Venlor (venlafaxine hydrochloride) is a prescription antidepressant medication belonging to the serotonin-norepinephrine reuptake inhibitor (SNRI) class. It is clinically indicated for the treatment of major depressive disorder (MDD), generalized anxiety disorder (GAD), social anxiety disorder (SAD), and panic disorder (PD). This medication works by increasing the levels of two key neurotransmitters in the brain—serotonin and norepinephrine—which are believed to play a crucial role in regulating mood, emotion, and anxiety. Venlor is available in both immediate-release (IR) and extended-release (XR) formulations, allowing for tailored treatment regimens under strict medical supervision. Its dual mechanism of action often makes it a preferred choice for patients who have not responded adequately to selective serotonin reuptake inhibitors (SSRIs) alone.

Features

• Active Ingredient: Venlafaxine hydrochloride.
• Therapeutic Class: Serotonin-Norepinephrine Reuptake Inhibitor (SNRI).
• Available Formulations: Immediate-release (IR) tablets and extended-release (XR) capsules.
• Standard Strengths: 25 mg, 37.5 mg, 50 mg, 75 mg, and 100 mg tablets; 37.5 mg, 75 mg, and 150 mg extended-release capsules.
• Administration: Oral, with or without food.
• Bioavailability: Approximately 45% for the parent drug venlafaxine.
• Half-life: Venlafaxine: 5±2 hours; active metabolite O-desmethylvenlafaxine: 11±2 hours.
• Metabolism: Primarily hepatic, via CYP2D6 isoenzyme.
• Excretion: Renal (87%) and fecal (10%).

Benefits

• Effectively alleviates the core symptoms of major depression, including low mood, anhedonia, and fatigue.
• Reduces excessive worry, nervousness, and physical symptoms associated with generalized anxiety disorder.
• Helps manage anticipatory anxiety and avoidance behaviors in social and panic disorders.
• May improve energy levels and concentration by modulating norepinephrine activity.
• The extended-release formulation allows for once-daily dosing, improving adherence and minimizing peak-trough fluctuations.
• Provides a therapeutic option for patients with treatment-resistant depression or comorbid anxiety and depression.

Common use

Venlor is primarily prescribed for the management of major depressive disorder (MDD) and several anxiety disorders. In MDD, it is used to treat persistent feelings of sadness, loss of interest, changes in sleep or appetite, low energy, and difficulty concentrating. For anxiety indications, it is effective in reducing the excessive, uncontrollable worry characteristic of generalized anxiety disorder, the fear of social situations in social anxiety disorder, and the sudden, intense episodes of fear in panic disorder. It may also be used off-label for conditions such as obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and neuropathic pain, based on clinical judgment.

Dosage and direction

Dosage must be individualized and initiated under the supervision of a healthcare provider. For the extended-release (XR) capsules, the typical starting dose for depression and anxiety disorders is 75 mg once daily, taken in the morning or evening with food. Depending on patient response and tolerability, the dose may be increased in increments of 75 mg per day at intervals of no less than 4 days, up to a maximum of 225 mg per day. For the immediate-release (IR) tablets, the usual starting dose is 37.5 mg administered twice daily. This can be increased to 75 mg twice daily, with further adjustments as needed. Doses above 225 mg per day require close medical monitoring. The capsules should be swallowed whole and must not be crushed, chewed, or placed in water. Abrupt discontinuation should be avoided; a gradual taper is necessary to minimize withdrawal symptoms.

Precautions

Patients should be monitored for clinical worsening, suicidality, or unusual changes in behavior, especially during the initial few months of therapy or after dosage changes. Venlor may increase the risk of bleeding; caution is advised in patients taking anticoagulants or with a history of bleeding disorders. It can cause an increase in blood pressure; regular monitoring of blood pressure is recommended, particularly at higher doses. Use with caution in patients with a history of mania/hypomania, seizures, or angle-closure glaucoma. May impair judgment, thinking, or motor skills; patients should be cautioned about operating hazardous machinery or driving until they know how the medication affects them. Alcohol consumption should be avoided due to potential additive CNS effects.

Contraindications

Venlor is contraindicated in patients with known hypersensitivity to venlafaxine hydrochloride or any excipients in the formulation. It must not be used concomitantly with, or within 14 days of discontinuing, monoamine oxidase inhibitors (MAOIs) due to the risk of serious, sometimes fatal, drug interactions, including serotonin syndrome. Concomitant use with linezolid or intravenous methylene blue is also contraindicated.

Possible side effect

Common side effects (≥5% incidence) include nausea, headache, drowsiness, dry mouth, dizziness, insomnia, constipation, sweating, nervousness, and asthenia. Other notable side effects may include:

• Increased blood pressure
• Decreased appetite, weight loss
• Sexual dysfunction (e.g., decreased libido, erectile dysfunction, anorgasmia)
• Abnormal dreams
• Tremor
• Blurred vision
• Yawning
• Tinnitus Serious side effects requiring immediate medical attention include signs of serotonin syndrome (agitation, hallucinations, tachycardia, hyperthermia, muscle rigidity), severe skin reactions, seizures, abnormal bleeding, manic episodes, hyponatremia, or angle-closure glaucoma.

Drug interaction

Venlor has a significant potential for drug interactions, primarily due to its metabolism via CYP2D6 and its serotonergic activity.

• MAOIs: Absolute contraindication (risk of serotonin syndrome).
• Other Serotonergic Drugs: (e.g., SSRIs, SNRIs, triptans, tramadol, fentanyl, lithium, St. John’s Wort) – increased risk of serotonin syndrome.
• Drugs that Inhibit CYP2D6: (e.g., quinidine, fluoxetine, paroxetine) – may increase venlafaxine plasma concentrations.
• Drugs that Prolong QT Interval: (e.g., certain antipsychotics, antiarrhythmics) – potential additive effect.
• NSAIDs, Aspirin, Warfarin: Increased risk of bleeding.
• Antihypertensive Drugs: Venlor may reduce their efficacy.

Missed dose

If a dose is missed, it should be taken as soon as remembered. However, if it is almost time for the next scheduled dose, the missed dose should be skipped and the regular dosing schedule resumed. Do not double the dose to make up for a missed one.

Overdose

Overdose symptoms may include dizziness, drowsiness, nausea, tachycardia, changes in blood pressure, seizures, and serotonin syndrome. In cases of suspected overdose, seek immediate medical attention or contact a Poison Control Center. Treatment is symptomatic and supportive; there is no specific antidote. ECG monitoring is advised due to the risk of QT prolongation.

Storage

Store at room temperature (20°C to 25°C or 68°F to 77°F), with excursions permitted between 15°C and 30°C (59°F and 86°F). Keep in the original container, tightly closed, and protect from moisture and light. Keep out of reach of children and pets.

Disclaimer

This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or medication. Do not disregard professional medical advice or delay in seeking it because of something you have read here.

Reviews

“After struggling with GAD for years and trying several SSRIs with limited success, my psychiatrist switched me to Venlor XR. The difference was noticeable within a few weeks. My constant worry has diminished significantly, and I feel more capable of handling daily stressors. The once-daily dosing is convenient. I did experience some initial nausea, but it subsided.” – J.D., 42 “Venlor has been instrumental in managing my treatment-resistant depression. It provided the ‘boost’ that other medications didn’t. However, the side effect of excessive sweating is quite bothersome. It’s a trade-off I’m willing to make for the mental stability it provides.” – M.K., 35 “Effective for my panic disorder, but the discontinuation syndrome is severe if I miss a dose or try to taper too quickly. It requires meticulous management under a doctor’s care.” – A.P., 29