How do I take this medicine? Take Venlafaxine exactly as directed by your doctor. Do not take more or less than instructed by your doctor. You may need to take Venlafaxine for some time before the full benefits can be felt. Do not be discouraged if you do not feel better soon after taking the medicine. Venlafaxine must be taken regularly for it to work well.
Your doctor may need to adjust your dose of Venlafaxine during treatment. When the dose is being adjusted, you may experience some side effects, such as unstable mood, thoughts of harming yourself, anxiety, panic, irritability, hostility, aggressiveness, restlessness or other unusual behaviour. Alert your doctor quickly if any of this happens.
Do not stop taking Venlafaxine unless instructed by your doctor. Your condition may worsen if the medicine is stopped suddenly. If your doctor thinks you do not need Venlafaxine anymore, he will usually reduce your dose slowly. Venlafaxine should not be stopped suddenly.
If you are taking Venlafaxine to treat hot flushes, you may not need to take it long-term. Your doctor will advise you about how long you need to take Venlafaxine.
Take Venlafaxine at meal times. Taking it with food may help to lessen some side effects such as nausea.
If you are taking the extended-release capsule (usually marked as "XR", "XL" or "SR"), swallow the capsule whole with a glass of water. If you cannot swallow the capsule, you may open the capsule. There are small pellets (tiny granules or balls) inside the capsule. Sprinkle the entire contents of the capsule on a small amount (for example, 1 tablespoon) of applesauce just before you take it. Swallow this mixture whole, with a glass of water. Do not chew or crush the pellets.
Do not chew, crush, break or divide the capsule or the pellets inside the capsule. Do not place the capsule or the pellets in water.
Try to take Venlafaxine at the same time each day. What should I do if I have forgotten to take this medicine? DO NOT double a dose under any circumstances.
Take the missed dose as soon as you remember.
If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.
If you often forget to take your medicine, let your doctor and pharmacist know. Can I take this with other medicines? Do not take these medicines while you are being treated with Venlafaxine:
- antidepressants such as monoamine oxidase inhibitors (MAOIs) and lithium. Some examples of MAOIs include moclobemide, phenelzine, isocarboxazid, selegiline and tranylcypromine
- lithium (a mood medicine)
- tramadol (a painkiller)
- sibutramine (a weight loss pill)
- warfarin (blood-thinning agent)
- migraine medicines such as sumatriptan and zolmitriptan
Alert the doctor quickly if you are taking St John's wort, antibiotics such as linezolid or HIV medicines such as indinavir.
Other medicines may also be unsuitable when taken together with Venlafaxine, such as:
- ketoconazole (an antifungal agent)
- mood medicines such as haloperidol, risperidone, imipramine
- metoprolol (a heart and blood pressure medication)
- a type of painkillers known as NSAIDs (such as diclofenac, mefenamic acid, naproxen, ibuprofen and related medicines)
If you are taking a gastric pill called cimetidine, your doctor may need to monitor your response to Venlafaxine if you are older than 60 years old or if you have liver disease or high blood pressure.
Always inform your doctor and pharmacist if you are taking any other medicines, including herbal tonics, supplements and medicines that you buy without a prescription. How should I store this medicine? Store in a cool, dry place away from the reach of children.
Medicines must not be used past the expiry date.
When should I not use this medicine? Do not take Venlafaxine if you are under 18 years of age or if you have a history of severe mood swings, poorly controlled blood pressure, irregular heartbeat or heart failure.
Do not take Venlafaxine if you are taking or have taken other mood medicines known as monoamine oxidase inhibitors (MAOIs) in the last 14 days. Some examples of MAOIs include isocarboxazid, phenelzine, moclobemide, selegiline and tranylcypromine. Alert your doctor immediately if you are taking or have taken any of these medicines or other MAOIs.
If you should stop taking Venlafaxine, always alert your doctor that you have taken Venlafaxine previously. MAOIs should not be taken within 7 days of stopping Venlafaxine. What should I take note of while taking this medicine? Alert the doctor if you are pregnant or if you become pregnant while being treated with Venlafaxine. Do not breastfeed while you are being treated with Venlafaxine.
Alert the doctor if you have any of these conditions:
- glaucoma (high pressure in the eyes)
- liver or kidney disease
- heart disease including recent heart attacks
- high blood pressure
- high cholesterol
- thyroid disease
- history of fits (epilepsy) or head trauma
- low sodium levels in your blood
Inform your doctor if you need to have electroconvulsive therapy (ECT) or if you are on blood-thinning medicines.
If you are taking the extended-release type of Venlafaxine, you may see tiny ball-shaped casings in your bowel movements. This is normal; do not be alarmed. These casings are just empty shells; the medicine inside them has already been absorbed by your body.
If you are going for an operation, including minor operations and dental work, inform your doctor or dentist that you are taking Venlafaxine.
Always keep your appointments with your doctor so that he will be able to monitor your response to Venlafaxine. Are there any restrictions on the type of food I can take? Avoid alcohol and tryptophan supplements.
What side effects could I experience? Venlafaxine may make you feel drowsy or dizzy. Your vision may also be blurred. If you feel drowsy, dizzy or have blurred vision, do not drive or take part in any activity in which you need to be alert.
Venlafaxine may make you dizzy when you get up from a sitting or lying down position. To minimise this problem, stand up slowly.
Venlafaxine may cause headache, unusual sweating (including sweating at night), difficulty sleeping, nausea, loss of appetite, dry mouth, constipation, urination problems and nervousness. There may be menstrual irregularities in women and abnormal ejaculation in men.
If any side effect is severe or does not go away, alert your doctor.
Other side effects with Venlafaxine are rare but may be serious. Stop taking Venlafaxine and alert your doctor immediately if you experience any of the following:
- thoughts of harming or killing yourself
- aggressive, hostile or angry behaviour
- fast or irregular heartbeat
- increased blood pressure
- pins or needles, or a painful tingling sensation in your hands or feet
- fits (epilepsy)
- jerky movements or other uncontrollable movements
- unusual bruising or bleeding
- black tarry stools
- rash that is severe or that covers many areas of the body
Alert your doctor if you develop any other side effects while being treated with Venlafaxine.