Generic Drug Therapeutic Class: Neurology-Psychiatry
Active ingredients: Venlafaxine
laboratory: Wyeth Pharmaceuticals FR
Box of 30
- Major depressive episodes (that is, characterized).
- Prevention of depressive recurrence in patients with unipolar disorder.
Dosage EFFEXOR 25 mg Tablet Box of 30
- Adult dosage:
. In depressions, in ambulatory treatment, the initial dosage is usually 75 mg / day (in 2 or 3 doses). After two weeks, if necessary, it can be raised up to 150 mg / day (in 2 or 3 shots).
. In the so-called "severe" forms of depression (see pharmacodynamic properties), the recommended daily dosage is 150 to 225 mg. It can be increased up to 350 mg / day in the hospitalized patient. In these cases, the dosage will be administered in 3 daily doses and the dose increase will be done in stages every 2 or 3 days depending on the efficacy and adverse effects of treatment.
After obtaining the desired therapeutic response, the treatment can be gradually reduced to the minimum dosage compatible with the maintenance of efficiency and good tolerance.
The maximum dosage allowed is 375 mg / day.
EFFEXOR 25 mg tablets should always be taken during a meal.
- In case of renal and / or hepatic insufficiency:
. In case of renal insufficiency, the dosage should be reduced. This reduction will be 50% if the glomerular filtration rate is less than 30 ml / min.
The product should not be administered during a dialysis session.
. In moderate hepatic impairment, the dosage should be reduced by half. A reduction of more than 50% may be necessary in some patients.
In the elderly, take into account the reduction of glomerular filtration frequently encountered; moreover, as with any antidepressant, vigilance is required when initiating treatment or adjusting the dosage.
- Duration of the treatment :
The treatment of major depressive episodes generally requiring a continuous medication prescription for several months, it is appropriate to re-evaluate periodically and on a case by case basis.
- Stop treatment:
When discontinuing venlafaxine therapy, it is recommended that the dose be gradually decreased to prevent the occurrence of withdrawal syndrome (see precautions for use and adverse effects). Thus, beyond a treatment of 6 weeks, this decrease will be done in at least 2 weeks. The decay period may depend on the dose, the duration of the treatment and the patient himself. The patient will be advised not to interrupt the treatment on his own.
- Prevention of recurrence of major depressive episodes:
The efficacy of venlafaxine has been demonstrated in the prevention of depressive recurrence in patients who responded to venlafaxine in the last episode. In the vast majority of cases, the recommended dosage during prophylactic maintenance is the same as that used to treat the current episode.
The patient should be re-evaluated periodically and the benefit of prophylaxis should be evaluated.
When discontinuing prophylaxis, it is recommended to proceed with a gradual decrease in dosage over a period of approximately 2 weeks.
This phase of decreasing dosage will be longer as the dosage used will have been high and the duration of treatment extended.
This medicine MUST NEVER BE prescribed in the following cases:
- Known hypersensitivity to venlafaxine.
- Children or adolescents under 18 years old.
- Breast-feeding: Because of a significant passage of this drug into breast milk, breastfeeding is contraindicated.
- Association with non-selective MAOIs (iproniazide) (see interactions section).
Due to the presence of lactose, this drug is contraindicated in cases of congenital galactosemia, glucose-galactose malabsorption syndrome or lactase deficiency.
NOT RECOMMENDED :
This medicine MUST NOT be prescribed in the following cases:
- Associations with sympathomimetics alpha and beta (adrenaline, noradrenaline and dopamine) parenterally, MAOI selective A (moclobemide, toloxatone), linezolid.
- Although no clear interaction has been demonstrated with alcohol, consumption is discouraged, as with any psychotropic medication.
Adverse effects Effexor
The incidence and severity of nausea (assessed by visual analogue scale) were reduced by 2 or 3 with the use of venlafaxine extended-release form compared with the immediate-release form, in healthy volunteers, and during clinical tests.
- The most common clinical side effects are:
nausea, constipation, anorexia, vertigo, dryness of the mouth, insomnia, drowsiness, nervousness, asthenia, hypersudation (nocturnal in particular), disorders of ejaculation and orgasm.
. A rise in blood pressure, systolic and diastolic, can be observed under venlafaxine. Discrete at doses less than 200 mg per day, the incidence of its occurrence is then similar to that seen with imipramine antidepressants; at higher doses, particularly 300 to 375 mg per day, this rise is more sensitive. It is recommended to monitor the blood pressure of patients treated with venlafaxine, especially at doses of 200 mg / day or more (see warnings).
. Increases in cholesterol levels have been observed, especially during prolonged administration and / or in high doses.
- Clinical adverse events observed at a lower frequency are:
. abdominal pain, dyspeptic disorders, diarrhea, flatulence, vomiting, weight loss, unusually weight gain,
. headache, anxiety, agitation, delirium, tremors, paresthesia, abnormal dreams,
. convulsions (see warnings),
. mydriasis, disturbances of accommodation,
. pollakiuria, dysuria, urine retention,
. hypotension, orthostatic hypotension, palpitations, vasodilation,
. decreased libido, impotence,
. rashes sometimes maculopapular, erythematous, pruritus, cutaneous-mucous bleeding (see precautions for use), exceptional cases of erythema multiforme have been reported,
- Uncommon side effects are:
Cases of serotonin syndrome have been observed exceptionally in association (see interactions).
- The rare side effects observed are:
. elevations of hepatic transaminases and hepatitis. In case of abnormal liver function, discontinuation of treatment is required. It most often leads to a return to normal,
. hyponatraemia (see precautions for use).
- Very rare side effects are:
. leukopenia, neutropenia and pancytopenia,
. increases in prolactin,
. extrapyramidal manifestations (including dystonia and tardive dyskinesia).
- The following withdrawal symptoms were observed during the abrupt or gradual discontinuation of treatment or when the dosage was decreased: anxiety, agitation, dizziness, convulsions, sleep disorders, asthenia, paresthesia, headache, tinnitus, nausea .
- In addition, certain undesirable effects are linked to the very nature of the depressive illness:
. removal of psychomotor inhibition, with suicidal risk,
. reversal of mood with onset of manic episodes,
. reactivation of delirium in psychotic subjects,
. paroxysmal manifestations of anxiety.