Venlor

Venlor (venlafaxine hydrochloride) is a prescription serotonin-norepinephrine reuptake inhibitor (SNRI) developed for the management of major depressive disorder, generalized anxiety disorder, social anxiety disorder, and panic disorder. As a dual-action antidepressant, it modulates key neurotransmitters implicated in mood regulation, offering a comprehensive neurochemical approach to symptom relief. Its extended-release formulation ensures stable plasma concentrations, supporting consistent therapeutic effect with once-daily dosing. Venlor is indicated for adults under specialist supervision, with treatment tailored to individual clinical presentation and tolerability.

Features

• Contains venlafaxine hydrochloride as the active pharmaceutical ingredient
• Available in immediate-release (IR) and extended-release (XR) formulations
• XR formulation allows for once-daily dosing, improving adherence
• Exhibits dose-dependent pharmacodynamics: serotonin reuptake inhibition at lower doses, dual serotonin and norepinephrine reuptake inhibition at higher doses
• Bioavailability of approximately 45% and not significantly affected by food
• Metabolized primarily via CYP2D6 isoenzyme to active metabolite O-desmethylvenlafaxine

Benefits

• Provides dual reuptake inhibition of serotonin and norepinephrine, targeting a broader range of depressive and anxiety symptoms
• May offer improved efficacy in patients with treatment-resistant depression or significant fatigue/apathy symptoms
• Extended-release version minimizes peak-trough fluctuations, reducing the incidence of side effects and improving tolerability
• Demonstrated effectiveness in reducing both emotional and somatic symptoms of anxiety disorders
• Flexible dosing allows for individualized treatment strategies based on symptom severity and patient response
• Established long-term maintenance data supporting sustained remission and relapse prevention

Common use

Venlor is primarily prescribed for the treatment of major depressive disorder (MDD) in adults, where it helps alleviate core symptoms such as depressed mood, loss of interest, sleep disturbances, and changes in appetite. It is also widely used in generalized anxiety disorder (GAD), reducing excessive worry and associated physical symptoms. Approved indications further include social anxiety disorder (SAD) and panic disorder, with or without agoraphobia. Off-label uses may include management of neuropathic pain, migraine prophylaxis, and treatment of vasomotor symptoms associated with menopause, though these require careful specialist evaluation.

Dosage and direction

Dosage must be individualized based on diagnosis, severity, and patient response. For major depressive disorder and generalized anxiety disorder, the recommended starting dose for Venlor XR is 75 mg once daily, taken with food at approximately the same time each day. Some patients may start at 37.5 mg once daily for the first 4–7 days to improve tolerability before increasing to 75 mg. Depending on therapeutic response, doses may be increased in increments of up to 75 mg at intervals of no less than 4 days, up to a maximum of 225 mg daily for depression and 225 mg for anxiety disorders. For panic disorder, starting dose is 37.5 mg daily for one week before increasing to 75 mg. Tablets should be swallowed whole; not crushed, chewed, or placed in water.

Precautions

Venlor may increase the risk of suicidal thoughts and behavior in children, adolescents, and young adults, particularly during initial treatment or dose adjustments. Patients should be closely monitored for clinical worsening, suicidality, or unusual changes in behavior. Caution is advised in patients with a history of mania/hypomania or seizures. May cause elevated blood pressure; regular monitoring is recommended, especially at higher doses. Use with caution in patients with hepatic or renal impairment, and dosage adjustment may be necessary. Venlor may impair judgment, thinking, or motor skills; patients should avoid driving or operating machinery until they know how the medication affects them. Abrupt discontinuation may lead to withdrawal symptoms; taper gradually under medical supervision.

Contraindications

Venlor is contraindicated in patients with known hypersensitivity to venlafaxine or any excipients in the formulation. Concomitant use with monoamine oxidase inhibitors (MAOIs) is contraindicated due to risk of serotonin syndrome; at least 14 days should elapse between discontinuing an MAOI and initiation of Venlor, and at least 7 days after stopping Venlor before starting an MAOI. Not recommended in patients with uncontrolled narrow-angle glaucoma or severe hepatic impairment.

Possible side effects

Common side effects (≥1/10) include nausea, headache, dry mouth, drowsiness, dizziness, insomnia, nervousness, and excessive sweating. Less frequently (≥1/100), patients may experience increased blood pressure, palpitations, blurred vision, constipation, vomiting, weight loss, tremor, yawning, or sexual dysfunction. Serotonin syndrome (agitation, hallucinations, tachycardia, hyperthermia) is a rare but serious potential adverse reaction, particularly when used with other serotonergic drugs. Other rare events include hyponatremia, abnormal bleeding, angle-closure glaucoma, and discontinuation symptoms. Report any persistent or severe side effects to a healthcare provider.

Drug interaction

Venlor has significant interaction potential, primarily due to its metabolism via CYP2D6 and serotonergic effects. Concurrent use with MAOIs is contraindicated. Strong CYP2D6 inhibitors (e.g., quinidine, fluoxetine, paroxetine) may increase venlafaxine concentrations. Use with other serotonergic drugs (e.g., SSRIs, SNRIs, triptans, tramadol) increases serotonin syndrome risk. May enhance anticoagulant effect of warfarin; monitor INR. Caution with drugs that increase bleeding risk (e.g., NSAIDs, aspirin). May interact with antipsychotics, anticonvulsants, or other CNS depressants. Avoid with alcohol.

Missed dose

If a dose is missed, take it as soon as remembered unless it is close to the time for the next scheduled dose. In that case, skip the missed dose and resume the usual dosing schedule. Do not double the dose to make up for a missed one. Consistent daily dosing is important to maintain stable blood levels and therapeutic effect.

Overdose

Symptoms of overdose may include dizziness, drowsiness, tachycardia, changes in blood pressure, serotonin syndrome, seizures, or coma. Cases of fatal overdose have been reported, particularly in combination with alcohol or other drugs. Suspected overdose requires immediate medical attention. Treatment is supportive and symptomatic; consider activated charcoal if presented early. No specific antidote exists. ECG and vital sign monitoring are recommended.

Storage

Store at room temperature (15–30°C or 59–86°F) in a dry place, protected from light and moisture. Keep in the original container, tightly closed. Do not remove desiccant if present. Keep out of reach of children and pets. Do not use after the expiration date printed on the packaging. Dispose of unused medication via pharmacy take-back programs; do not flush.

Disclaimer

This information is for educational purposes and does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before starting, changing, or stopping any medication. Do not disregard or delay seeking professional advice due to content read here. Individual patient needs and responses may vary.

Reviews

Clinical studies and patient reports indicate that Venlor is effective in reducing symptoms of depression and anxiety, with many patients experiencing significant improvement in mood, energy, and overall functioning. Some users note initial side effects such as nausea or drowsiness, which often subside with continued use. Long-term users appreciate the once-daily dosing convenience of the XR formulation. Effectiveness appears dose-dependent, with better outcomes often seen at moderate to higher therapeutic ranges. Withdrawal symptoms upon discontinuation are commonly reported; gradual tapering is strongly advised under medical supervision.