The complete text of the Medication Guide is reprinted at the end of this document.Patients should be advised of the following issues and should be asked to alert their prescriber if these occur while taking Effexor XR.Advise patients, their families and caregivers to look for the emergence of suicidality, worsening of depression, and other psychiatric symptoms (anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia, psychomotor restlessness, hypomania, mania, other unusual changes in behavior), especially early during treatment and when the dose is adjusted up or down. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24. Caution patients about operating hazardous machinery, including automobiles, until they are reasonably certain that Effexor XR therapy does not adversely affect their ability to engage in such activities.Advise patients to avoid alcohol while taking Effexor XR

Suicide is a known risk of depression and certain other psychiatric disorders, and these disorders themselves are the strongest predictors of suicide. The extent to which the finding of an increased risk of fatal outcomes can be attributed to the toxicity of venlafaxine in overdosage, as opposed to some characteristic(s) of venlafaxine-treated patients, is not clear. You take it with food.It comes in three strengths: 37.5 mg, 75 mg, and 150 mg.The usual starting dosage of Effexor XR for major depressive disorder (MDD) is 75 mg once daily.

There was insufficient information to determine the effect of age or race on outcome in these studies.In a longer term study (study 3), adult outpatients meeting DSM-IV criteria for PD who had responded during a 12-week open phase with Effexor XR (75 to 225 mg per day) were randomly assigned to continue the same Effexor XR dose (75, 150, or 225 mg) or switch to placebo for observation for relapse under double-blind conditions. Symptoms of mania include "high" or irritable mood, very high self-esteem, decreased need for sleep, pressure to keep talking, racing thoughts, being easily distracted, frequently involved in activities with a large risk for bad consequences (for example, excessive buying sprees).Medical attention should be sought if serotonin syndrome is suspected. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.The following information describes dosages that are commonly used or recommended. With input from you, your health care provider will assess how long you will need to take the medicine.Missing doses of venlafaxine may increase your risk for relapse in your symptoms.Stopping venlafaxine abruptly may result in one or more of the following withdrawal symptoms: irritability, nausea, feeling dizzy, vomiting, nightmares, headache, and/or paresthesias (prickling, tingling sensation on the skin).Depression is also a part of bipolar illness. The most commonly reported events in overdosage include tachycardia, changes in level of consciousness (ranging from somnolence to coma), mydriasis, seizures, and vomiting. The insurance company will review the request and let you and your doctor know if your plan will cover Effexor XR.If you’re not sure if you’ll need to get prior authorization for Effexor XR, contact your insurance company.If you need financial support to pay for Effexor XR, or if you need help understanding your insurance coverage, help is available.Pfizer, Inc., the manufacturer of Effexor XR, offers a copay savings program, which may help lower the cost of Effexor XR.