This Medication was approved by the U.S. Food and Drug Administration.			Revised: 8/2022
MEDICATION GUIDE EFFEXOR XR (e-fex-or XR) (venlafaxine extended-release) capsules
What is the most important information I should know about EFFEXOR XR? EFFEXOR XR may cause serious side effects, including: Increased risk of suicidal thoughts and actions. EFFEXOR XR and other antidepressant medicines may increase suicidal thoughts and actions in some children, adolescents, and young adults, especially within the first few months of treatment or when the dose is changed. EFFEXOR XR is not for use in children. Depression or other serious mental illnesses are the most important causes of suicidal thoughts or actions. How can I watch for and try to prevent suicidal thoughts and actions in myself or a family member? Pay close attention to any changes, especially sudden changes, in mood, behaviors, thoughts, or feelings. This is very important when an antidepressant medicine is started or when the dose is changed. Call your healthcare provider right away to report new or sudden changes in mood, behavior, thoughts, or feelings. Keep all follow-up visits with your healthcare provider as scheduled. Call your healthcare provider between visits as needed, especially if you have concerns about symptoms. Call your healthcare provider or get emergency help right away if you or a family member have any of the following symptoms, especially if they are new, worse, or worry you:
	attempts to commit suicide acting aggressive, being angry, or violent new or worse depression panic attacks new or worse irritability an extreme increase in activity or talking (mania)		thoughts about suicide or dying acting on dangerous impulses new or worse anxiety feeling very agitated or restless trouble sleeping other unusual changes in behavior or mood
What is EFFEXOR XR? EFFEXOR XR is a prescription medicine used to treat adults with: a certain type of depression called Major Depressive Disorder (MDD) Generalized Anxiety Disorder (GAD) Social Anxiety Disorder (SAD) Panic Disorder (PD) It is not known if EFFEXOR XR is safe and effective for use in children.
Do not take EFFEXOR XR if you: are allergic to venlafaxine hydrochloride, desvenlafaxine succinate, or any of the ingredients in EFFEXOR XR. See the end of this Medication Guide for a complete list of ingredients in EFFEXOR XR. take a Monoamine Oxidase Inhibitor (MAOI) have stopped taking an MAOI in the last 14 days are being treated with the antibiotic linezolid or intravenous methylene blue Ask your healthcare provider or pharmacist if you are not sure if you take an MAOI, including MAOIs such as linezolid or intravenous methylene blue. Do not start taking an MAOI for at least 7 days after you stop treatment with EFFEXOR XR.
Before taking EFFEXOR XR tell your healthcare provider about all your medical conditions, including if you: have, or have a family history of suicide, bipolar disorder, depression, mania or hypomania have high blood pressure have heart problems have cerebrovascular problems or had a stroke have or have had bleeding problems have high pressure in the eye (glaucoma) have high cholesterol or high triglycerides have kidney or liver problems have or had seizures or convulsions have low sodium levels in your blood have lung problems drink alcohol are pregnant or plan to become pregnant. EFFEXOR XR may harm your unborn baby. Talk to your healthcare provider about the risk to you and your unborn baby if you take EFFEXOR XR during pregnancy. Tell your healthcare provider if you become pregnant or think you are pregnant during treatment with EFFEXOR XR. Pregnancy Exposure Registry. There is a pregnancy registry for women who are exposed to EFFEXOR XR during pregnancy. The purpose of the registry is to collect information about the health of you and your baby. If you become pregnant during treatment with EFFEXOR XR, talk to your healthcare provider about registering with the National Pregnancy Registry for Antidepressants. You can register by calling 1-844-405-6185 or by visiting online at https://womensmentalhealth.org/research/pregnancyregistry/antidepressants. are breastfeeding or plan to breastfeed. EFFEXOR XR passes into your breast milk and may harm your baby. Talk to your healthcare provider about the best way to feed your baby during treatment with EFFEXOR XR. Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. EFFEXOR XR and other medicines may affect each other causing possible serious side effects. EFFEXOR XR may affect the way other medicines work and other medicines may affect the way EFFEXOR XR works. Especially tell your healthcare provider if you take: medicines to treat migraine headaches known as triptans tricyclic antidepressants fentanyl lithium tramadol tryptophan buspirone amphetamines St. John's Wort phentermine other medicines containing desvenlafaxine or venlafaxine medicines that can affect blood clotting such as aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), warfarin Ask your healthcare provider if you are not sure if you are taking any of these medicines. Your healthcare provider can tell you if it is safe to take EFFEXOR XR with your other medicines. Do not start or stop any other medicines during treatment with EFFEXOR XR without first talking to your healthcare provider. Stopping EFFEXOR XR suddenly may cause you to have serious side effects. See, "What are the possible side effects of EFFEXOR XR?" Know the medicines you take. Keep a list of them to show to your healthcare provider and pharmacist when you get a new medicine.
How should I take EFFEXOR XR? Take EFFEXOR XR exactly as your healthcare provider tells you to. Do not change your dose or stop taking EFFEXOR XR without first talking to your healthcare provider. Your healthcare provider may need to change the dose of EFFEXOR XR until it is the right dose for you. Take EFFEXOR XR 1 time each day with food. EFFEXOR may be taken either in the morning or in the evening, but take it the same way each time. Swallow EFFEXOR XR whole with fluid. Do not divide, crush, chew, or dissolve EFFEXOR XR. If you cannot swallow EFFEXOR XR capsules whole, the EFFEXOR XR capsules may be opened and the entire contents sprinkled on a spoonful of applesauce. Swallow the EFFEXOR XR and applesauce mixture right away without chewing. Follow with a glass of water to make sure you have swallowed all of the EFFEXOR XR pellets. If you take too much EFFEXOR XR, call healthcare provider or poison control center at 1-800-222-1222 or go to the nearest hospital emergency room right away.
What should I avoid while taking EFFEXOR XR? Do not drive, or operate heavy machinery, or do other dangerous activities until you know how EFFEXOR XR affects you. EFFEXOR XR cam make you drowsy. You should not drink alcohol during treatment with EFFEXOR XR. Drinking alcohol during treatment with EFFEXOR XR can increase your risk of having serious side effects.
What are the possible side effects of EFFEXOR XR? EFFEXOR XR may cause serious side effects, including: See, "What is the most important information I should know about EFFEXOR XR?" Serotonin syndrome. Taking EFFEXOR XR can cause a potentially life-threatening problem called serotonin syndrome. The risk of developing serotonin syndrome is increased when EFFEXOR XR it taken with certain other medicines. See, "Do not take EFFEXOR XR if you:" Stop taking EFFEXOR XR and call your healthcare provider or go to the nearest hospital emergency room right away if you have any of the following signs and symptoms of serotonin syndrome:
	agitation confusion fast heartbeat dizziness flushing tremors, stiff muscles, or muscle twitching seizures		seeing or hearing things that are not real (hallucinations) coma changes in blood pressure sweating high body temperature (hyperthermia) loss of coordination nausea, vomiting, diarrhea
Increases in blood pressure. Your healthcare provider should check your blood pressure before starting treatment and regularly during treatment with EFFEXOR XR. If you have high blood pressure, it should be controlled before you start treatment with EFFEXOR XR. Increased risk of bleeding. Taking EFFEXOR XR with aspirin, non-steroidal anti-inflammatory drugs (NSAIDs), or blood thinners may add to this risk. Tell your healthcare provider right away about any unusual bleeding or bruising. Eye problems (angle-closure glaucoma). EFFEXOR XR may cause a certain type of eye problem called angle-closure glaucoma. You may want to undergo an eye examination to see if you are at risk and receive preventative treatment if you are. Call your healthcare provider if you have eye pain, changes in your vision, or swelling or redness in or around the eye. Manic episodes. Manic episodes may happen in people with bipolar disorder who take EFFEXOR XR. Symptoms may include:
	greatly increased energy racing thoughts unusually grand ideas talking more or faster than usual		severe trouble sleeping reckless behavior excessive happiness or irritability
Discontinuation syndrome. Suddenly stopping EFFEXOR XR may cause you to have serious side effects. Your healthcare provider may want to decrease your dose slowly. Symptoms may include:
	dizziness irritability and agitation anxiety sweating seizures ringing in your ears (tinnitus)	nausea problems sleeping tiredness confusion electric shock sensation (paresthesia)	headache diarrhea abnormal dreams changes in your mood hypomania
Seizures (convulsions). Low sodium levels in your blood (hyponatremia). Low sodium levels can happen during treatment with EFFEXOR XR. Low sodium levels in your blood may be serious and may cause death. Elderly people may be at greater risk for this. Signs and Symptoms of low sodium levels in your blood may include: headache difficulty concentrating memory changes confusion weakness and unsteadiness on your feet which can lead to falls In severe or more sudden cases, signs and symptoms include: hallucinations (seeing or hearing things that are not real) fainting seizures coma respiratory arrest Lung problems. Some people who have taken the medicine venlafaxine which is the same kind of medicine as the medicine in EFFEXOR XR have had lung problems. Symptoms of lung problems include difficulty breathing, cough, or chest discomfort. Tell your healthcare provider right away if you have any of these symptoms. Sexual problems (dysfunction). Taking selective serotonin reuptake inhibitors (SNRIs), including EFFEXOR XR, may cause sexual problems. Symptoms in males may include: delayed ejaculation or inability to have an ejaculation decreased sex drive problems getting or keeping an erection Symptoms in females may include: decreased sex drive delayed orgasm or inability to have an orgasm Talk to your healthcare provider if you develop any changes in your sexual function or if you have any questions or concerns about sexual problems during treatment with EFFEXOR XR. There may be treatments your healthcare provider can suggest.
Your healthcare provider may tell you to stop taking EFFEXOR XR if you develop serious side effects during treatment with EFFEXOR XR.
The most common side effects of EFFEXOR XR include:
	nausea dry mouth male and female sexual problems loss of appetite (anorexia)		sleepiness sweating constipation
These are not all the possible side effects of EFFEXOR XR. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
How should I store EFFEXOR XR? Store EFFEXOR XR at room temperature between 68°F to 77°F (20°C to 25°C). Keep EFFEXOR XR in a dry place. Keep EFFEXOR XR and all medicines out of the reach of children.
General Information about the safe and effective use of EFFEXOR XR. Medicines are sometimes prescribed for purposes other than those listed in a Medication Guide. Do not use EFFEXOR XR for a condition for which it was not prescribed. Do not give EFFEXOR XR to other people, even if they have the same symptoms that you have. It may harm them. You can ask your healthcare provider or pharmacist for information about EFFEXOR XR that is written for healthcare professionals.
What are the ingredients in EFFEXOR XR? Active ingredient: venlafaxine Inactive ingredients: cellulose, ethylcellulose, gelatin, hypromellose, iron oxides, and titanium dioxide. This product's label may have been updated. For current full prescribing information, please visit www.pfizer.com. LAB-0542-11.0 For more information about EFFEXOR XR call 1-800-438-1985 or go to www.EFFEXORXR.com.