Venlor: Restoring Balance in Major Depressive Disorder
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Synonyms | |||
Venlor (venlafaxine hydrochloride) is a prescription serotonin-norepinephrine reuptake inhibitor (SNRI) developed for the management of major depressive disorder (MDD), generalized anxiety disorder (GAD), social anxiety disorder, and panic disorder. As a dual reuptake inhibitor, it modulates key neurotransmitters implicated in mood regulation, offering a comprehensive neurochemical approach for patients with moderate to severe symptoms. Its extended-release formulation ensures stable plasma concentrations, supporting consistent therapeutic effect and improved tolerability profile compared to immediate-release alternatives. Clinicians value Venlor for its efficacy in treatment-resistant cases and its capacity to address both emotional and physical symptoms of depression.
Features
- Contains venlafaxine hydrochloride as the active pharmaceutical ingredient
- Available in extended-release (XR) capsules (37.5 mg, 75 mg, 150 mg) and immediate-release tablets
- Functions as a potent serotonin-norepinephrine reuptake inhibitor (SNRI)
- Exhibits dose-dependent neurotransmitter activity: primarily serotonergic at lower doses, noradrenergic effects increasing with higher doses
- Bioavailability of approximately 45% and elimination half-life of 5±2 hours (11±2 hours for active metabolite O-desmethylvenlafaxine)
- Metabolism primarily hepatic, via CYP2D6 isoenzyme
Benefits
- Effectively alleviates core depressive symptoms such as low mood, anhedonia, and fatigue
- Reduces anxiety symptoms commonly comorbid with depression
- Improves social and occupational functioning by addressing both emotional and physical aspects of depression
- May benefit patients with treatment-resistant depression unresponsive to SSRIs
- Extended-release formulation minimizes peak-trough fluctuations, reducing side effect intensity
- Demonstrates efficacy in maintaining remission with long-term use
Common use
Venlor is primarily indicated for the treatment of major depressive disorder (MDD) in adults, demonstrating significant improvement in Hamilton Depression Rating Scale (HAM-D) scores. It is also approved for generalized anxiety disorder (GAD), social anxiety disorder, and panic disorder. Off-label uses include management of neuropathic pain, migraine prophylaxis, and treatment of vasomotor symptoms associated with menopause, though these applications require careful clinical evaluation. The medication is typically incorporated into a comprehensive treatment plan that may include psychotherapy and lifestyle modifications.
Dosage and direction
For major depressive disorder, the recommended starting dose is 75 mg/day, administered in a single dose with food. Depending on patient response and tolerability, the dose may be increased to 150 mg/day after at least 4 days, and further to 225 mg/day after another 4-day interval. Maximum recommended dose is 375 mg/day for severely depressed patients. Dosage adjustments are necessary in patients with hepatic or renal impairment, and in CYP2D6 poor metabolizers. Venlor XR capsules should be swallowed whole and not crushed, chewed, or placed in water. Abrupt discontinuation should be avoided; tapering is recommended to minimize withdrawal symptoms.
Precautions
Venlor may increase the risk of suicidal thoughts and behavior in children, adolescents, and young adults, particularly during initial treatment or dosage adjustments. Patients should be monitored closely for clinical worsening, suicidality, or unusual changes in behavior. Caution is advised in patients with history of mania/hypomania, seizures, or bleeding disorders. Venlor may elevate blood pressure in some patients; regular monitoring is recommended. Use with caution in patients with angle-closure glaucoma. Elderly patients may be more sensitive to side effects. Venlor should be used during pregnancy only if clearly needed, as it may cause neonatal complications.
Contraindications
Venlor is contraindicated in patients hypersensitive to venlafaxine or any components of the formulation. Concomitant use with monoamine oxidase inhibitors (MAOIs) is contraindicated due to risk of serotonin syndrome; a minimum 14-day washout period is required after MAOI discontinuation before initiating Venlor, and 7 days after stopping Venlor before starting an MAOI. Additional contraindications include uncontrolled narrow-angle glaucoma and severe hepatic impairment.
Possible side effects
Common side effects (≥5%) include nausea, headache, drowsiness, dry mouth, dizziness, insomnia, constipation, sweating, and nervousness. Less frequently, patients may experience increased blood pressure, palpitations, blurred vision, weight changes, sexual dysfunction, or abnormal dreams. Serious side effects requiring immediate medical attention include serotonin syndrome symptoms (agitation, hallucinations, fever), suicidal thoughts, unusual bleeding, seizures, or manic episodes. Most side effects are dose-dependent and may diminish with continued treatment.
Drug interaction
Venlor has significant interaction potential due to its metabolism via CYP2D6 and serotonergic effects. Concurrent use with other serotonergic drugs (tramadol, triptans, other antidepressants) increases risk of serotonin syndrome. Strong CYP2D6 inhibitors (paroxetine, fluoxetine) may increase venlafaxine concentrations. Venlor may increase bleeding risk when used with NSAIDs or anticoagulants. Caution is advised with drugs that prolong QT interval. Venlor may decrease the efficacy of tamoxifen through CYP2D6 inhibition.
Missed dose
If a dose is missed, it should be taken as soon as remembered, unless it is close to the next scheduled dose. In that case, the missed dose should be skipped and the regular dosing schedule resumed. Doubling doses to make up for a missed dose is not recommended. Patients should contact their healthcare provider if multiple doses are missed, as abrupt discontinuation may cause withdrawal symptoms.
Overdose
Venlor overdose may manifest as serotonin syndrome, seizures, ECG changes (prolonged QT interval), drowsiness, tachycardia, or hypertension. Fatalities have occurred particularly with mixed overdoses involving other drugs. Management includes supportive care, gastric lavage if presented early, and activated charcoal. Specific antidotes are not available; benzodiazepines may be used for seizures, and cyproheptadine considered for serotonin syndrome. ECG monitoring is essential for at least 24 hours in symptomatic patients.
Storage
Store at room temperature (20-25°C/68-77°F), with excursions permitted to 15-30°C (59-86°F). Keep in original container, tightly closed, and protect from moisture and light. Keep out of reach of children and pets. Do not use after expiration date printed on packaging. Dispose of unused medication through medication take-back programs or according to local regulations.
Disclaimer
This information is for educational purposes only and does not constitute medical advice. Venlor is a prescription medication that should be used only under the supervision of a qualified healthcare professional. Individual response to medication may vary. Patients should not initiate, discontinue, or change dosage without consulting their physician. The complete prescribing information should be consulted before administration.
Reviews
Clinical studies demonstrate Venlor’s efficacy, with meta-analyses showing response rates of 50-70% in major depressive disorder. Patients often report improved mood, energy, and functionality within 2-4 weeks of therapeutic dosing. However, reviews frequently mention initial side effects including nausea and insomnia, which often subside with continued use. Many patients appreciate the once-daily dosing convenience of the extended-release formulation. Some long-term users report withdrawal symptoms upon discontinuation, emphasizing the need for proper tapering under medical supervision.