What is the most important information I should know about Effexor?

Do not take Effexor if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam) or tranylcypromine (Parnate) during the past 14 days. When these medicines were taken at the same time serious and sometimes fatal reactions have occurred so they must not be used together with Effexor.

You may have an increased risk of suicidal thoughts or behavior at the start of treatment with an antidepressant medication, especially if you are 18 years of age or younger. Talk with your doctor about this risk. While you are taking Effexor you will have to be monitored for worsening symptoms of depression and/ or suicidal thoughts during the first weeks of treatment or whenever your dose is changed. In addition to you watching for changes in your own symptoms, your family or other caregivers should be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

Contact your doctor if you have any of the following side effects, especially if they are new symptoms or if they get worse: irritability, mood changes, anxiety, aggressiveness, panic attacks, trouble sleeping, agitation, severe restlessness, mania (mental and/ or physical hyperactivity) or thoughts of suicide or hurting yourself.

It may take 4 weeks or more for you to start feeling better. Do not stop using Effexor without talking to your doctor first. You may have unpleasant side effects if you stop taking this medication suddenly.

What is Effexor?

Effexor is in a class of drugs called antidepressants. Effexor affects chemicals in the brain that may become unbalanced and cause depression, panic or anxiety.

Effexor is used to treat major depressive disorder, anxiety and panic disorder.

Effexor may also be used for purposes other than those listed in this medication guide.

What should I discuss with my healthcare provider before taking Effexor?

You may have an increased risk of suicidal thoughts or behavior at the start of treatment with an antidepressant medication, especially if you are under 18 years old. Talk with your doctor about this risk. While you are taking Effexor you will need to be monitored for worsening symptoms of depression and/ or suicidal thoughts during the first weeks of treatment or whenever your dose is changed. In addition to you watching for changes in your own symptoms, your family or other caregivers should be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

Do not take Effexor if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), selegeline (Eldepryl, Emsam) or tranylcypromine (Parnate) during the past 14 days. Serious and sometimes fatal reactions have occurred when these medicines were taken at the same time and they must not be used together with Effexor. You must wait at least 7 days after you stop taking Effexor before you start taking an MAO inhibitor.

Before taking Effexor, tell your doctor if you have:

high cholesterol;

kidney disease;

a bleeding or blood clotting disorder;

a family or personal history of bipolar disorder (manic depression);

glaucoma;

a family or history of suicidal thoughts or actions;

high blood pressure;

seizures or epilepsy;

diet pills; or

cirrhosis or other liver disease.

If you have any of the conditions listed above, you may not be able to take Effexor or you may need a dosage adjustment or special monitoring during treatment.

FDA pregnancy category C. This medication may be harmful to an unborn baby. Similar medicines have caused problems in newborn babies of mothers who used the drug late in pregnancy (during the third trimester). Notify your doctor if you are pregnant or plan to become pregnant during treatment.

Do not use Effexor without telling your doctor if you are breast-feeding a baby as this medication can pass into breast milk and may harm a nursing baby.

Older adults may be more sensitive to the side effects of this medication.

How should I take Effexor?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts or take it for longer than recommended by your doctor. Your doctor may occasionally change your dose to make sure you get the best results from the medication.

Take each dose with water. You should take Effexor with food.

Swallow the controlled-release capsule (Effexor XR) whole, without crushing or chewing. To make the medication easier to swallow, you may open the capsule and sprinkle the medicine into a small amount of applesauce. Swallow all of the mixture without chewing and do not save any for later use.

Try to take Effexor at the same time each day.

It may take 4 weeks or more for you to start feeling better. Do not stop using Effexor without first talking to your doctor. You may have unpleasant side effects if you stop taking this medication suddenly.

Store Effexor at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. However, if it is almost time for the next regularly scheduled dose, skip the missed dose and take the next one as directed. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have taken too much of this medication.

Symptoms of an Effexor overdose may include dizziness, sleepiness, nausea and numbness or tingling in your hands or feet.

What should I avoid while taking Effexor?

Avoid using other medicines that make you sleepy (such as cold medicine, pain medication, muscle relaxers, other antidepressants and medicine for seizures). They can add to sleepiness caused by Effexor.

Avoid drinking alcohol, which can increase some of the side effects of Effexor.

Effexor can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

What are the possible side effects of Effexor?

If you have any of these signs of an allergic reaction: skin rash or hives; difficulty breathing; swelling of your face, lips, tongue or throat, seek emergency medical help.

Contact your doctor promptly if you have any of the following side effects, especially if they are new symptoms or if they get worse: trouble sleeping, mood changes, agitation, anxiety, panic attacks, irritability, severe restlessness, aggressiveness, mania (mental and/ or physical hyperactivity), thoughts of suicide or hurting yourself.

Call your doctor at once if you have any of these serious side effects:

increased blood pressure (severe headache, blurred vision);

seizure (convulsions); or

feeling light-headed, fainting;

fast or slow heartbeat.

Other less serious side effects are more likely to occur, such as:

dry mouth;

drowsiness or dizziness;

nervousness or anxiety;

sleep problems (insomnia);

nausea, vomiting, diarrhea, constipation;

decreased sex drive, impotence or difficulty having an orgasm;

headache, blurred vision;

tremor or chills;

increased sweating; or

changes in appetite or weight.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect Effexor?

Do not take Effexor together with a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl), or tranylcypromine (Parnate). You must wait at least 14 days after stopping an MAOI before you can take Effexor. You must wait at least 7 days after you stop taking Effexor before you start taking an MAO inhibitor.

Before taking Effexor, tell your doctor if you are using any of the following medicines:

methadone (Dolophine, Methadose);

diet pills;

diuretics;

cimetidine (Tagamet, Tagamet HB);

warfarin (Coumadin);

amiodarone (Cordarone), quinidine (Quinadex, Cardioquin, Quinaglute), mibefradil (Posicor)

HIV medicines such as indinavir (Crixivan), ritonavir (Norvir); saquinavir (Invirase), nelfinavir (Viracept);

haloperidol (Haldol) or risperidone (Risperdal); or

Other antidepressants such as clomipramine (Anafranil), desipramine (Norpramin), duloxetine (Cymbalta), fluoxetine (Prozac), paroxetine (Paxil), buproprion (Wellbutrin, Zyban).

If you are using any of these drugs, you may not be able to use Effexor or you may need dosage adjustments or special tests during treatment.

There may be other drugs not listed that can affect Effexor. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.