Venlafaxine, Oral Tablet

Health Line

28-05-2025

Venlafaxine oral tablets are prescribed for depression and social anxiety disorder. Venlafaxine is a generic antidepressant drug. Side effects can include nausea and decreased appetite.
Highlights for venlafaxine
Venlafaxine oral tablets come in immediate-release and extended-release form. They're only available as generic drugs.
Both forms of venlafaxine tablets are used to treat depression. The extended-release tablets are also used to treat social anxiety disorder.
Venlafaxine also comes as an extended-release oral capsule, which is available as the brand-name drug Effexor XR. This article focuses on the tablets.
Important warnings
Boxed warning
Venlafaxine has a boxed warning. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For details, see the ' Venlafaxine warnings ' section.
Other warnings
Serotonin syndrome: Venlafaxine may cause a possibly life threatening condition called serotonin syndrome. Symptoms of serotonin syndrome can include:
hallucinations and delusions
agitation
coma
fast heart rate
changes in blood pressure
dizziness
loss of consciousness
seizures
shakiness
muscle tremors or stiff muscles
sweating
nausea and vomiting
High blood pressure: Venlafaxine may increase your blood pressure. Your doctor will likely make sure your blood pressure is normal before you start taking venlafaxine. They will check your blood pressure regularly during your treatment.
Increased bleeding: This drug may increase your risk for bleeding or bruising if used with aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen, or the blood thinner warfarin. Talk with your doctor if you're taking or planning to take any prescription or over-the-counter medications that increase the risk of bleeding.
Venlafaxine uses
Venlafaxine oral tablets are used to treat major depressive disorder, also called depression. The extended-release tablets are also used to treat social anxiety disorder.
Venlafaxine may be used as part of a combination therapy. This means you may need to take it with other medications to treat your condition.
Symptoms of depression can include:
feeling sad
loss of interest in things you used to enjoy
difficulty sleeping or sleeping more than usual
difficulty thinking or focusing
Social anxiety disorder is a type of anxiety experienced during social interactions, which can cause a fast heart rate, sweating, and shakiness. Symptoms can also include a fear of being judged by others and avoidance of social situations.
How venlafaxine works
Venlafaxine belongs to a class of antidepressant drugs called serotonin-norepinephrine reuptake inhibitors (SNRIs). SNRIs work by increasing the levels of chemicals called serotonin and norepinephrine in your brain. Having more serotonin and norepinephrine in your brain can help reduce symptoms of depression and anxiety.
Venlafaxine side effects
The following lists describe some of the more common side effects that venlafaxine may cause. These lists don't include all possible side effects.
Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. Sharing your experience helps make medications safer for everyone by giving doctors and researchers more information about how the drug works in real life. If you develop a side effect while taking venlafaxine and want to tell the FDA about it, visit MedWatch or call 800-FDA-1088.
More common side effects
The more common side effects of venlafaxine can include:
unusual dreams
sexual problems, such as:
decreased interest in sex
erectile dysfunction (inability to get or keep an erection)
trouble having an orgasm
loss of appetite
constipation
nausea or vomiting
dry mouth
drowsiness
trouble sleeping or changes in sleep habits
yawning
tremors or shaking
dizziness
blurry vision
sweating
feeling anxious, nervous, or jittery
headache
increased heart rate
Note: Venlafaxine oral tablet may cause drowsiness. It may also affect your ability to make decisions, think clearly, or react quickly. You should not drive, use heavy machinery, or do things that require you to be alert until you know how venlafaxine affects you.
If these effects are mild, they may go away within a few days or a couple of weeks. If they're more severe or don't go away, talk with your doctor or pharmacist.
Serious side effects
Call your doctor right away if you have serious side effects. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you're having a medical emergency. Serious side effects and their symptoms can include the following:
Mood changes, such as:
new or worsened depression
new or worsened anxiety
agitation, restlessness, anger, or irritability
Serotonin syndrome. Symptoms can include:
agitation
hallucinations (seeing or hearing something that isn't there)
changes in your mental status
coordination problems
muscle twitching or overactive reflexes
fast heart rate
nausea, vomiting, and diarrhea
muscle stiffness
High blood pressure. This condition may not cause symptoms, but in severe cases symptoms can include:
headache
chest pain
Mania. Symptoms can include:
severe trouble sleeping
racing thoughts
reckless behavior
excessive energy, happiness, or irritability
talking more or faster than usual
Eye problems. Symptoms can include:
eye pain
vision changes
enlarged pupils
swelling or redness in or around your eyes
Low sodium levels. Symptoms can include:
headache
weakness
confusion
difficulty concentrating
Bleeding, which can cause symptoms such as:
bruising easily
frequent nosebleeds
frequent bleeding from your gums while brushing your teeth or flossing
dark, tar-like stool
bleeding from wounds that's hard to stop
Lung disease or pneumonia. Symptoms can include:
shortness of breath
cough
chest discomfort
Suicidal thoughts or behaviors in young adults (venlafaxine has a boxed warning about this risk).
Aggressive, violent, or impulsive behaviors.
Seizures.
Allergic reaction
For some people, venlafaxine can cause an allergic reaction. In general, symptoms of an allergic reaction can be mild or serious.
What might help
If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms and can determine whether you should continue venlafaxine treatment.
If you have symptoms of a severe allergic reaction, such as swelling or difficulty breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.
If your doctor confirms you've had a serious allergic reaction to venlafaxine, they may have you switch to a different treatment.
Venlafaxine dosage
Your doctor will recommend the dosage of venlafaxine that's right for you. Below are commonly used dosages, but always take the dosage your doctor prescribes.
Your dosage, drug form, and how often you take venlafaxine will depend on:
your age
the condition being treated
which type of tablet you take
other medical conditions you have
how you react to the first dose
Forms and strengths
Venlafaxine is available in the following forms and strengths:
immediate-release tablet (starts working soon after you swallow it): 25 mg, 37.5 mg, 50 mg, 75 mg, 100 mg
extended-release tablet (works over time after you swallow it): 37.5 mg, 75 mg, 150 mg, 225 mg
The tablets should be taken with food. The immediate-release tablets are taken two or three times per day, and the extended-release tablets are taken once per day.
Dosage for depression
Venlafaxine's recommended dosage for depression depends on which tablet you're taking, as described in the following table.
Starting dosage for depression Dosage increases
Venlafaxine immediate-release tablets 75 mg per day divided into two or three doses • if needed, your doctor may increase your dosage up to 150 mg per day
• the maximum dosage is typically 225 mg per day
• for severe depression, doctors may prescribe up to 375 mg per day
Venlafaxine extended-release tablets • 75 mg per day (a single dose taken in the morning or evening)
• in some cases, doctors may prescribe a lower starting dosage of 37.5 mg per day for 4 to 7 days (a single dose taken in the morning or evening) • if needed, your doctor may increase your dose by up to 75 mg every 4 days
• the maximum dosage is 225 mg per day
Dosage for social anxiety disorder
The dosage of venlafaxine extended-release tablets for social anxiety disorder is 75 mg per day, taken as one single dose in the morning or evening.
Dosage considerations
People with liver problems: People with mild to moderate liver problems should take about half of the typical venlafaxine dose. People with severe liver disease or cirrhosis may need an even lower dosage.
People with kidney problems: People with mild to moderate kidney problems should take 50% to 75% of the typical venlafaxine dosage. People who are on dialysis should take half of the typical dosage.
Your doctor will consider your medical history and prescribe the best venlafaxine dosage for you.
What are some frequently asked questions about venlafaxine?
Find answers to some commonly asked questions about venlafaxine.
Does venlafaxine cause withdrawal?
Yes, suddenly stopping venlafaxine without slowly decreasing your dose can cause withdrawal symptoms, which can be severe. Withdrawal symptoms are effects that can occur when you stop taking a drug that your body has become dependent on. These symptoms, also referred to as discontinuation symptoms, can include:
anxiety
irritability
restlessness
tiredness, trouble sleeping, or nightmares
headache
sweating
dizziness
tingling or 'pins and needles' feeling
shaking
confusion
nausea and vomiting
diarrhea
If you want to stop taking venlafaxine, talk with your doctor. They'll have you slowly decrease your dosage, to help avoid withdrawal symptoms. Be sure to follow their dosing instructions.
Is venlafaxine the same as Xanax?
Venlafaxine and Xanax (alprazolam) are prescribed for some of the same conditions, but they belong to different drug classes and are used differently. Venlafaxine is an antidepressant that's typically used long term, and Xanax is a benzodiazepine prescribed for short-term use.
Xanax is approved to treat generalized anxiety disorder and panic disorder. Venlafaxine may be used to treat generalized anxiety disorder, panic disorder, depression, and social anxiety disorder, depending on which form you're prescribed.
Your doctor or pharmacist can tell you more about how these drugs compare.
Venlafaxine may interact with other medications
Taking a medication with certain vaccines, foods, and other things can affect how the medication works. These effects are called interactions.
Before starting venlafaxine treatment, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also, tell them about any herbs or vitamins and supplements you take. Sharing this information can help you avoid potential interactions.
Examples of drugs that can cause interactions with venlafaxine are listed in the following sections.
Drugs that should not be taken with venlafaxine
Your doctor will not prescribe the following drugs with venlafaxine due to a risk of dangerous side effects:
Monoamine oxidase inhibitors (MAOIs), including linezolid (Zyvox) and methylene blue: Unless directed by your doctor, do not start venlafaxine within 2 weeks of stopping an MAOI and do not take an MAOI within 7 days of stopping venlafaxine. Taking venlafaxine and an MAOI too close together in time may cause serious or life threatening side effects including high fever and sudden changes in your heart rate or blood pressure.
Drugs for weight loss, such as phentermine (Adipex-P, Lomaira): Using venlafaxine with drugs such as phentermine may lead to excessive weight loss, serotonin syndrome, and heart problems.
Other interactions
Other medications that are known to interact with venlafaxine include:
Cimetidine. Taking this drug with venlafaxine raises your risk of high blood pressure or liver disease. These risks are even greater if you're age 65 years or older.
Haloperidol. Taking this drug with venlafaxine raises your risk of QT prolongation. This is a heart condition with symptoms such as dizziness and an irregular heart rhythm.
Warfarin (Jantoven). Taking this drug with venlafaxine raises your risk of bleeding. Your doctor will monitor you closely, especially when starting or stopping your venlafaxine therapy. Tell your doctor right away if you notice any abnormal bleeding or bruising.
Aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil), naproxen (Anaprox DS, Naprelan, Naprosyn), and ketoprofen. Taking any of these drugs with venlafaxine raises your risk of bleeding. Your doctor will monitor you closely, especially when starting or stopping your venlafaxine therapy. Tell your doctor right away if you notice any abnormal bleeding or bruising.
Drugs such as ritonavir, clarithromycin, or ketoconazole. Drugs such as ritonavir, clarithromycin, or ketoconazole can slow the breakdown of drugs in your body. If you take any of these drugs with venlafaxine, the amount of venlafaxine may build up in your body. This would increase your risk of side effects.
Drugs that cause drowsiness, such as zolpidem, lorazepam, and diphenhydramine (Benadryl). Taking any of these drugs with venlafaxine may make the sleepiness from venlafaxine even worse.
Other drugs that can increase serotonin levels, such as fluoxetine (Prozac), paroxetine (Paxil), citalopram (Celexa), duloxetine (Cymbalta), lithium, and tramadol (ConZip). Venlafaxine increases your levels of serotonin. Taking it with any of these drugs may increase your serotonin levels even more. If your serotonin levels are too high, a life threatening condition called serotonin syndrome can occur. Your doctor will monitor you closely when starting or increasing your dosage of either drug.
Migraine drugs called triptans, such as sumatriptan (Imitrex), rizatriptan (Maxalt, Maxalt-MLT), and zolmitriptan (Zomig). Taking venlafaxine with any of these drugs may increase your risk of a life threatening condition called serotonin syndrome. Your doctor will monitor you closely when starting or increasing your dosage of either drug.
Metoprolol (Toprol XL). Metoprolol may be less effective when you take it with venlafaxine. This may cause your blood pressure to rise. Talk with your doctor before taking these drugs together.
Venlafaxine cost and savings
Whether you have health insurance or not, cost may be a factor when you're considering venlafaxine. Venlafaxine's cost may depend on several things, such as your treatment plan and the pharmacy you use.
Here are a few things to consider regarding cost:
Cost information and savings coupons: You can visit Optum Perks to get price estimates of what you'd pay for venlafaxine when using coupons from the site. See the coupon options below. (Note: Optum Perks coupons cannot be used with any insurance copays or benefits.)
Drug assistance programs and other resources: Some websites provide details about drug assistance programs, ways to make the most of your insurance coverage, and links to savings cards and other services. Two such websites are:
Medicine Assistance Tool
NeedyMeds
Venlafaxine warnings
Venlafaxine oral tablet comes with several warnings.
Boxed warning
This drug has a boxed warning. Boxed warnings are the most serious warnings from the Food and Drug Administration (FDA). They alert doctors and patients about drug effects that may be dangerous.
Antidepressants, including venlafaxine, may increase suicidal thoughts or actions in some children and young adults. This usually happens within the first few months of treatment or during dosage changes. Venlafaxine is not approved for use in children under 18 years old.
Call your doctor right away if you notice any new or sudden changes in your mood, behavior, thoughts, or feelings, especially if they are severe.
Venlafaxine and alcohol
You should not drink alcohol with venlafaxine tablets. Drinking alcohol raises your risk of drowsiness from venlafaxine. This may affect your ability to make decisions, think clearly, and react quickly.
If you drink alcohol, talk with your doctor about this before starting venlafaxine treatment.
Other warnings
Venlafaxine can sometimes cause harmful effects in people who have certain conditions. This is known as a drug-condition interaction. Other factors may also affect whether venlafaxine is a good treatment option for you.
Talk with your doctor about your health history before you take venlafaxine. Be sure to tell them if any of the following factors apply to you:
liver, kidney, or heart problems
hyperthyroidism (high thyroid levels)
history of seizures
glaucoma
previous allergic reaction to venlafaxine or any of its ingredients
Pregnancy and breastfeeding
Your doctor might prescribe venlafaxine for use during pregnancy if the possible benefits of treatment outweigh the risks. There haven't been enough studies done in humans to be certain how the drug might affect a pregnant person or a fetus.
Talk with your doctor if you're pregnant or planning to become pregnant. Call your doctor right away if you become pregnant while taking this drug.
Venlafaxine may pass into breast milk and cause side effects in a child who is breastfed. Talk with your doctor about breastfeeding your child. You may need to decide whether to stop breastfeeding or stop taking this medication.
How to take venlafaxine
You should take venlafaxine tablets with food. And try to take your dose(s) at about the same time(s) each day. The immediate-release tablets are taken two or three times per day, and the extended-release tablets are taken once per day.
Venlafaxine tablets are typically used for long-term treatment, foras long as you and your doctor consider the drug to be safe and effective for you.
If you stop taking the drug suddenly or don't take it at all: Your depression or anxiety symptoms may get worse. Do not stop venlafaxine without talking with your doctor.
Stopping venlafaxine too quickly can cause serious symptoms. If this happens, your doctor may have you start taking venlafaxine again and decrease your dosage slowly. See the 'What are some frequently asked questions about venlafaxine?' section for details.
If you miss doses or don't take the drug on schedule: The medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.
If you take too much: You could have dangerous levels of venlafaxine in your body. This can lead to death. Symptoms of an overdose of this drug can include:
fast heart rate or heart rhythm changes
unusual sleepiness
enlarged pupils
seizure
vomiting
low blood pressure
muscle aches or pains
dizziness
If you think you've taken too much of this drug, call your doctor or seek guidance from America's Poison Centers at 800-222-1222 or through its online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.
What to do if you miss a dose: Take your dose as soon as you remember. If you remember just a few hours before your next scheduled dose, take only one dose. Never try to catch up by taking two doses at once. This could result in dangerous side effects.
How to tell if the drug is working: The symptoms of your depression or anxiety should be less severe or happen less often.
Important considerations for taking venlafaxine
Keep these considerations in mind if your doctor prescribes venlafaxine oral tablet for you.
General
Take venlafaxine with food.
You can cut or crush the immediate-release tablet, but do not cut or crush the extended-release tablet.
Storage
Store the immediate-release oral tablet at room temperature between 68°F and 77°F (20°C and 25°C).
Store the extended-release oral tablet at temperatures between 59°F and 86°F (15°C and 30°C).
Keep this drug away from light.
Do not store this medication in moist or damp areas, such as bathrooms.
Travel
When traveling with your medication:
Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled container with you.
Do not put this medication in your car's glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.
Are there any alternatives?
There are other drugs available to treat your condition. Some may be better suited for you than others. Talk with your doctor about other drug options that may work for you.
Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.