Efexor XL

What is it?

An anxiolytic preparation which is a 5HT/noradrenaline re-uptake inhibitor, available as sustained release capsules in two different strengths; peach coloured, containing 75mg of venlafaxine, as hydrochloride, marked W75 and orange coloured, containing 150mg and marked W150. Also, EFEXOR TABLETS, shield- shaped, peach coloured tablets in 3 different strengths containing 37.5mg, 50mg or75mg of venlafaxine as hydrochloride, respectively, each marked with logo and strength.

Medical Uses

Anxiety disorders, depression and prevention of depression or to avoid relapse; anxiety and depression in combined states.

Dosage

Adults, capsules, anxiety disorder, 75mg once each day with food for 8 weeks; discontinue if patient's condition has not improved. Depression, capsules, 75mg once each day as starting dose, continuing for 2 weeks. Then increase to 150mg once each day, if required, to a maximum daily dose of 225mg. Dosage and response should be closely monitored. Adults, tablets, depression, 37.5mg twice each day with food for several weeks, then increase gradually by titration to 75mg twice daily. If condition is severe, begin with 75mg then titrate to increase every 2 or 3 days by amounts of 75mg, to a daily maximum of 375mg. Gradually reduce dose as condition responds.

Special Care

Liver or kidney disease, unless mild, mania, history of epilepsy, glaucoma, heart disease which is unstable, heart attack. Monitor blood pressure of patients on long-term treatment and continue to assess those who have received drug for some time. Patients to be advised to report any appearance of a rash and drug should be stopped gradually over a one week period.

Avoid Use

Children, pregnancy, breastfeeding.

Possible Drug and Food Interactions

Drugs which inhibit 2D6 and CYP3A4, indinavir, MAOIs, warfarin, drugs which act on the central nervous system.

Known Side Effects

Headache, weakness, dizziness, dry mouth, nausea, sleepiness, insomnia, nervousness, sweating, muscle and joint pain, palpitations, reversible alterations in liver enzymes, urinary frequency, low blood pressure on assuming upright position, raised blood pressure, rash, shortness of breath, abnormal orgasm/ejaculation, changes in blood cholesterol levels.