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Venlafaxine.

Structure

Venlafaxine 37.5 capsules:
- 37.5 mg - Venlafaxine Hydrochloride;

Venlafaxine 75 capsules:
- 75 mg - Venlafaxine Hydrochloride;

Venlafaxine 150 capsules:
- 150 mg - Venlafaxine Hydrochloride;

Indications

Venlafaxine is prescribed for the treatment of Major Depression and Generalised Anxiety Disorder.

Dosage

Venlafaxine should be administered in a single dose with food in the morning or in the evening at approximately the same time each day. Each capsule should be swallowed whole with fluid and not divided, crushed, chewed or placed in water.

Initial Treatment
Dosage for Elderly Patients
No dose adjustment is recommended for elderly patients solely on the basis of age. As with any drug for the treatment of depression however, caution should be exercised in treating the elderly. When individualizing the dosage, extra care should be taken when increasing the dose.

Dosage for Patients with Renal Impairment
Venlafaxine is recommended that the total daily dose should be reduced by 25-50%. In patients undergoing hemodialysis, it is recommended that the total daily dose should be reduced by 50% and that the dose be withheld until the dialysis treatment is completed (4 hrs).

Dosage for Patients with Hepatic Impairment
Venlafaxine is recommended that the starting dose be reduced by 50% in patients with moderate hepatic impairment.

Switching Patients from Venlafaxine Tablets
Depressed patients who are currently being treated at a therapeutic dose with Venlafaxine may be switched to Venlafaxine at the nearest equivalent dose (mg/day), e.g., 37.5 mg venlafaxine two-times-a-day to 75 mg Venlafaxine once daily. However, individual dosage adjustments may be necessary.

Dosage for Generalised Anxiety Disorder
Venlafaxine recommended starting dose is 75 mg/day, administered in a single dose. For some patients, it may be desirable to start at 37.5 mg/day for 4 to 7 days, to allow new patients to adjust to the medication before increasing to 75 mg/day.
Doses may be increased to a maximum of approximately 225 mg/day in patients not responding to the initial 75-mg/day doses. Dose increases should be in increments of up to 75 mg/day, as needed, and should be made at intervals of not less than 4 days.

Major Depression
For most patients, the recommended starting dose for Venlafaxine is 75 mg/day, administered in a single dose. For some patients, it may be desirable to start at 37.5 mg/day for 4 to 7 days, to allow new patients to adjust to the medication before increasing to 75 mg/day. Doses may be increased to a maximum of approximately 225 mg/day in patients not responding to the initial 75-mg/day doses. Dose increases should be in increments of up to 75 mg/day, as needed, and should be made at intervals of not less than 4 days, since steady state plasma levels of venlafaxine and its major metabolite are achieved in most patients by day 4.

Maintenance/Extended Treatment
There is no body of evidence available from controlled trials to indicate how long patients with depression should be treated with Venlafaxine.
Venlafaxine is generally agreed, however, that pharmacological treatment for acute episodes of depression should continue for up to six months or longer. Whether the dose of antidepressant needed to induce remission is identical to the dose needed to maintain euthymia is unknown.

Switching Patients to or from Monoamine Oxidase Inhibitors
At least 14 days should elapse between discontinuation of a MAOI and initiation of therapy with Venlafaxine. In addition at least 7 days should be allowed after stopping Venlafaxine before starting a MAOI.

Discontinuing Venlafaxine
When discontinuing Venlafaxine after more than 1 week of therapy, it is generally recommended that the dose be tapered to minimize the risk of discontinuation symptoms.

Contraindications

Concomitant use in patients taking monoamine oxidase inhibitors (MAOIs) is contraindicated.

Venlafaxine is contraindicated in patients known to be hypersensitive to venlafaxine hydrochloride.

Form

Blister strip of 10 capsules;

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2004 - 2017