levomilnacipran)
• SSRIs (e.g., Fluoxetine, Sertraline, Paroxetine, Citalopram, Escitalopram)
• Atypical Antidepressants (e.g., Bupropion, Mirtazapine, Vortioxetine, Vilazodone)
• Tricyclic Antidepressants (TCAs) (e.g., Amitriptyline, Nortriptyline)
• MAOIs (e.g., Phenelzine, Tranylcypromine, Selegiline)
• Psychotherapy (e.g., Cognitive Behavioral Therapy - CBT)

If your symptoms or health issues persist or worsen, it is essential to contact your doctor promptly. To ensure safe use, never share your medication with others or take someone else's medication. This medication is accompanied by a Medication Guide, which provides crucial information for patients. Please read this guide carefully and review it again whenever you receive a refill. If you have any questions or concerns about this medication, consult your doctor, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek emergency medical attention. When reporting the incident, be prepared to provide details about the medication taken, the quantity, and the time it occurred.