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Venlafaxine HCL ER: How Much is it and What is the Dosage?

Millions of Americans are affected each year with common mental illnesses like major depressive disorder, generalized anxiety disorder, panic disorder, social anxiety disorder, and bipolar disorder. The number of affected patients has resulted in tremendous research and development in treatment for these conditions, including extended release capsule and extended release tablet prescription medications like venlafaxine HCL ER.  Venlafaxine HCL ER can help treat major depressive disorder, generalized anxiety disorder, and panic disorder, but how much is it and what is the dosage?

What is Venlafaxine HCL ER?

Venlafaxine HCL ER and was approved by the U.S. Food and Drug Administration (FDA) in 1997 for the treatment of depression under the brand name Effexor ER.  The drug, which is available by prescription only,  belongs to a class of medications called selective serotonin norepinephrine reuptake inhibitor antidepressants (SNRIs), which are commonly used to treat mental health conditions that include depression and anxiety. Venlafaxine hydrochloride converts to the active desvenlafaxine to take effect. 

What is Venlafaxine HCL ER Used to Treat?

Venlafaxine HCL ER is approved for the treatment of several mental illnesses, including major depressive disorder, generalized anxiety disorder, and panic disorder. A brief explanation of each of these conditions and their associated symptoms is provided below.

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Clinical Depression/Major Depressive Disorder

Clinical depression, which is sometimes called major depressive disorder, is a type of mental illness in which a person experiences intense, persistent feelings of sadness that last for at least two weeks or more. Major depressive disorder can cause emotional changes that can impact your mood or behavior, and many people also experience physical changes that contribute to differences in sleeping patterns and appetite. It is common for people with major depressive disorder to have difficulty performing routine daily tasks, lose interest in hobbies or activities that they previously enjoyed, and experience suicidal thoughts or behaviors. An estimated seven percent of American adults experience an episode of major depressive disorder each year. The following symptoms are commonly associated with major depressive disorder:

  • Lost of interest in activities you used to enjoy
  • Nervous energy
  • Feeling sad, empty, or tearful
  • Mood swings
  • Feelings of worthlessness, guilt, hopelessness, or helplessness
  • Difficult concentrating and low energy
  • Sleeping and eating more or less than usual
  • Feelings of moving or thinking in slow motion
  • Suicidal thoughts or behaviors

Generalized Anxiety Disorder

Our bodies naturally respond to sources of stress with anxiety, which is characterized by fear or apprehension about what is to come. Although we all feel anxious at different times in our lives, anxiety becomes a problem when the feelings last longer than six months, begin to interfere with a person’s quality of life, or become extreme.  Generalized anxiety disorder, or GAD, is a common form of anxiety disorder in which a person’s anxiety has no obvious cause or reason. Many people with GAD are able to recognize that their feelings are irrational, but they still find themselves unable to control their feelings. Symptoms of generalized anxiety disorder include an increased heart rate, trouble concentrating, rapid breathing, restlessness, and difficulty falling asleep. 

Panic disorder

When a person experiences panic attacks, or sudden episodes of intense anxiety and fear that cause physical symptoms without an obvious cause, on a regular basis, they are said to have panic disorder. Panic attacks are a terrifying experience for many people, as it often feels like the patient is having a panic attack. Many people experience one or two panic attacks throughout the course of their lives during particularly stressful times, such as the death of a loved one, but when panic attacks are experienced on a recurring basis, it is a sign of  panic disorder. Symptoms of panic attacks include:

  • Feeling detached from reality
  • Fear of loss of control 
  • Chest pain
  • Sense of impending doom or danger
  • Rapid, pounding heart rate
  • Trembling or shaking
  • Numbness or tingling sensation
  • Sweating
  • Chills
  • Nausea
  • Dizziness, lightheadedness or faintness
  • Headache
  • Shortness of breath or tightness in your throat
  • Hot flashes
  • Abdominal cramping

What is the Cost of Venlafaxine HCL ER?

Venlafaxine HCL ER is sold as both a generic drug and under its brand name, Effexor XR. Like most prescription drugs, Effexor XR is significantly more expensive because of its status as the brand name medication and first release, while the generic form of the drug is much less expensive. As indicated in the table below, a 30-day supply of Effexor XR is approximately 40 times more expensive than the same form and strength of venlafaxine HCL ER. Additionally, most commercial insurance companies, Medicare, and Medicaid cover venlafaxine HCL ER, while Effexor XR may not be covered. No matter what type of insurance coverage you have, if any, you can save money when purchasing either form of the drug using a pharmacy discount card. Pharmacy discount cards have no eligibility requirements, are free, and provide discounts on all brand name and generic drugs that are approved by the FDA.

Costs of a 30-Day Supply of Effexor XR and Venlafaxine HCL ER

Effexor XR

Venlafaxine HCL ER

37.5 mg oral capsules

$364.30

$8.50

150 mg oral capsules

$405.70

$10.30

What is the Dosage of Venlafaxine HCL ER?

The right dose of venlafaxine varies from person to person and will be determined by your healthcare provider based on the condition being treated, your age, and the form of the medication you take. SSNRIs like venlafaxine may need to be adjusted several times before the right dose is found, so people taking the medication should be aware that it might take several months before symptoms have completely abated. Adults with major depressive disorder typically take an initial dose of 75 mg, which is taken orally once per day, while a maintenance dose is typically between 75 mg to 225 mg taken orally once per day. Patients with moderate depression take a maximum dose of 225 mg per day, while severely depressed patients can take a maximum dose of 375 mg per day. 

Panic disorder in adults is treated with a lower initial dosage of 37.5 mg taken orally once a day for 7 days. After the initial seven day treatment period, 75 mg is taken orally once per day. The maintenance dose for adults with panic disorder is 75 mg to 225 mg of venlafaxine HCL ER taken once a day, while the maximum dosage is 225 mg per day.When taken for generalized anxiety disorder, the initial dosage is 75 mg taken orally once a day, with the maintenance dosage somewhere between 75 mg and 225 mg taken orally once a day. The maximum dose for adults with generalized anxiety disorder is 225 mg per day.

Because of the way that venlafaxine HCL ER works on the chemistry of the brain, it is possible to experience withdrawal symptoms when use of the medication is stopped abruptly or during a change in dosage. Patients who have been taking venlafaxine HCL ER are particularly susceptible to withdrawal symptoms. In order to avoid withdrawal symptoms, it’s best to change your dose or stop taking venlafaxine HCL ER only under a doctor’s supervision, as this will reduce your chance of experiencing symptoms and help your doctor to manage any symptoms that you do experience. You should seek medical advice if you experience symptoms of venlafaxine withdrawal, including:

  • Irritability
  • Vomiting
  • Headache
  • Nausea
  • Dizziness
  • Paresthesias (prickling or tingling sensation on the skin)
  • Nightmares

Are There Any Side Effects Associated With Venlafaxine HCL ER?

Possible side effects of venlafaxine generally fall into two categories: common and less common. Common side effects associated with venlafaxine that do not require medical attention unless they are severe or do not go away include:

  • Vomiting
  • Constipation
  • Gas
  • Burping
  • Drowsiness
  • Dizziness
  • Nightmares
  • Sore throat, chills, or other signs of infection
  • Changes in sexual desire or ability
  • Weakness or tiredness
  • Change in ability to taste food
  • Weight loss
  • Diarrhea
  • Heartburn
  • Dry mouth
  • Pain, burning, numbness or tingling in part of the body
  • Twitching
  • Sweating
  • Frequent urination
  • Headache
  • Nausea
  • Stomach pain
  • Yawning
  • Hot flashes or flushing
  • Difficulty urinating
  • High blood pressure
  • Loss of appetite
  • Uncontrollable shaking of a part of the body
  • Muscle tightness
  • Ringing in the ears
  • Enlarged pupils 

Other serious side effects of venlafaxine HCL ER are less common, but can be potentially dangerous. If you experience any of the following side effects while taking venlafaxine HCL ER, seek medical attention immediately:  

  • Fever
  • Hallucinations
  • Seizures
  • Allergic reaction
  • Small purple spots on the skin
  • Vision changes
  • Rash
  • Lung disease (very rare)
  • Itching
  • Chest pain
  • Fast, pounding, or irregular heartbeat
  • Unusual bruising or bleeding
  • Eye pain or redness
  • Fever, confusion, severe muscle stiffness, sweating, or fast or irregular heartbeat
  • Problems with coordination
  • Coma
  • Hives
  • Trouble breathing or swallowing

Are there any drug interactions associated with venlafaxine HCL ER?

Patients should not take other serotonin-altering drugs with Venlafaxine HCl due to increased risk of serotonin syndrome. 

Patients should not take Venlafaxine HCl ER if you are nursing as it can pass into breast milk. 

Patients with medical conditions including angle closure glaucoma, kidney disease, liver disease, increased risk of bleeding, suicidal thoughts should not take Venlafaxine HCl. 

Patients should provide their doctor and pharmacist with a list of all prescription and over the counter medications being taken, including any vitamins, nutritional supplements, or herbs, in order to avoid potential drug interactions. Potential drug interactions associated with venlafaxine HCL ER include:

  • MAO inhibitors such as isocarboxazid, phenelzine, selegiline, and tranylcypromine
  • Amphetamines
  • Anticoagulants, such as warfarin
  • Medications for anxiety
  • Medications for mental illness
  • Medications for pain
  • Clozapine
  • Diuretics
  • Indinavir
  • Ketoconazole
  • Linezolid
  • Lithium
  • Medications for seizure
  • Medications for weight loss
  • Medications for migraines, including frovatriptan, naratriptan, almotriptan, zolmitriptan, eletriptan, rizatriptan, sumatriptan 
  • Methadone
  • Monoamine oxidase inhibitors (MAOIs)
  • Buspirone
  • Nonsteroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen and naproxen
  • Ritonavir
  • Sedatives
  • Duloxetine
  • Haloperidol
  • Imipramine
  • St. John’s wort
  • Tryptophan
  • Sleeping pills
  • Tramadol
  • Methylene blue
  • Phentermine
  • Amiodarone
  • Antidepressants
  • Cimetidine
  • Selective serotonin reuptake inhibitors (SSRIs) such as citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, and sertraline
  • Sibutramine
  • Tranquilizers

Store this drug at room temperature out of the reach of children. 

Sources:

https://www.webmd.com/drugs/2/drug-4870-5047/venlafaxine-oral/venlafaxine-oral/details 

https://www.drugs.com/venlafaxine.html 

https://medlineplus.gov/druginfo/meds/a694020.html 

https://www.mayoclinic.org/drugs-supplements/venlafaxine-oral-route/description/drg-20067379 

https://www.healthline.com/health/venlafaxine-oral-tablet 

https://www.nami.org/About-Mental-Illness/Treatments/Mental-Health-Medications/Types-of-Medication/Venlafaxine-(Effexor) 

Published October 2nd, 2020 by Bridget Reed
Fact Checked by Chris Riley

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