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In one case, toxic hepatitis associated with low dose (37.5 mg/day) venlafaxine was reported in a patient with a history of chronic hepatitis. Endocrine Endocrine side effects have included flushing. Endocrine side effects reported in premarketing Phase 3 trials have rarely included galactorrhea, goiter, hyperthyroidism, hypothyroidism, thyroid nodule, and thyroiditis. It is important to emphasize that, although the events reported occurred during treatment with venlafaxine, they were not necessarily caused by it. Events are further categorized by body system and listed in order of decreasing frequency using the following definitions: frequent adverse events are defined as those occurring on one or more occasions in at least 1/100 patients; infrequent adverse events are those occurring in 1/100 to 1/1000 patients; rare events are those occurring in fewer than 1/1000 patients. Body as a whole—Frequent: accidental injury, chest pain substernal, neck pain; Infrequent: face edema, intentional injury, malaise, moniliasis, neck rigidity, pelvic pain, photosensitivity reaction, suicide attempt, withdrawal syndrome; Rare: appendicitis, bacteremia, carcinoma, cellulitis. Cardiovascular system—Frequent: migraine; Infrequent: angina pectoris, arrhythmia, extrasystoles, hypotension, peripheral vascular disorder (mainly cold feet and/or cold hands), syncope, thrombophlebitis; Rare: aortic aneurysm, arteritis, first-degree atrioventricular block, bigeminy, bradycardia, bundle branch block, capillary fragility, cardiovascular disorder (mitral valve and circulatory disturbance), cerebral ischemia, coronary artery disease, congestive heart failure, heart arrest, mucocutaneous hemorrhage, myocardial infarct, pallor. Digestive system—Frequent: eructation; Infrequent: bruxism, price effexor xr dysphagia, tongue edema, esophagitis, gastritis, gastroenteritis, gastrointestinal ulcer, gingivitis, glossitis, rectal hemorrhage, hemorrhoids, melena, oral moniliasis, stomatitis, mouth ulceration; Rare: cheilitis, cholecystitis, cholelithiasis, duodenitis, esophageal spasm, hematemesis, gastrointestinal hemorrhage, gum hemorrhage, hepatitis, ileitis, jaundice, intestinal obstruction, parotitis, periodontitis, proctitis, increased salivation, soft stools, tongue discoloration. Endocrine system—Rare: goiter, hyperthyroidism, hypothyroidism, thyroid nodule, thyroiditis. Hemic and lymphatic system—Frequent: ecchymosis; Infrequent: anemia, leukocytosis, leukopenia, lymphadenopathy, thrombocythemia, thrombocytopenia; Rare: basophilia, bleeding time increased, cyanosis, eosinophilia, lymphocytosis, multiple myeloma, purpura. Metabolic and nutritional—Frequent: edema, weight gain; Infrequent: alkaline phosphatase increased, dehydration, hypercholesteremia, hyperglycemia, hyperlipemia, hypokalemia, SGOT (AST) increased, SGPT price effexor xr increased, thirst; Rare: alcohol intolerance, bilirubinemia, BUN increased, creatinine increased, diabetes mellitus, price effexor xr gout, healing abnormal, hemochromatosis, hypercalcinuria, hyperkalemia, hyperphosphatemia, hyperuricemia, hypocholesteremia, hypoglycemia, hyponatremia, hypophosphatemia, hypoproteinemia, uremia. Musculoskeletal system—Infrequent: arthritis, arthrosis, bone pain, bone spurs, bursitis, leg price effexor xr myasthenia, tenosynovitis; Rare: pathological fracture, myopathy, osteoporosis, osteosclerosis, plantar fasciitis, rheumatoid arthritis, tendon rupture. Nervous system—Frequent: trismus, vertigo; Infrequent: akathisia, apathy, ataxia, circumoral paresthesia, CNS stimulation, emotional lability, euphoria, hallucinations, hostility, hyperesthesia, hyperkinesia, hypotonia, incoordination, libido increased, manic reaction, myoclonus, neuralgia, neuropathy, psychosis, seizure, abnormal speech, stupor; Rare: akinesia, alcohol abuse, aphasia, bradykinesia, buccoglossal syndrome, cerebrovascular accident, loss of consciousness, delusions, price effexor xr dystonia, facial paralysis, feeling drunk, abnormal gait, Guillain-Barre Syndrome, hyperchlorhydria, hypokinesia, impulse control difficulties, neuritis, nystagmus, paranoid reaction, paresis, psychotic depression, reflexes decreased, reflexes increased, suicidal ideation, torticollis. Respiratory system—Frequent: bronchitis, dyspnea; Infrequent: asthma, chest congestion, epistaxis, hyperventilation, laryngismus, laryngitis, pneumonia, voice alteration; Rare: atelectasis, hemoptysis, hypoventilation, hypoxia, larynx edema, pleurisy, pulmonary embolus, sleep apnea. Skin and appendages—Infrequent: acne, alopecia, brittle nails, contact dermatitis, dry skin, eczema, price effexor xr hypertrophy, maculopapular rash, psoriasis, urticaria; Rare: erythema nodosum, exfoliative dermatitis, lichenoid dermatitis, price effexor xr discoloration, skin discoloration, furunculosis, hirsutism, leukoderma, petechial rash, pustular rash, vesiculobullous rash, seborrhea, skin atrophy, skin striae. Special senses—Frequent: abnormality of accommodation, abnormal vision; Infrequent: price effexor xr conjunctivitis, corneal lesion, diplopia, dry eyes, eye pain, hyperacusis, otitis media, parosmia, photophobia, taste loss, visual field defect; Rare: blepharitis, price effexor xr conjunctival edema, deafness, exophthalmos, glaucoma, retinal hemorrhage, subconjunctival hemorrhage, keratitis, labyrinthitis, miosis, papilledema, decreased pupillary reflex, otitis externa, scleritis, uveitis. Urogenital system—Frequent: metrorrhagia*, prostatic disorder (prostatitis and enlarged prostate)*, vaginitis*; Infrequent: albuminuria, amenorrhea*, cystitis, dysuria, hematuria, leukorrhea*, menorrhagia*, nocturia, bladder pain, breast pain, polyuria, pyuria, urinary incontinence, urinary urgency, vaginal hemorrhage*; Rare: abortion*, anuria, balanitis*, breast discharge, breast engorgement, breast enlargement, endometriosis*, fibrocystic breast, calcium crystalluria, cervicitis*, ovarian cyst*, prolonged erection*, gynecomastia (male)*, hypomenorrhea*, kidney calculus, kidney pain, kidney function abnormal, female lactation*, mastitis, menopause*, oliguria, price effexor xr pyelonephritis, salpingitis*, urolithiasis, uterine hemorrhage*, price effexor xr spasm*, vaginal dryness*. * Based on the number of men and women as appropriate. Postmarketing Reports Voluntary reports of other adverse events price effexor xr associated price effexor xr the use of venlafaxine that have been received since market introduction and that may have no causal relationship with the use of venlafaxine include the following: agranulocytosis, anaphylaxis, angioedema, aplastic anemia, catatonia, congenital anomalies, impaired coordination and balance, CPK increased, deep vein thrombophlebitis, delirium, EKG abnormalities such as QT prolongation; cardiac arrhythmias including atrial fibrillation, supraventricular tachycardia, ventricular extrasystole, and rare reports of ventricular fibrillation and ventricular tachycardia, including torsade de pointes; toxic epidermal necrolysis/Stevens-Johnson Syndrome, erythema multiforme, extrapyramidal symptoms (including dyskinesia and tardive dyskinesia), angle-closure glaucoma, hemorrhage (including eye and gastrointestinal bleeding), hepatic events (including GGT elevation; abnormalities of unspecified liver function tests; liver damage, necrosis, or failure; and fatty liver), interstitial lung disease, involuntary movements, LDH increased, neutropenia, night sweats, pancreatitis, pancytopenia, panic, prolactin increased, renal failure, rhabdomyolysis, shock-like electrical sensations or price effexor xr (in some cases, subsequent to the discontinuation of venlafaxine or tapering of dose), price effexor xr syndrome of inappropriate antidiuretic hormone secretion (usually in the elderly). There have been price effexor xr price effexor xr elevated clozapine levels that were temporally associated with adverse events, including seizures, following the price effexor xr of venlafaxine. Untoward events associated with this exposure were recorded by clinical investigators using terminology of their own choosing. The onset of withdrawal symptoms ranges from 14 to 48 hours after the last dose of venlafaxine extended-release and symptoms tend to resolve rapidly (range, within 2 to 24 hours) after resumption of therapy.

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Symptoms resolved following treatment with IV steroids and antidepressant therapy was safely switched to paroxetine. It is important price effexor xr emphasize that, although the events price effexor xr occurred during treatment with venlafaxine, they were not necessarily caused by it. Events are further categorized by body system and listed in order of decreasing frequency using the following definitions: frequent adverse events are price effexor xr as those occurring on one or more occasions in at least 1/100 patients; price effexor xr adverse events are those occurring in 1/100 to 1/1000 patients; rare events are those occurring in fewer than 1/1000 patients. Body as a whole—Frequent: accidental injury, chest pain substernal, neck pain; Infrequent: face edema, intentional injury, malaise, moniliasis, neck rigidity, pelvic price effexor xr price effexor xr reaction, suicide attempt, withdrawal syndrome; price effexor xr appendicitis, bacteremia, carcinoma, cellulitis. Cardiovascular system—Frequent: migraine; Infrequent: angina pectoris, arrhythmia, extrasystoles, hypotension, peripheral vascular disorder (mainly cold feet and/or cold hands), syncope, thrombophlebitis; Rare: aortic aneurysm, arteritis, first-degree atrioventricular block, bigeminy, bradycardia, bundle branch block, capillary fragility, cardiovascular disorder (mitral valve and circulatory price effexor xr cerebral ischemia, coronary artery disease, congestive heart failure, heart arrest, mucocutaneous hemorrhage, myocardial infarct, pallor. Digestive system—Frequent: eructation; Infrequent: bruxism, colitis, dysphagia, tongue edema, esophagitis, gastritis, gastroenteritis, gastrointestinal ulcer, gingivitis, glossitis, rectal hemorrhage, hemorrhoids, melena, oral moniliasis, stomatitis, mouth ulceration; Rare: cheilitis, cholecystitis, cholelithiasis, duodenitis, esophageal spasm, hematemesis, gastrointestinal price effexor xr gum hemorrhage, hepatitis, ileitis, jaundice, intestinal obstruction, parotitis, periodontitis, proctitis, increased salivation, soft stools, tongue discoloration. Endocrine system—Rare: goiter, hyperthyroidism, hypothyroidism, thyroid nodule, thyroiditis. Hemic and lymphatic system—Frequent: ecchymosis; Infrequent: anemia, leukocytosis, leukopenia, lymphadenopathy, thrombocythemia, thrombocytopenia; Rare: basophilia, bleeding time increased, cyanosis, eosinophilia, lymphocytosis, multiple myeloma, purpura. Metabolic and nutritional—Frequent: edema, weight gain; Infrequent: alkaline phosphatase increased, dehydration, hypercholesteremia, hyperglycemia, hyperlipemia, hypokalemia, SGOT (AST) increased, SGPT (ALT) increased, thirst; Rare: alcohol intolerance, bilirubinemia, BUN increased, creatinine increased, diabetes mellitus, glycosuria, gout, healing abnormal, hemochromatosis, hypercalcinuria, hyperkalemia, hyperphosphatemia, hyperuricemia, hypocholesteremia, hypoglycemia, hyponatremia, hypophosphatemia, hypoproteinemia, uremia. Musculoskeletal system—Infrequent: arthritis, arthrosis, bone pain, bone spurs, bursitis, leg cramps, myasthenia, tenosynovitis; Rare: pathological fracture, myopathy, osteoporosis, osteosclerosis, plantar fasciitis, rheumatoid arthritis, tendon rupture. Nervous system—Frequent: trismus, vertigo; Infrequent: akathisia, apathy, ataxia, circumoral paresthesia, CNS stimulation, emotional lability, euphoria, hallucinations, hostility, hyperesthesia, hyperkinesia, hypotonia, incoordination, libido increased, manic reaction, myoclonus, neuralgia, neuropathy, psychosis, seizure, abnormal speech, stupor; Rare: akinesia, alcohol abuse, aphasia, bradykinesia, buccoglossal syndrome, cerebrovascular accident, loss of consciousness, delusions, dementia, dystonia, facial paralysis, feeling drunk, abnormal gait, Guillain-Barre Syndrome, hyperchlorhydria, hypokinesia, impulse control difficulties, neuritis, nystagmus, paranoid reaction, paresis, psychotic depression, reflexes decreased, reflexes increased, suicidal ideation, torticollis. Respiratory system—Frequent: bronchitis, dyspnea; Infrequent: asthma, chest congestion, epistaxis, price effexor xr laryngismus, laryngitis, pneumonia, voice alteration; Rare: atelectasis, hemoptysis, hypoventilation, hypoxia, larynx edema, pleurisy, pulmonary embolus, sleep apnea. Skin and appendages—Infrequent: acne, alopecia, brittle nails, contact dermatitis, dry skin, eczema, skin hypertrophy, maculopapular rash, psoriasis, urticaria; Rare: erythema nodosum, exfoliative dermatitis, lichenoid dermatitis, hair discoloration, skin discoloration, furunculosis, hirsutism, leukoderma, petechial rash, pustular rash, vesiculobullous rash, seborrhea, skin atrophy, skin striae. Special senses—Frequent: abnormality of accommodation, abnormal vision; Infrequent: cataract, conjunctivitis, corneal lesion, diplopia, dry eyes, eye pain, hyperacusis, otitis media, parosmia, photophobia, taste loss, visual field defect; Rare: blepharitis, chromatopsia, conjunctival edema, deafness, exophthalmos, glaucoma, retinal hemorrhage, subconjunctival hemorrhage, keratitis, labyrinthitis, miosis, papilledema, decreased pupillary reflex, otitis externa, scleritis, uveitis. Urogenital system—Frequent: metrorrhagia*, prostatic disorder (prostatitis and enlarged prostate)*, vaginitis*; Infrequent: albuminuria, amenorrhea*, cystitis, dysuria, hematuria, leukorrhea*, menorrhagia*, nocturia, bladder pain, breast pain, polyuria, pyuria, urinary incontinence, urinary urgency, vaginal hemorrhage*; Rare: abortion*, anuria, balanitis*, breast discharge, breast engorgement, breast enlargement, endometriosis*, fibrocystic breast, calcium crystalluria, cervicitis*, ovarian cyst*, prolonged erection*, gynecomastia (male)*, hypomenorrhea*, kidney calculus, kidney pain, kidney function abnormal, female lactation*, mastitis, menopause*, oliguria, orchitis*, pyelonephritis, salpingitis*, urolithiasis, uterine hemorrhage*, uterine spasm*, vaginal dryness*. * Based on the number of men and women as appropriate. Postmarketing Reports Voluntary reports of other adverse events temporally associated with the use of venlafaxine that have been received since market introduction and that may have no causal relationship with the use of venlafaxine include the following: agranulocytosis, anaphylaxis, angioedema, aplastic anemia, catatonia, congenital anomalies, impaired coordination and balance, CPK increased, deep vein thrombophlebitis, delirium, EKG abnormalities such as QT prolongation; cardiac arrhythmias including atrial fibrillation, supraventricular tachycardia, ventricular extrasystole, and rare reports of ventricular fibrillation and ventricular tachycardia, including torsade de pointes; toxic epidermal necrolysis/Stevens-Johnson Syndrome, erythema multiforme, extrapyramidal symptoms (including dyskinesia and tardive dyskinesia), angle-closure glaucoma, hemorrhage (including eye and gastrointestinal bleeding), hepatic events (including price effexor xr price effexor xr abnormalities of unspecified liver function tests; liver damage, necrosis, or failure; and fatty liver), interstitial lung disease, involuntary movements, LDH increased, neutropenia, night sweats, pancreatitis, pancytopenia, panic, prolactin increased, renal failure, rhabdomyolysis, shock-like electrical sensations or tinnitus (in some cases, subsequent to the discontinuation of venlafaxine or tapering of dose), and syndrome of inappropriate antidiuretic hormone secretion (usually in the elderly). There have been reports of elevated clozapine levels that price effexor xr temporally associated with adverse events, including seizures, following the addition of venlafaxine. Although these events occurred during treatment with venlafaxine, causality has not been determined. There have been postmarketing reports of angioedema. Genitourinary One case of unexpected orgasm and subsequent ejaculation with no erection as well as orgasmic episodes with no ejaculation or erection has also been reported. Although these events occurred during treatment with venlafaxine, causality has not been determined. Psychiatric Psychiatric side effects have included visual price effexor xr hypomania, and mania. Psychiatric side effects reported in premarketing Phase 3 trials have included emotional lability, delusions, euphoria, hallucinations, manic reaction, psychosis, suicidal ideation, abnormal/changed behavior, homicidal ideation, paranoid reaction, and psychotic depression. A case of increased libido and spontaneous erections has price effexor xr been reported. Although rare, several cases of venlafaxine- induced urinary symptoms including nocturia, enuresis, increased urge/frequency, and incontinence have been reported. Following discontinuation of therapy the amount price effexor xr REM sleep price effexor xr to rebound. The conditions and duration of exposure to venlafaxine in both development programs varied greatly, and included (in overlapping categories) open and double-blind studies, uncontrolled and controlled studies, inpatient (Effexor only) and outpatient studies, fixed-dose and titration studies. Although these events occurred during treatment with venlafaxine, causality has not been determined. Impaired coordination and balance have been reported in postmarketing studies. Seizures have been reported in 0.26% of treated patients during premarketing testing. All reported events are included except price effexor xr already listed in Table 2 and those events for which a drug cause was remote. In one case, toxic hepatitis associated with low dose (37.5 mg/day) venlafaxine was reported in a patient with a history of chronic hepatitis. Endocrine Endocrine side effects have included flushing. Endocrine side effects reported in premarketing Phase 3 trials have rarely included galactorrhea, goiter, hyperthyroidism, hypothyroidism, thyroid nodule, and thyroiditis. Although these events occurred during treatment with venlafaxine, causality has not been determined. There price effexor xr been a minimum of approximately fifteen cases of hyponatremia in which at least one was life threatening, including at least one case of recurrent venlafaxine- induced hyponatremia after rechallenge. A recent short-term study (6 weeks) has reported an average weight loss of 2 to 3 pounds in patients treated with venlafaxine. Numerous cases of price effexor xr have price effexor xr reported following treatment price effexor xr a selective serotonin reuptake inhibitor (SSRI). Angle-closure glaucoma has been reported rarely. Ocular side effects reported in premarketing Phase 3 trials have included abnormality of accommodation, mydriasis, conjunctivitis, diplopia, dry eyes, eye pain, photophobia, visual field defect, blepharitis, cataract, chromatopsia, conjunctival edema, corneal lesion, exophthalmos, eye hemorrhage, glaucoma, retinal hemorrhage, subconjunctival hemorrhage, keratitis, miosis, papilledema, decreased pupillary reflex, scleritis, and price effexor xr In premarketing trials, treatment with Effexor tablets was associated with a mean final on-therapy increase in total cholesterol of 3 mg/dL. Patients treated with Effexor tablets for at least 3 months in placebo-controlled 12-month price effexor xr trials had a mean final on-therapy increase in total cholesterol of 9.1 mg/dL compared with a decrease of 7.1 price effexor xr among placebo-treated price effexor xr Although these events occurred during treatment with venlafaxine, causality price effexor xr not been determined. A case of dose-related increase of intraocular pressure caused by venlafaxine use has been reported. Metabolic Metabolic side effects have included weight loss (3%). Metabolic side effects reported in premarketing Phase 3 trials have price effexor xr weight price effexor xr increased alkaline phosphatase, dehydration, hypercholesteremia, hyperglycemia, hyperlipemia, hypoglycemia, hypokalemia, increased SGOT (AST), increased SGPT (ALT), thirst, bilirubinemia, increased BUN, increased creatinine, diabetes mellitus, glycosuria, gout, abnormal healing, hemochromatosis, hypercalcinuria, hyperkalemia, hyperphosphatemia, hyperuricemia, hypocholesteremia, hyponatremia, hypophosphatemia, hypoproteinemia, and uremia. Although these events occurred during treatment with venlafaxine, causality has not been determined. Ocular Ocular side effects have included abnormal vision, primarily blurred vision, in approximately 6% of patients. Although price effexor xr events occurred during treatment with venlafaxine, causality has not been determined. Ocular Ocular side effects have included abnormal vision, primarily blurred vision, in approximately 6% of patients. All reported events are included except those already listed in Table 2 and those events for which a drug cause was remote. Additional data are required to confirm this finding. Cardiovascular side effects have frequently included vasodilatation, hypertension, palpitation, postural hypotension, and tachycardia. Cardiovascular side effects reported in premarketing Phase 3 trials have included angina pectoris, arrhythmia, bradycardia, extrasystoles, hypotension, peripheral vascular disorder (mainly cold feet and/or cold hands), syncope, thrombophlebitis, aortic aneurysm, arteritis, first-degree atrioventricular block, bigeminy, bundle branch block, capillary fragility, cerebral ischemia, coronary artery disease, congestive heart failure, heart arrest, hematoma, cardiovascular disorder (mitral valve and circulatory disturbance), mucocutaneous hemorrhage, myocardial infarct, pallor, and sinus arrhythmia. The reduction in REM sleep is greatest early in treatment, but gradually returns towards baseline during long-term therapy; however, ROL remains long. The onset of venlafaxine- associated interstitial pneumonitis has ranged from 1 to 18 months after initial exposure to the drug and symptomatic improvement occurred after discontinuation of venlafaxine and treatment with corticosteroids. Top More Effexor resources Effexor Detailed Consumer Information (PDR) Effexor Prescribing Information (FDA) Effexor Consumer Overview Effexor Advanced Consumer (Micromedex) - Includes Dosage Information Effexor MedFacts Consumer Leaflet (Wolters Kluwer) Venlafaxine Prescribing Information (FDA) Effexor XR Prescribing Information (FDA) Effexor XR Extended-Release Capsules MedFacts Consumer Leaflet (Wolters Kluwer). Untoward events associated with this exposure were recorded by clinical investigators using terminology of their own choosing. Hyponatremia tends to develop within the first few weeks of treatment (range 3 to 120 days) and typically resolves within 2 weeks (range 48 hours to 6 weeks) after therapy has been discontinued with price effexor xr patients requiring treatment. In a flexible-dose study, with doses in the range of 200 to 375 mg/day and mean dose greater than 300 mg/day, the mean change in heart rate was 8.5 beats per minute compared with price effexor xr beats per minute for placebo. Other Events Observed During the Premarketing Evaluation price effexor xr Venlafaxine During its premarketing assessment, multiple doses of Effexor were administered to 2897 patients in Phase 2 and Phase 3 studies. Following discontinuation of venlafaxine, symptoms resolved within approximately 72 hours. The authors state that it is possible that the anasarca was due to an allergic or delayed- type price effexor xr reaction given the circumstances. There are numerous case reports of withdrawal symptoms following abrupt discontinuation of treatment, and a single case report of price effexor xr tinnitus associated with venlafaxine. Withdrawal effects occur upon abrupt discontinuation of treatment and the severity of symptoms appears to be dependent on length of therapy and dose (including low dose therapy). Although these events occurred during treatment with venlafaxine, causality has not been determined. Although these events occurred during treatment with venlafaxine, causality has not been determined. There is a single case report of breast pain associated with venlafaxine therapy. Dermatologic At least 3 cases of venlafaxine- induced alopecia have been reported. price effexor xr onset of venlafaxine- associated interstitial pneumonitis has ranged from 1 to 18 months after initial exposure to the drug and symptomatic improvement occurred after discontinuation of venlafaxine and treatment with corticosteroids. Top More price effexor xr resources Effexor Detailed Consumer Information (PDR) Effexor Prescribing Information (FDA) Effexor Consumer Overview Effexor Advanced Consumer (Micromedex) - Includes Dosage Information Effexor MedFacts Consumer Leaflet (Wolters Kluwer) Venlafaxine Prescribing Information (FDA) Effexor XR Prescribing price effexor xr (FDA) Effexor XR Extended-Release Capsules MedFacts Consumer Leaflet (Wolters Kluwer). However, there is a dose dependency for blood pressure increase. Laboratory Changes Of the serum chemistry and hematology parameters monitored during clinical trials with Effexor, a statistically significant difference with placebo was seen only for serum cholesterol. The conditions and duration of exposure to price effexor xr in both development programs varied greatly, and included (in overlapping categories) open and double-blind studies, uncontrolled and controlled studies, inpatient (Effexor only) and outpatient price effexor xr fixed-dose and titration studies.