About Effexor
This bicyclic antidepressant is favored for its milder side effect
profile as compared to traditional tricyclic antidepressants, and
tends to work more quickly than other depression treatments. Effexor
works in the central nervous system by making the neurotransmitters
serotonin, norepinephrine, and dopamine, more availailable to the
brain. This effect is considered responsible for stabilization of
mood and thought patterns.
Effexor has been found to be an effective treatment for the following
conditions. An unlabeled condition is one which the manufacturer
does not specify, but which clinical experience has shown the medication
to be useful for:
- Chronic Fatigue Syndrome (unlabeled)
- Depression, and prevention of relapses into depression
- Depression in children with ADHD (unlabeled)
- Generalized Anxiety Disorder
- Hot Flash reduction in cancer patients and post-menopausal women
(unlabeled, may take several weeks for full effect)
- Major Depression
- Obsessive Compulsive Disorder (unlabeled)
It may take up to two weeks for Effexor to provide its full benefits,
and its actions require a steady blood level to work properly. Adhering
to a regular daily dosage schedule is recommended.
Effexor is only available by prescription.
Effexor Side Effects
Common Effexor Side Effects: Anxiety, constipation, decreased
appetite, diarrhea, drowsiness, dry mouth, excessive sweating, fatigue,
gas, heartburn, insomnia, nausea, nervousness, rhinitis, shaking,
stomach cramping, tingling sensations, trembling, unusual dreams,
vomiting, weakness, or weight loss. These side effects are generally
mild and go away with continued use. They do not usually indicate
any serious reaction, though you may want to speak to your doctor
if they bother you.
Less Common Side Effects: Altered sense of taste, excessive
yawning, tense muscles. These side effects are generally mild and
go away with continued use. They do not usually indicate any serious
reaction, though you may want to speak to your doctor if they bother
you.
Serious Effexor Side Effects: Altered or blurred vision,
chest pain, decreased libido, headache, high blood pressure, irregular
or racing heartbeat, ringing in ears, or severe changes in mood
or mental state. Speak with your doctor as soon as possible if you
experience any of these symptoms.
Rare and Serious Side Effects: Difficulty with urination,
dizziness or fainting when standing or getting up, itching or rash,
lockjaw, menstrual irregularity, seizures, or swelling. Seek medical
treatment immediately if you should experience these symptoms.
Overdose may be indicated by more than one of the following:
convulsions, drowsiness, extreme agitation, extreme fatigue or weakness,
racing heartbeat, severe tingling sensations like you would experience
when your foot 'fell asleep', shaking, trembling.
Serotonin Syndrome - This rare side effect is possible with
medications which affect serotonin levels, usually antidepressants.
Some medications which only mildly affect serotonin metabolism on
their own, or interfere with the metabolism of an antidepressant,
may also increase the risk of this syndrome in combination with
a medication like Effexor. The symptoms include agitation, confusion,
diarrhea, fever, lack of coordination, shaking, shivering, sweating,
trembling , twitching, or uncontrollable excitement. If you experience
several of these symptoms at the same time, seek medical attention
at once. If you cannot be taken to a hospital or doctor immediately,
call 911 for instructions and help.
Cautions: Effexor may not be right for everyone. Speak to
your doctor about a history of any of the following conditions so
that they can evaluate whether or not this treatment will be safe
and effective for you.
- Allergy: Any allergic reaction to Effexor in the past,
or while taking it, is a contraindication for continued use. Also
inform your physician of any other food or drug allergies you
may have experienced in the past.
- Brain Damage, Disease, or Retardation: You may be at
an increased risk for seizure.
- Heart Disease or High Blood Pressure: Effexor may increase
blood pressure, worsening these conditions. Your doctor may not
consider this treatment to be safe.
- Hyperlipidemia: Patients with high lipid levels will
have to be evaluated on an individual basis.
- Insomnia: If you are prone to insomnia, this medication
may worsen the condition, though your doctor may be able to alleviate
the effects.
- Kidney or Liver Disease: Effexor will clear from the
body far more slowly, and starting doses of 50-75% less than the
standard dosage may be recommended. Do not use alcohol during
treatment.
- Mania: Increases the risk of mania in hypomania, manic
depression, or bipolar disorder.
- Pregnancy: If you are pregnant, or plan to become pregnant,
your doctor may advise against treatment.
- Seizure: Effexor may increase the risk of seizure in
individuals who are predisposed to them.
- Suicidal Tendencies: As with many other depression medications,
caution is strongly advised in individuals with a history of suicide
attempts or suicidal thoughts.
- Surgery: Advise your surgeon or dentist in advance that
you take Effexor. This medication may interact with certain drugs
given in surgery, particularly anesthesia.
- Underweight: Effexor commonly causes minor weight loss.
This may be dangerous for individuals suffering from anorexia,
bulimia, experiencing a disease that causes wasting (like AIDS),
or treatment process (like chemotherapy) that causes extreme weight
loss or loss of appetite. Be cautious if you are recovering from
any long illness or infection, and your doctor has told you that
you need to gain weight.
Effexor Interactions
Effexor may have interactions with certain medications, with the
likelihood of undesirable side effects from either treatment possibly
increased. This medication is active in the central nervous system
(CNS). Use it cautiously with other medications that have CNS effects,
like mood enhancement, drowsiness, excitability, relaxation, slowed
reactions, or altered perceptions. Speak to your doctor about mixing
this medication with herbal and over the counter treatments as well,
since not all of these are safe to combine with Effexor.
If you take, or plan to take, any of the following during your
Effexor treatment, speak with your prescribing physician or your
pharmacist. Some drugs are not safe to mix at all, and some may
require dosage adjustments to avoid increased side effects.
- Alchohol - May accelerate CNS depression, resulting in greater
drowsiness. Do not drink heavily, or daily, while using this medication.
If you take multiple medications which are processed through the
liver, do not drink while taking Effexor. Speak to your doctor
for personalized guidelines during treatment, as some individuals
may need to avoid alcohol completely.
- Ambien (zolpidem)- Increased
risk of hallucinations. These medications should never be used
together.
- Antiseizure medication like Dilantin (phenytoin) may build up
in the body when combined with Effexor.
- Beta Blockers - The side effects of these medications may be
increased by Effexor treatment, as it may prevent the clearing
of beta blockers from the body.
- BuSpar (buspirone) -
Increased risk of dangerous side effects like serotonin syndrome.
Speak to your doctor regarding a safe waiting period between taking
these medications.
- Calcium Channel Blockers - Toxicity from these drugs may result,
as Effexor may block their removal through the liver.
- Cold medications containing Dextromethorphan - Use only with
the advice of your doctor, as toxicity from either drug may result.
- Coumadin (warfarin) - May
result in excessive bleeding.
- Desyrel (trazodone)- Increases
the risk of serotonin syndrome.
- Gingko Biloba - This herb may act as an MAO inhibitor, and should
not be used at all during treatment with Effexor.
- Ginseng (any variety) - This herb may act as an MAO inhibitor,
and should not be used at all during treatment with Effexor.
- Lithium (Eskalith, etc.) - These medications should not be mixed,
consult your doctor regarding a minimum safe waiting period.
- Manarex (moclobemide) - Do not use these medications within
3 days of each other, consult your doctor regarding safe usage.
- MAO inhibitors - Effexor must never be mixed with MAO (monoamine
oxidase) inhibitors, a class of antidepressants and antisenility
drugs, such as Eldepryl (selegiline), Furoxone (furazolidone),
Nardil (phenelzine), Marplan (isocarboxazid), or Parnate (tranylcypromine).
Never use Effexor within 14 days of starting or stopping an
MAO inhibitor. Patients over 65 should allow a longer wait
period between using Effexor and an MAO, as medications may stay
in their system longer than in other patients. This drug combination
could cause dangerous increases in blood pressure, tremor, hyperthermia
(fever), seizure, and possibly death.
- Meridia (sibutramine)
- Increases the risk of toxicity and serotonin syndrome from Effexor.
Avoid this combination entirely.
- Migraine medications of the triptan class such as Amerge
(naratriptan), Imitrex
(sumatriptan), Maxalt (rizatriptan), or Zomig (zolmitriptan)
can cause coordination difficulties or weakness when mixed with
Effexor. Avoid this combination.
- Muscle relaxants such as Flexeril
(cyclobenzaprine), Norflex
(orphenadrine), Skelaxin
(metaxalone), Soma (carisoprodol),
or Robaxin (methocarbamol)
may cause oversedation in combination with this medication.
- Narcotic pain medication like Codeine, Demerol
(meperidine), Buprenex (buprenorphine), Darvon (propoxyphene),
Dilaudid (hydromorphone), MS Contin or Kadian (morphine), nalbuphine,
OxyContin (oxycodone),
Percocet (oxycodone and
acetaminophen), Stadol (butorphanol), Talwin compound (pentazocine),
or Vicodin (hydrocodone and
acetaminophen), Vicoprofen
(hydrocodone and ibuprofen) may increase the CNS depressant
effects of Effexor. Demerol and Talwin may increase the risk of
serotonin syndrome. Consult your doctor for advice on how to take
these medications together safely.
- Norvir (ritonavir) - Toxic buildups of Effexor may occur.
- Parlodel (bromocriptine) - Increases the risk of serotonin syndrome.
- Quinaglute (quinadine) - Toxic buildups of Effexor may occur.
- Ritalin (methylphenidate)
- Selective serotonin reuptake inhibitors (SSRIs) like Celexa
(citalopram), Paxil (paroxetine),
Prozac (fluoxetine), Luvox (fluvoxamine), or Zoloft (sertraline)
should not be mixed with Effexor. They may increase the risk of
serious side effects like serotonin syndrome, which is dangerous
and potentially life-threatening. A period of 14 days is generally
a sufficient wait, though this may vary between patients. A five
week wait may be recommended between treatment with Prozac and
Effexor.
- Sinemet (carbidopa, levodopa) - Increased risk of serotonin
syndrome.
- Street drugs such as LSD, Ecstasy (MDMA), or marijuana. These
drugs also affect serotonin levels in the brain and may react
strongly with a serotonin reuptake inhibitor like Effexor. Do
not combine.
- Tagamet (cimetidine) - May cause Effexor to build up to toxic
levels.
- Tikosyn (dofetilide) - Toxicity of this medication may result
from combination with Effexor.
- Tricyclic antidepressants such as Elavil
(amitriptyline), Asendin (amoxapine), Anafranil (clomipramine),
Pertofrane or Norpramin (desipramine), Sinequan
(doxepin), Tofranil (imipramine), Aventyl or Pamelor (nortriptyline),
Vivactil (protriptyline), and Surmontil (trimipramine), may be
blocked from removal by the liver when used with Effexor. This
could lead to increased risk of undesirable side effects.
- Tryptophan or 5-HTP (Contained in certain amino acid supplements
or by itself) - This supplement may increase the risk of serotonin
syndrome when mixed with Prozac.
- Ultram (tramadol) - Increased
risk of seizures.
Sedative medications, any drug that makes you drowsy or slows your
reaction time, may cause oversedation in combination with Effexor.
If you currently take muscle relaxants, sleep aids, tranquilizers,
antihistamines, cold medication, or any other drug which makes you
drowsy, consult your doctor regarding safe usage. Ask your doctor
or pharmacist about the safety of beginning any new treatment while
using Effexor (even over the counter medications), and always give
your prescribing physician an updated list of any medications that
may have been prescribed to you by another doctor.
Effexor Dosages
While the following doses are customary, your doctor may prescribe you a different amount based on factors like age, body mass, and medical history. If the dose that your doctor suggests is different from the standard dosage outlined below, follow the instructions given to you by your doctor, and do not change your dose without their advice.
Standard Dosage for Depression
- Tablet: 75 mg in 2 to 3 divided doses to start, up to 375 mg
if a greater dose is indicated.
- Extended Release Capsule: 75 mg once daily to start, up to 225
mg if a greater dose is indicated.
Standard Dosage for Anxiety
- Extended Release Capsule: 75 mg once daily to start, up to 225
mg if a greater dose is indicated.
Effexor tablets come in the following dosages:
- 25 mg peach tablet, shield shaped, stamped '25' on one side
and '701' on the other
- 37.5 mg peach tablet, shield shaped, stamped '37.5' on one side
and '781' on the other
- 50 mg peach tablet, shield shaped, stamped '50' on one side
and '703' on the other
- 75 mg peach tablet, shield shaped, stamped '75' on one side
and '704' on the other
- 100 mg peach tablet, shield shaped, stamped '100' on one side
and '705' on the other
Effexor XR Capsules come in the following dosages:
- 37.5 mg capsule, grey cap marked 'Effexor XR', peach body marked
'37.5'
- 75 mg capsule, peach cap marked 'Effexor XR', peach body marked
'75'
- 150 mg capsule, dark orange cap marked 'Effexor XR', dark orange
body marked '150'
Effexor Directions
For maximum effectiveness, this medication needs to be maintained
in steady levels in the brain. Take your doses at the same time
every day, and take missed doses as soon as you remember. If you
miss a dose and it's almost time for your next one, skip the missing
dose and resume your normal schedule. Effexor may be taken with
food, though the XR form of this drug must not be crushed, and the
capsule must not be opened.
Store Effexor away from direct light and heat. Store in a dry location;
avoid storing it in the bathroom, near sinks, or other areas where
it may become damp. Do not use after the expiration date.
Keep Effexor away from children; both when storing it, and when discarding
any unused medication.
Effexor may cause drowsiness or disorientation, and you should familiarize
yourself with your reaction to it before engaging in potentially
hazardous activities. Be cautious if you plan to drive or operate
heavy machinery, avoid these activities if you find yourself feeling
tired or experience slowed reactions.
Effexor and Pregnancy
Animal studies have indicated an increased risk of miscarriage with high doses of Effexor. Speak with your doctor about your treatment if you are pregnant, or plan to become pregnant.
Effexor does pass into breast milk, and nursing mothers may be advised to suspend treatment, or stop breastfeeding while using this medication.
Effexor and Children
Although Effexor has not been fully studied for safety in young
children, though it has been used to treat them in certain cases.
Only your doctor can determine if this would be an appropriate treatment,
dosage would have to be determined on an individual basis, and carefully
monitored.
Effexor and Seniors
Effexor does not appear to have significantly different effects
in the elderly, though some side effects may be more common and
detrimental in the senior population. Of particular concern is the
risk of an increase in blood pressure, increased sodium loss, and
antidiuretic effects. It is also normal for individuals over 60
to have reduced kidney function, which is an indication for lower
doses, as the medication will clear from the body more slowly. Constipation
may be more of a problem, and a doctor may recommend taking a fiber
supplement, or psyllium husks, half an hour befoure your morning
meal to reduce this concern.
Seniors should generally be started on lower doses, and monitored
more carefully, as is the case with many other types of treatment
administered to this population.
Effexor and Effexor XR are trademarks of Wyeth-Ayerst
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The information contained in this document is provided for educational purposes
and information only. It is not a
substitute for consultation with a physician or Health professional, either to diagnose
symptoms or prescribe treatment. Any dosages mentioned are general
guidelines only, please follow the directions of your doctor or
pharmacist exactly when taking medication. We have made every effort to
ensure that this information is accurate, but only your doctor,
physician or Health professional can say
if a medication, a drug alternative or drug combination, is safe for you. Information
intended for US residents only.
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