MaXine

Major depressive disorder; generalized anxiety disorder; social anxiety disorder; panic disorder w/ or w/o agoraphobia.

Major depressive disorder & generalized anxiety disorder Initially 75 mg/day single dose. Some patients may start at 37.5 mg/day for 4-7 days before increasing to 75 mg/day. Dose may be increased in increments of up to 75 mg/day, as needed, at intervals of not <4 days to max of approx 225 mg/day. Social anxiety disorder 75 mg/day single dose. Panic disorder Initially 37.5 mg/day single doses for 7 days, followed by doses of 75 mg/day. Subsequent wkly doses may be increased in increments of up to 75 mg/day, as needed, at intervals of not <7 days to max of approx 225 mg/day. Patient w/ mild to moderate hepatic impairment Reduce total daily dose by 50%. Patient w/ cirrhosis Reduction of dose by >50% may be necessary. Patient w/ renal impairment (GFR 10-70 mL/min) Reduce total daily dose by 25-50%. Patient undergoing hemodialysis Reduce total daily dose by 50%.

Should be taken with food: Take as single dose in the morning or in the evening at approx the same time each day. Swallow whole w/ fluid & do not divide/crush/chew/place in water, or may be administered by opening the cap & sprinkling the entire content on a spoonful of applesauce. Swallow the mixt immediately w/o chewing & follow w/ a glass of water to ensure complete swallowing of the pellets.

Hypersensitivity. Concomitant use of MAOIs (including linezolid or IV methylene blue) or w/in 7 days of stopping venlafaxine. Use of venlafaxine w/in 14 days of stopping MAOI therapy.

Closely monitor patients for clinical worsening, suicidality, emergence of agitation, irritability or unusual changes in behavior. Not approved for use in treating bipolar depression. Increased likelihood of precipitation of mixed/manic episode in patients at risk for bipolar disorder; screen patients w/ depressive symptoms for bipolar disorder prior to initiating treatment. Concomitant use w/ metoprolol; risperidone; indinavir; CNS-active drugs; triptans; drugs that prolong QT interval. Reports of false +ve urine immunoassay screening tests for phencyclidine & amphetamine. No clinical data establishing benefit w/ combined electroconvulsive therapy. Complications requiring prolonged hospitalization, resp support & tube feeding in neonates exposed to venlafaxine late in 3rd trimester. Should only be used during pregnancy if clearly needed. Discontinue nursing during treatment or discontinue venlafaxine. Safety & effectiveness have not been established in ped population. Regularly monitor wt & height, particularly in long-term treatment, should the decision be made to treat ped patients. Safety has not been systematically assessed for chronic treatment >6 mth in ped patients. Associated w/ cases of clinically significant hyponatremia in elderly patients.

Abnormal ejaculation, dry mouth, anorexia, constipation, sweating. Major depressive disorder: Nausea, dizziness, somnolence, abnormal dreams. Impotence in men, anorgasmia in women, decreased libido, flatulence, insomnia, nervousness, tremor, abnormal vision, HTN, vasodilatation, yawning. Generalized anxiety disorder: Impotence, nausea, abnormal vision. Social anxiety disorder: Asthenia, nausea, insomnia, decreased libido, nervousness, somnolence, tremor, impotence, yawn. Panic disorder: Somnolence, tremor. Substernal chest pain, chills, fever, neck pain; migraine, tachycardia; increased appetite; ecchymosis; edema, wt gain; amnesia, confusion, depersonalization, hypesthesia, abnormal thinking, trismus, vertigo; increased cough, dyspnea; pruritus; abnormality of accommodation, mydriasis, taste perversion; albuminuria, impaired urination.

Increased plasma conc & reduced BP-lowering effect of metoprolol. Slight inhibition of risperidone metabolism, resulting in increased AUC of risperidone. Decreased AUC & C_max of indinavir. Increased risk of QTc prolongation &/or ventricular arrhythmias w/ other drugs which prolong the QTc interval (eg, some antipsychotics & antibiotics). Rare post-marketing reports of serotonin syndrome w/ triptans. Concomitant use w/ CNS-active drugs.

Antidepressants

N06AX16 - venlafaxine ; Belongs to the class of other antidepressants.

Rx