LAFIX
VENLAFAXINE · by WNSFEILD
Composition
Cap/Tab 37.5 mg/50 mg/75 mg/150 mg: Venlafaxine 37.5 mg/50 mg/75 mg/150 mg. XR Cap 75 mg/150 mg: Venlafaxine 75 mg/150 mg.
Indications & Dosage
Major depression: Adult: Initially 75 mg regular tab in 2 divided doses or XR tab once daily, then increased if necessary up to 375 mg daily, increased at intervals of at least 2 weeks, faster dose titration may be necessary in some patients; max. 375 mg per day. Generalized anxiety disorder, Social anxiety disorder: Adult: 75 mg XR tab once daily, increased if necessary up to 225 mg once daily, increased at intervals of at least 2 weeks; max. 225 mg per day.
Contraindications
High risk of cardiac ventricular arrhythmia, uncontrolled hypertension.
Precautions
Moderate to severe renal or hepatic impairment, hepatic cirrhosis, diabetes, heart disease (monitor blood pressure), history of bleeding disorders, history of epilepsy, personal or family history of mania, susceptibility to angle-closure glaucoma, drug abuse. Monitor BP and serum cholesterol. Re-evaluate patients on long term therapy. Advise patients to report development of rash. Withdraw gradually over at least 1 week or at least 2 weeks if high doses used for >6 weeks. Monitor patients with risks for suicidal behaviour.
Interactions
MAOIs, lithium, CNS active drugs, SSRIs, potent inhibitors of CYP3A4 or drugs combinations that inhibit CYP3A4 and 2D6, warfarin, indinavir.
Pregnancy
Avoid unless potential benefit outweighs risk
Lactation
Contraindicated
Side Effects
Agitation, alopecia, angioedema, apathy, Arrhythmias, bleeding disorders, bruxism, abnormal dreams, anorexia, anxiety, asthenia, changes in serum cholesterol, chills, confusion, difficulty with micturition, dizziness, drowsiness, dry mouth, headache, hypertension, hypertonia, insomnia, menstrual disturbances, mydriasis, nausea, nervousness, palpitation, sensory disturbances, sexual dysfunction, sweating, tremor, vasodilatation, visual disturbances, vomiting, weight changes, diarrhoea, ecchymosis, GI haemorrhage, hallucinations, incoordination, myoclonus, photosensitivity, postural hypotension, rash, taste disturbance, tinnitus, urinary retention. Rare: Akathisia, extrapyramidal symptoms, hypomania, mania, seizures, urinary incontinence