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Drug

Venlafaxine

Common brand names:

Effexor

Pronounced

"ven-luh-FAX-een"

Drug Interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

Some products that may interact with this drug are: other drugs that can cause bleeding/bruising (including antiplatelet drugs such as clopidogrel, NSAIDs such as ibuprofen/naproxen, "blood thinners" such as dabigatran/warfarin).

Aspirin can increase the risk of bleeding when used with this medication. However, if your doctor has told you to take low-dose aspirin to prevent heart attack or stroke (usually 81-162 milligrams a day), you should keep taking the aspirin unless your doctor tells you not to. Ask your doctor or pharmacist for more details.

Taking MAO inhibitors with this medication may cause a serious (possibly fatal) drug interaction. Avoid taking MAO inhibitors (isocarboxazid, linezolid, metaxalone, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, tranylcypromine) during treatment with this medication. Most MAO inhibitors should also not be taken for two weeks before and at least 7 days after treatment with this medication. Ask your doctor when to start or stop taking this medication.

The risk of serotonin syndrome/toxicity increases if you are also taking other drugs that increase serotonin. Examples include street drugs such as MDMA/"ecstasy," St. John's wort, certain antidepressants (including SSRIs such as fluoxetine/paroxetine, other SNRIs such as duloxetine/milnacipran), tryptophan, among others. The risk of serotonin syndrome/toxicity may be more likely when you start or increase the dose of these drugs.

Tell your doctor or pharmacist if you are taking other products that cause drowsiness such as opioid pain or cough relievers (such as codeine, hydrocodone), alcohol, marijuana (cannabis), drugs for sleep or anxiety (such as alprazolam, lorazepam, zolpidem), muscle relaxants (such as carisoprodol, cyclobenzaprine), or antihistamines (such as cetirizine, diphenhydramine).

Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.

Venlafaxine is very similar to desvenlafaxine. Do not take medications containing desvenlafaxine while using venlafaxine.

This medication may interfere with certain lab tests (including urine tests for amphetamines), possibly causing false test results. Make sure lab personnel and all your doctors know you use this drug.

Negative Interactions
4
- Venlafaxine
  5-HTP
  Potential Negative Interaction
  Venlafaxine, a potent serotonin reuptake inhibitor, has been associated with several cases of serotonin syndrome. 5-HTP and L-tryptophan are converted to serotonin in the brain, and taking them with venlafaxine may increase venlafaxine-induced side effects. While no interactions with venlafaxine and 5-HTP or L-tryptophan have been reported, until more is known, people taking venlafaxine are cautioned to avoid 5-HTP or L-tryptophan.
  5-HTP
  Venlafaxine
  ×
  1. Brubacher JR, Hoffman RS, Lurin MJ. Serotonin syndrome from venlafaxine-tranylcypromine interaction. Vet Hum Toxicol 1996;38:358-61.
  2. Weiner LA, Smythe M, Cisek J. Serotonin syndrome secondary to phenelzine-venlafaxine interaction. Pharmacotherapy 1998;18:399-403.
  3. Bhatara VS, Magnus RD, Paul KL, Preskorn SH. Serotonin syndrome induced by venlafaxine and fluoxetine: a case study in polypharmacy and potential pharmacodynamic and pharmacokinetic mechanisms. Ann Pharmacother 1998;32:432-6.
  4. Diamond S, Pepper BJ, Diamond ML, et al. Serotonin syndrome induced by transitioning from phenelzine to venlafaxine: four patient reports. Neurology 1998;51:274-6.
- Venlafaxine
  L-Tryptophan
  Potential Negative Interaction
  Venlafaxine, a potent serotonin reuptake inhibitor, has been associated with several cases of serotonin syndrome. 5-HTP and L-tryptophan are converted to serotonin in the brain, and taking them with venlafaxine may increase venlafaxine-induced side effects. While no interactions with venlafaxine and 5-HTP or L-tryptophan have been reported, until more is known, people taking venlafaxine are cautioned to avoid 5-HTP or L-tryptophan.
  L-Tryptophan
  Venlafaxine
  ×
  1. Brubacher JR, Hoffman RS, Lurin MJ. Serotonin syndrome from venlafaxine-tranylcypromine interaction. Vet Hum Toxicol 1996;38:358-61.
  2. Weiner LA, Smythe M, Cisek J. Serotonin syndrome secondary to phenelzine-venlafaxine interaction. Pharmacotherapy 1998;18:399-403.
  3. Bhatara VS, Magnus RD, Paul KL, Preskorn SH. Serotonin syndrome induced by venlafaxine and fluoxetine: a case study in polypharmacy and potential pharmacodynamic and pharmacokinetic mechanisms. Ann Pharmacother 1998;32:432-6.
  4. Diamond S, Pepper BJ, Diamond ML, et al. Serotonin syndrome induced by transitioning from phenelzine to venlafaxine: four patient reports. Neurology 1998;51:274-6.
- Venlafaxine
  Sour Date Nut
  Potential Negative Interaction
  There is one published report of a woman collapsing after taking venlafaxine in combination with the Chinese herbal remedy sour date nut (Ziziphus jujube), although she tolerated venlafaxine by itself without side effects. People taking venlafaxine should not take sour date nut.
  Sour Date Nut
  Venlafaxine
  ×
  1. Stewart DE. Venlafaxine and sour date nut. Am J Psychiatry 2004;16:1129-30.
- Venlafaxine
  St. John’s Wort
  Potential Negative Interaction
  Although there have been no interactions reported in the medical literature, it is best to avoid using venlafaxine with St. John’s wort unless you are under the supervision of a qualified healthcare professional.