Consumer Medicine Information
What is in this leaflet
This leaflet answers some common questions about venlafaxine. It does not contain
all the available information. It does not take the place of talking to your doctor
All medicines have risks and benefits. Your doctor has weighed the risks of you using
this medicine against the benefits they expect it will have for you.
If you have any concerns about taking this medicine, ask your doctor or pharmacist.
Keep this leaflet with the medicine.
You may want to read it again.
What this medicine is used for
Venlafaxine is used to treat major depression, and to prevent it coming back. It is
also used to treat panic attacks and anxiety.
Venlafaxine belongs to a group of medicines called serotonin-noradrenaline reuptake
Depression may cause emotional and physical symptoms such as feeling low, poor appetite
or lack of energy.
Excessive anxiety may cause you to feel constantly and uncontrollably worried and
distressed. It may also make you feel irritable, and cause difficulty in thinking
How it works
Venlafaxine increases the level of serotonin and noradrenaline in the brain, helping
to restore your feeling of wellness.
Ask your doctor if you have any questions about why this medicine has been prescribed
Your doctor may have prescribed Venlafaxine XR for another reason.
This medicine is available only with a doctor's prescription.
This medicine is not addictive.
There is not enough information to recommend the use of this medicine for children
under the age of 18 years.
Before you take this medicine
When you must not take it
Do not take this medicine if you have an allergy to:
any of the ingredients listed at the end of this leaflet
Some of the symptoms of an allergic reaction may include:
shortness of breath
wheezing or difficulty breathing
swelling of the face, lips, tongue, throat or other parts of the body
rash, itching or hives on the skin
Do not take this medicine if you are taking other medicines called Monoamine Oxidase
MAOIs may be used for the treatment of depression (phenelzine, tranylcypromine, moclobemide),
Parkinson's disease (selegiline) or infections (linezolid) or diagnosis of certain
conditions/treatment of certain blood disorders (methylene blue). Taking venlafaxine
with a MAOI may cause a serious reaction with a sudden increase in body temperature,
extremely high blood pressure and severe convulsions.
Do not take venlafaxine until 14 days after stopping most MAOIs, and do not take any
MAOIs until more than one week after stopping venlafaxine.
You may take venlafaxine 24 hours after stopping the reversible MAOI called moclobemide.
Do not take this medicine after the expiry date printed on the pack or if the packaging
is torn or shows signs of tampering.
If it has expired or is damaged, return it to your pharmacist for disposal.
If you are not sure whether you should start taking this medicine, talk to your doctor.
Before you start to take it
Tell your doctor if you have allergies to any other medicines, foods, preservatives
Tell your doctor if you have or have had any of the following medical conditions:
epilepsy, fits or seizures
a personal or family history of bipolar disorder
drug abuse or misuse
blood pressure problems
acute angle glaucoma or increased pressure in the eye
a tendency to bleed more than normal or other blood disorders
raised cholesterol levels
kidney or liver problems
low sodium levels in your blood, or a condition called SIADH (Syndrome of Inappropriate
Antidiuretic Hormone Secretion)
thoughts or actions relating to self-harm or suicide
Tell your doctor if you are pregnant or plan to become pregnant.
There have been reports that babies exposed to venlafaxine and other antidepressants
during the third trimester of pregnancy may develop complications after birth. Do
not take this medicine whilst pregnant until you and your doctor have discussed the
risks and benefits involved.
Tell your doctor if you are breastfeeding.
Venlafaxine passes into breast milk and there is a possibility that the breastfed
baby may be affected. For this reason, the use of venlafaxine is not recommended if
you are breastfeeding.
If you have not told your doctor about any of the above, tell them before you start
taking this medicine.
Taking other medicines
Tell your doctor and pharmacist if you are taking any other medicines, including any
that you get without a prescription from your pharmacy, supermarket or health food
Some medicines may interact with venlafaxine. These include:
MAOIs (e.g. phenelzine, tranylcypromine, moclobemide, selegiline, linezolid, methylene
Do not take venlafaxine until 14 days after stopping most MAOIs, and do not take any
MAOIs until more than one week after stopping venlafaxine.
For moclobemide, do not take venlafaxine until at least 24 hours after stopping moclobemide,
and do not take moclobemide until more than one week after stopping venlafaxine.
St John's wort (Hypericum perforatum) or tryptophan
dopamine agonists used to treat Parkinson's disease
any other medications for depression, anxiety, obsessive-compulsive disorder or premenstrual
haloperidol, risperidone, lithium or clozapine, used to treat mood disorders
tramadol, a strong pain killer
any medicine which may affect the brain (e.g. amphetamines)
cimetidine, used to treat reflux
triptans, used to treat migraines
amiodarone or quinidine, used to treat irregular heartbeats
warfarin and clopidogrel (used to prevent blood clots)
diuretics, used for reducing water in your body
medicines used to treat diabetes
If you are taking any of these, you may need a different dose, or you may need to
take different medicines.
Your doctor may also wish to do some heart tests such as an electrocardiogram (ECG)
or blood tests if you are using any of the following whilst taking venlafaxine:
warfarin, used to prevent blood clotting
indinavir, an antiviral medicine
erythromycin, used to treat infections
ketoconazole or fluconazole, used as antifungal medicines
medicines used for weight loss (e.g. phentermine, sibutramine)
metoprolol, used to treat high blood pressure or angina
medications that can affect your heart beat
These medicines may be affected by this medicine or may affect how well it works.
You may need different amounts of your medicines, or you may need to take different
Your doctor and pharmacist have more information on medicines to be careful with or
avoid while taking this medicine.
Other interactions not listed above may also occur.
How to take this medicine
Follow all directions given to you by your doctor or pharmacist carefully.
They may differ to the information contained in this leaflet.
If you do not understand the instructions on the box, ask your doctor or pharmacist
How much to take
Your doctor will tell you how much of this medicine you should take, depending on
your condition and if you are taking any other medicines.
The usual starting dose is 75 mg taken once daily. If necessary, after two weeks,
your doctor may increase your dose. The maximum dose you should take in one day is
How to take it
Swallow the capsules whole with a glass of water. Do not divide, crush, chew or place
the capsules in water.
Inside venlafaxine XR capsules, there are tablets that contain the venlafaxine. As
the medicine travels the length of your gastrointestinal tract, venlafaxine is slowly
When to take it
Take this medicine at about the same time each day.
Taking it at the same time each day will have the best effect. It will also help you
remember when to take it.
How long to take it for
Continue taking your medicine for as long as your doctor tells you.
Although you may begin to feel better after two weeks, it may take several weeks before
you feel much better. Even when you feel well again, you may need to keep taking venlafaxine
for several months to make sure the benefits last.
Make sure you have enough to last over weekends and holidays.
If you forget to take it
If it is less than 12 hours until your next dose, skip the missed dose and take your
next dose at the usual time.
Otherwise take it as soon as you remember and then go back to taking your medicine
as you would normally.
Do not take a double dose to make up for missed doses.
This may increase the chance of you experiencing side effects.
Contact your doctor if you have missed more than two doses in a row. If you have trouble
remembering to take your medicine, ask your pharmacist for some hints.
If you take too much (overdose)
Immediately telephone your doctor or the Poisons Information Centre (telephone 13
11 26) for advice or go to the Emergency Department at your nearest hospital if you
think that you or anyone else may have taken too much of this medicine. Do this even
if there are no signs of discomfort or poisoning. You may need urgent medical attention.
If you take too much venlafaxine, you may experience sleepiness, vomiting, dilated
pupils, increased heart rate, changes in heart rhythm, seizure (fits), breathing difficulties
or becoming unconscious.
While you are taking this medicine
Things you must do
Watch carefully for signs that your depression is getting worse, especially in the
first few weeks of treatment or if your dose has changed.
Tell your doctor immediately if you experience any of the following symptoms, especially
if they are severe, you have not had these symptoms before or they happen very suddenly:
anxiety or agitation, panic attacks
difficulty sleeping, restlessness
aggressiveness, hostility or impulsiveness
overactivity or uninhibited behaviour
other unusual changes in behaviour
thoughts of suicide.
Tell your doctor immediately if you have any thoughts about suicide or doing harm
All thoughts or talk about suicide or violence are serious. If you or someone you
know is showing the following warning signs, either contact your doctor right away
or go to the nearest hospital for treatment.
thoughts or talk about death or suicide.
thoughts or talk about self-harm or doing harm to others.
any recent attempts of self-harm.
an increase in aggressive behaviour, irritability or agitation.
If you are being treated for depression, discuss with your doctor any problems you
may have and how you feel, especially any feelings of severe sadness, thoughts of
suicide, bursts of unusual energy, anger or aggression, or if you become particularly
agitated or restless.
If you are about to be started on any new medicine, tell your doctor that you are
taking this medicine.
Tell any other doctors, dentists and pharmacists who are treating you that you take
If you become pregnant while taking this medicine, tell your doctor immediately.
Make sure your midwife and doctor know immediately that you are pregnant and taking
venlafaxine, as there is a possibility of problems developing in unborn children.
Symptoms such as feeding difficulty, vomiting, tremor, irritability and constant crying
have been reported rarely in newborn babies after mothers have taken venlafaxine in
the last 3 months of pregnancy. In addition, when taken particularly in the last 3
months of pregnancy, medicines like venlafaxine may increase the risk of a serious
condition in babies, called persistent pulmonary hypertension of the newborn (PPHN),
making the baby breathe faster and appear bluish. These symptoms usually begin during
the first 24 hours after the baby is born. If this happens to your baby, you should
contact your midwife and doctor immediately.
Tell your doctor if you are about to have any blood tests.
Keep all of your doctor's appointments so that your progress can be checked.
Your doctor may occasionally do tests to make sure the medicine is working and to
prevent side effects. Some people (especially older people or those taking diuretics)
may experience a lack of sodium in the blood when taking this medicine.
Tell your doctor if you get a headache or start to feel dizzy, confused, forgetful,
weak, unsteady or unable to concentrate. Make sure to drink plenty of fluids.
Things you must not do
Do not give this medicine to anyone else, even if they have the same condition as
Do not take your medicine to treat any other complaint unless your doctor tells you
Do not stop taking your medicine, or change the dosage, without first checking with
Check with your doctor for the best way to slowly reduce the amount of venlafaxine
you are taking before stopping completely, as this can reduce the possibility of these
Side effects from stopping treatment with venlafaxine suddenly may include headache,
nausea and vomiting, insomnia, nervousness, anxiety, confusion and agitation, diarrhoea,
sweating, flu-like symptoms, loss of appetite, dizziness, impaired coordination and
balance, tremor, tingling or numbness of the hands and feet.
Things to be careful of
Venlafaxine may make you feel drowsy. Be careful driving or operating machinery until
you know how this medicine affects you.
Avoid drinking alcohol while you are taking venlafaxine.
Tell your doctor or pharmacist as soon as possible if you do not feel well while you
are taking venlafaxine.
All medicines can have side effects. Sometimes they are serious but most of the time
they are not. You may need medical attention if you get some of the side effects.
Do not be alarmed by the following lists of side effects. You may not experience any
Tell your doctor or pharmacist if you notice any of the following:
stomach problems e.g. nausea, vomiting, loss of appetite, diarrhoea, constipation,
difficulty sleeping, abnormal dreams, yawning, feeling drowsy
sexual function problems such as delayed ejaculation, erection problems, decreased
sex drive or difficulties achieving orgasm
nervousness, teeth grinding
a feeling of apathy or not caring about things or not being part of your body
excessive enthusiasm or desire, delusions (mania)
fainting or dizziness after standing up
changes in muscle tone, muscle weakness or fatigue
restlessness, agitation or difficulty sitting still
heavy or irregular menstrual periods
sweating (including night sweats), hot flushes
weight loss or weight gain
unusual milk production
dilated pupils, sensitivity to sunlight
ringing in the ears
altered taste, dry mouth, sore throat
increased blood pressure or blood cholesterol levels
numbness, pins and needles
The above list includes the more common side effects. Mostly, these are mild.
Tell your doctor as soon as possible if you notice any of the following:
cloudy urine, problems passing urine, passing urine more frequently, or being unable
to control urination
muscle tremors, spasms, twitching, jerky movements or sustained muscle contractions
impaired coordination and balance
increase in bone fractures
abnormal facial movements such as tongue thrusting, repetitive chewing, jaw swinging,
rapid heart beat
problems with breathing
bleeding or bruising more easily than normal
The above list includes serious side effects. You may need medical attention. Most
of these side effects are rare.
If you experience any of the following, stop taking your medicine and contact your
doctor immediately or go to the Emergency department at your nearest hospital:
shortness of breath, wheezing or difficulty breathing; swelling of the face, lips,
tongue, throat or other parts of the body; rash, itching or hives on the skin (signs
of an allergic reaction)
fits or seizures, which may be accompanied by a sudden fever
symptoms of sudden fever with sweating, rapid heartbeat and muscle stiffness, which
may lead to loss of consciousness
palpitations, fainting, shortness of breath or chest pain
dark, red or cola coloured urine, muscle weakness and tenderness, stiffness or aching
stomach pain, yellowing of the skin, nausea, fever, clammy skin and sweating
yellowing of the skin or eyes, fever, fatigue, loss of appetite, dark coloured urine
or light-coloured bowel movements
a severe skin reaction with painful red areas and large blisters, accompanied by fever
and chills, aching muscles and generally feeling unwell.
high fever, agitation, confusion, trembling and abrupt contractions of muscles
severe chills, fever, sore throat and mouth ulcers
black sticky bowel motions or bloody diarrhoea
The above list includes very serious side effects. These effects are usually very
rare. You may need urgent medical attention or hospitalisation.
Tell your doctor or pharmacist if you notice anything that is making you feel unwell.
Other side effects not listed above may occur in some patients.
Storage and disposal
Keep your medicine in its pack until it is time to take it.
If you take your medicine out of its pack it may not keep well.
Keep your medicine in a cool dry place where the temperature will stay below 25°C.
Do not store your medicine, or any other medicine, in the bathroom or near a sink.
Do not leave it on a window sill or in the car.
Heat and dampness can destroy some medicines.
Keep this medicine where children cannot reach it.
A locked cupboard at least one-and-a-half metres above the ground is a good place
to store medicines.
If your doctor tells you to stop taking this medicine or the expiry date has passed,
ask your pharmacist what to do with any medicine left over.
What it looks like
75 mg capsules:
Peach opaque / peach opaque size '1' hard gelatin capsules having thick and thin radial
circular bands on the body and cap in red ink. The capsule is filled with white to
off white, round, biconvex, film coated mini tablets.
Blister pack of 28 capsules. AUST R: 286958
150 mg capsules:
Dark orange / dark orange opaque size '0' hard gelatin capsules having thick and thin
radial circular bands on the body and cap in white ink. The capsule is filled with
white to off white, round, biconvex, film coated mini tablets.
Blister pack of 28 capsules. AUST R: 286957
*Not all strengths may be available.
Each capsule contains 75 or 150 mg of venlafaxine hydrochloride as the active ingredient.
It also contains the following:
colloidal anhydrous silica
Brilliant blue FCF
allura red AC
sunset yellow FCF (only for 150 mg)
iron oxide black (only for 75 mg)
iron oxide red (only for 75 mg)
TekPrint SB-0007P White Ink (150 mg capsules only)
TekPrint SB-1033 Red Ink (75 mg capsules only)
This medicine does not contain gluten, lactose, sucrose, tartrazine or any other azo
Apotex Pty Ltd
16 Giffnock Avenue
Macquarie Park, NSW 2113
Tel: (02) 8877 8333
APO and APOTEX are registered trademarks of Apotex Inc.
This leaflet was prepared in March 2019.