Generic Venlor ( Venlafaxine )

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Venlor is a brand of venlafaxine, a serotonin and norepinephrine reuptake inhibitor (SNRI) used to treat depression, including depression associated with anxiety. It is also used for generalized anxiety disorder, social anxiety disorder, and panic disorder. The medication works by increasing the levels of serotonin and norepinephrine in the brain, which helps improve mood and reduce anxiety.
The usual starting dose for depression and anxiety disorders is 75 mg once daily, taken with food. Your doctor may increase the dose gradually if needed, up to a maximum of 225 mg per day for depression. Do not change your dose without talking to your doctor first.
The administration form is prolonged-release tablets containing 75 mg of venlafaxine (as venlafaxine hydrochloride). In Canada, venlafaxine is more commonly available as extended-release capsules under the brand name Effexor XR and as generics such as ACT Venlafaxine XR, Apo-Venlafaxine XR, and Sandoz Venlafaxine XR.
Venlor does not work overnight. It may take several weeks of steady dosing before you notice the full benefit for depression or anxiety. Do not stop taking it just because you do not feel better in the first few days.
Alcohol should be avoided during treatment. It can increase the drowsiness and dizziness that venlafaxine can cause, and it may worsen some of the side effects of the medication.
The most common side effects are nausea, dry mouth, headache, sweating, and insomnia. Sexual side effects such as decreased libido or difficulty reaching orgasm are also common.
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Common Use Venlor

Venlafaxine is a serotonin and norepinephrine reuptake inhibitor. It works by blocking the reuptake of serotonin and norepinephrine in the brain, which increases their availability in the spaces between nerve cells. This is thought to improve mood and reduce anxiety. Health Canada has approved venlafaxine extended-release capsules for the symptomatic relief of major depressive disorder, generalized anxiety disorder, social anxiety disorder, and panic disorder with or without agoraphobia. Venlor, the brand name available in some markets, is indicated for the treatment of depression, including depression with associated anxiety, and for the prevention of relapses of depression in patients who have responded to initial treatment. Venlafaxine is not approved for use in children under 18 years of age.

Basic Venlor Information

• INN (International Nonproprietary Name): Venlafaxine hydrochloride
• Brand names available in Canada: Effexor XR® (BGP Pharma ULC); generics include ACT Venlafaxine XR (Teva Canada Limited), Apo-Venlafaxine XR (Apotex Inc.), Auro-Venlafaxine XR (Auro Pharma Inc.), Bio-Venlafaxine XR (Biomed Pharma), M-Venlafaxine XR (Mylan Pharmaceuticals ULC), MINT-Venlafaxine XR (Mint Pharmaceuticals Inc.), Sandoz Venlafaxine XR (Sandoz Canada Inc.), Taro-Venlafaxine XR (Taro Pharmaceuticals Inc.), and Venlafaxine XR (Sanis Health Inc.). Venlor is not marketed in Canada; it is a brand available in other countries.
• ATC Code: N06AX16
• Forms and dosages: Extended-release capsules and prolonged-release tablets – 37.5 mg, 75 mg, and 150 mg. Venlor is available as prolonged-release tablets in 37.5 mg, 75 mg, 150 mg, 225 mg, and 300 mg strengths.
• Manufacturers in Canada: BGP Pharma ULC (Effexor XR, DIN 02237280 for 75 mg), Teva Canada Limited (ACT Venlafaxine XR, DIN 02304325 for 75 mg), Apotex Inc. (Apo-Venlafaxine XR, DIN 02331691 for 75 mg, status dormant), Auro Pharma Inc. (Auro-Venlafaxine XR, DIN 02452847 for 75 mg), Biomed Pharma (Bio-Venlafaxine XR, DIN 02567563 for 75 mg), Sandoz Canada Inc. (Sandoz Venlafaxine XR), Taro Pharmaceuticals Inc. (Taro-Venlafaxine XR, DIN 02380072), and Sanis Health Inc. (Venlafaxine XR, DIN 02354713 for 37.5 mg).
• Registration status in Canada: Approved by Health Canada. Effexor XR 75 mg (DIN 02237280) is currently marketed by BGP Pharma ULC, with an original marketing date of March 4, 1998. Multiple generic venlafaxine XR products are approved and marketed under various DINs. Venlor itself is not approved by Health Canada.
• OTC / Rx classification: Prescription only (Rx) – not legally sold over-the-counter in Canadian pharmacies

Dosage & Direction

Take Venlor exactly as your doctor prescribes. The recommended starting dose for venlafaxine extended-release is 75 mg once daily, taken with food. Your doctor may increase the dose gradually if needed. For depression, the usual dose range is 75 mg to 225 mg per day. Some patients may start at 37.5 mg once daily for the first 4 to 7 days before increasing to 75 mg once daily. Take the tablet or capsule at approximately the same time each day, either in the morning or in the evening. Swallow it whole with water. Do not crush, chew, or split it, as this can release the drug too quickly and increase the risk of side effects. If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed one and continue with your regular schedule. Do not take two doses at once. Do not stop taking Venlor suddenly without talking to your doctor. Stopping abruptly can cause discontinuation syndrome, with symptoms such as nausea, dizziness, insomnia, irritability, and "electric-shock" sensations. Your doctor will taper the dose gradually over at least one to two weeks, or longer if needed.

Precautions

Venlafaxine can cause a rise in blood pressure. Your doctor should check your blood pressure before you start treatment and periodically during treatment, especially after any dose adjustment. This is particularly important if you have a history of high blood pressure, heart disease, or other cardiovascular conditions. The medication can cause serotonin syndrome, a potentially life-threatening condition caused by too much serotonin in the body. The risk is higher when venlafaxine is taken with other serotonergic drugs, including MAO inhibitors, other SNRIs, SSRIs, triptans, tramadol, and St. John's wort. Symptoms include agitation, confusion, rapid heartbeat, muscle rigidity, and sweating. Stop the medication and seek emergency care if these occur. Venlafaxine can increase the risk of bleeding, especially when taken with aspirin, NSAIDs, warfarin, or other anticoagulants. Tell your doctor if you take any of these medications. The medication can cause hyponatremia (low sodium in the blood), especially in older adults and people taking diuretics. Symptoms include headache, difficulty concentrating, memory problems, confusion, and weakness. Venlafaxine can cause angle-closure glaucoma in patients with untreated anatomically narrow angles. Tell your doctor if you have a history of glaucoma. Venlafaxine is not recommended during pregnancy unless the benefit clearly outweighs the risk. It can cause withdrawal symptoms in a newborn if used in the third trimester. It passes into breast milk, so breastfeeding is not recommended without medical advice. Women who could become pregnant should discuss the risks and benefits with their doctor. Venlafaxine should not be used in children under 18 years of age. Older adults may be more sensitive to the side effects and may need lower doses. Tell your doctor if you have liver or kidney problems, as dose adjustments may be needed. Venlafaxine can cause drowsiness and dizziness. Do not drive or operate heavy machinery until you know how it affects you.

Contraindications

Do not take Venlor if you have had an allergic reaction to venlafaxine or any of the inactive ingredients in the tablet. Venlafaxine is contraindicated in patients taking monoamine oxidase inhibitors (MAOIs), including phenelzine, tranylcypromine, and moclobemide. Do not start an MAOI within 14 days of stopping venlafaxine, and do not start venlafaxine within 14 days of stopping an MAOI. This combination can cause a life-threatening condition called serotonin syndrome. Venlafaxine should not be used during pregnancy or breastfeeding unless specifically directed by a doctor. Do not take venlafaxine if you have severe liver impairment. If you are unsure whether any of these apply to you, check with your doctor or pharmacist.

Possible Side Effects

More than 1 in 10 people experience nausea, dry mouth, headache, sweating, and insomnia. Other common side effects include dizziness, drowsiness, fatigue, constipation, decreased appetite, and nervousness. Sexual side effects such as decreased libido or difficulty reaching orgasm are common but often not discussed. These effects may fade as your body adjusts, but if they persist or bother you, tell your doctor. Serious side effects require immediate medical attention. Serotonin syndrome presents with agitation, confusion, rapid heartbeat, muscle rigidity, and sweating. Increased bleeding risk can cause easy bruising or unusual bleeding. Hyponatremia can cause headache, confusion, and weakness. Angle-closure glaucoma presents with sudden eye pain, blurred vision, and redness. Severe allergic reactions, including rash, hives, swelling of the face or throat, and difficulty breathing, need emergency care. If you develop any of these serious effects, stop the medication and seek medical help right away. Discontinuation syndrome can occur if the medication is stopped suddenly, causing flu-like symptoms, dizziness, and "electric-shock" sensations.

Drug Interaction

Venlafaxine interacts with several medications. MAO inhibitors are strictly contraindicated and must not be used with venlafaxine. Other serotonergic drugs, including other SNRIs, SSRIs, tricyclic antidepressants, triptans, fentanyl, tramadol, and St. John's wort, can increase the risk of serotonin syndrome. Drugs that affect bleeding, such as aspirin, NSAIDs, warfarin, and other anticoagulants, can increase the risk of bleeding when taken with venlafaxine. Venlafaxine is a weak inhibitor of CYP2D6, so it can increase the levels of drugs metabolized by this enzyme, including certain antidepressants, antipsychotics, beta-blockers, and opioids. If you take one of these, your doctor may need to adjust the dose. Venlafaxine can also interact with diuretics, increasing the risk of hyponatremia. Tell your doctor and pharmacist about every medication you take, including over-the-counter products, vitamins, and herbal supplements.

Missed Dose

If you miss a dose of Venlor, take it as soon as you remember. If it is almost time for your next dose, skip the missed one and continue with your regular schedule. Do not take two doses at once to make up for a missed one. If you miss several doses in a row, contact your doctor before restarting. Missing doses can cause your symptoms to return, so try to take the medication at the same time each day.

Overdose

Overdose with Venlor can cause drowsiness, nausea, vomiting, fast heart rate, and tremor. In severe cases, it can cause serotonin syndrome, seizures, and changes in heart rhythm. There is no specific antidote. Treatment is supportive and may include activated charcoal if the overdose was recent, intravenous fluids, and monitoring of vital signs. Contact a poison control centre or go to an emergency department immediately if you or someone else has taken too much. Do not try to manage an overdose at home.

Storage

Store Venlor tablets at room temperature between 20 and 25 degrees Celsius (68 and 77 degrees Fahrenheit). Brief exposure to temperatures between 15 and 30 degrees Celsius (59 and 86 degrees Fahrenheit) is acceptable. Keep the container tightly closed and protect it from light and moisture. Do not store in the bathroom or near a sink. Keep out of reach of children and pets. Do not use after the expiry date on the label. Dispose of unused medication according to local guidelines.

Disclaimer

We provide only general information about medications which does not cover all directions, possible drug integrations, or precautions. Information at the site cannot be used for self-treatment and self-diagnosis. Any specific instructions for a particular patient should be agreed with your health care adviser or doctor in charge of the case. We disclaim reliability of this information and mistakes it could contain. We are not responsible for any direct, indirect, special or other indirect damage as a result of any use of the information on this site and also for consequences of self-treatment.

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