Precautions and Warnings With Venlafaxine XR

Some Precautions and Warnings With Venlafaxine XR

Some warnings and precautions with venlafaxine XR include the following:
  • Antidepressants (including venlafaxine XR) may increase the risk of suicidal thinking or behavior in children, teenagers, and adults (see Antidepressants and Suicide for more information). Therefore, if you notice any changes in symptoms or new symptoms while taking venlafaxine XR, talk with your healthcare provider immediately. Some of these symptoms may include anxiety, hostility, agitation, panic, restlessness, hallucinations, extreme hyperactivity, and suicidal thinking or behavior (see Effexor XR and Suicide for more information).
  • Before prescribing venlafaxine XR for depression, your healthcare provider should make sure that you do not have bipolar disorder (instead of depression). Sometimes the symptoms of bipolar disorder and depression are very similar, and venlafaxine XR can cause problems in people with bipolar disorder.
  • In previous studies, venlafaxine XR was shown to slightly increase blood pressure and heart rate. Your healthcare provider should monitor your blood pressure and heart rate while you are taking venlafaxine XR.
  • Antidepressants can cause a group of dangerous symptoms known as serotonin syndrome. Taking venlafaxine XR with other medications that affect serotonin can increase your risk of serotonin syndrome. These other medications can include other antidepressants, triptans (migraine medications), and several other medications (see Drug Interactions With Venlafaxine XR for more information). Contact your healthcare provider immediately if you have any possible symptoms of serotonin syndrome, including:


    • Confusion
    • Seeing or hearing things that are not really there (hallucinations)
    • Fast heartbeat (tachycardia)
    • Feeling faint
    • Fever
    • Sweating
    • Muscle spasms
    • Difficulty walking
    • Diarrhea.
  • Your healthcare provider should monitor you closely if you have glaucoma (a condition of the eye) while you are taking venlafaxine XR, as venlafaxine XR may make glaucoma worse.
  • Venlafaxine XR may increase your risk for certain lung problems. Be sure to let your healthcare provider know right away if you have signs of lung problems, such as difficulty breathing, coughing, or chest pain.


  • Venlafaxine XR can cause anxiety, nervousness, and insomnia. Tell your healthcare provider if you experience these symptoms while taking venlafaxine XR.


  • Venlafaxine XR may increase the risk of bleeding or bruising. This is probably most dangerous in people who already have a bleeding disorder or who take other medications that increase the risk of bleeding.


  • Venlafaxine XR can cause a loss of appetite and weight loss. Usually, weight loss is small. However, it is possible to lose large amounts of weight while taking venlafaxine XR (see Effexor XR and Weight Loss).
  • Venlafaxine XR can cause seizures or high cholesterol, or may increase your risk of bleeding. Let your healthcare provider know if you have a seizure or if you notice any unusual bleeding (such as unusual bruising or blood in the stool) while taking this medicine.
  • Since venlafaxine XR is removed from the body using the liver and kidneys, you may need a lower venlafaxine XR dosage if you have liver or kidney problems.
  • Venlafaxine XR can interact with certain other medications (see Drug Interactions With Venlafaxine XR).
  • You should talk with your doctor about whether you should avoid alcohol while taking venlafaxine XR (see Alcohol and Effexor XR).
  • If you are elderly or are taking a diuretic, venlafaxine XR could cause low salt levels in the blood (hyponatremia). Salt levels generally return to "normal" when venlafaxine XR is discontinued.
  • If you are stopping venlafaxine XR, you should be monitored by a healthcare professional for venlafaxine XR withdrawal symptoms. If you do develop any symptoms of venlafaxine XR withdrawal (such as irritability, anxiety, confusion, headache, lethargy, or insomnia), your healthcare provider may slow down the rate at which the venlafaxine XR is stopped (see Effexor XR Withdrawal).


  • This medication can cause false positives on some urine drug tests for phencyclidine (PCP) or amphetamines. If this happens, more specific tests can be done to confirm (or deny) the results of the initial test. 


  • Venlafaxine XR may affect your ability to perform complex tasks requiring mental and motor skills. Therefore, you should become accustomed to the effect it may have on you before participating in activities requiring mental or motor concentration (such as driving a car or operating machinery). Taking venlafaxine XR with alcohol or other medications that cause drowsiness can increase this effect.
  • Venlafaxine XR is considered a pregnancy Category C medication. This means that the medication may not be safe to use during pregnancy. Talk with your healthcare provider about the risks and benefits of using venlafaxine XR during pregnancy (see Effexor XR and Pregnancy for more information).
  • Venlafaxine XR passes through breast milk. Therefore, if you are breastfeeding or plan to start breastfeeding, be sure to talk with your healthcare provider about using venlafaxine XR (see Effexor and Breastfeeding).
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