| Major depressive disorder. View labelExact | Label dose is 50 mg once daily with or without food; doses >100 mg/day add little efficacy and increase adverse effects. | Serotonin-norepinephrine reuptake inhibitor (SNRI); active metabolite of venlafaxine. | UGT, CYP3A4 (minor), CYP2D6 (minimal) | Single-dose mean 11 h; Single-dose range 9–13 h; Steady-state mean 11 h | No | — | - Blood pressure and heart rate at baseline and periodically, especially in patients with pre-existing hypertension.
- Renal function for long-term therapy so dosing remains aligned with kidney function changes over time.
- Discontinuation symptoms during missed doses or tapering; plan refill timing and taper steps are often planned in advance.
- Mood elevation or agitation in bipolar-spectrum illness; coordinate prevention plans via the bipolar disorder hub.
| No | 2026-03-31 |
|---|
| Major depressive disorder; generalized anxiety disorder; social anxiety disorder; panic disorder. View labelExact | Initiate XR 37.5 mg once daily with food for 4–7 days, then 75 mg/day; increase by 75 mg increments at ≥7-day intervals up to 225 mg/day (300 mg off-label). | Serotonin-norepinephrine reuptake inhibitor (SNRI). | CYP2D6, CYP3A4 (minor), UGT | Single-dose mean 5 h; Single-dose range 4–6 h; Steady-state mean 11 h; Steady-state range 9–13 h | No | — | - Blood pressure and heart rate at baseline and after titration, with extra attention at higher doses.
- Discontinuation symptoms during missed doses or tapering; plan refill timing and taper steps proactively.
- Sodium in older adults or diuretic users if symptoms suggest hyponatremia (confusion, fatigue, falls).
- Mood elevation or agitation in bipolar-spectrum illness; coordinate prevention plans via the bipolar disorder hub.
- Medication reconciliation to avoid serotonergic combinations and to plan MAOI washouts when regimens change.
| No | 2025-10-05 |
|---|
| Major depressive disorder; generalized anxiety disorder; diabetic peripheral neuropathic pain; fibromyalgia; chronic musculoskeletal pain. View labelExact | Major depressive disorder (clinical depression) and generalized anxiety disorder: typical initiation is 30 mg once daily for one week for tolerability, then 60 mg once daily. If needed, 90–120 mg/day is sometimes used (divide when >60 mg/day), though antidepressant benefit often plateaus beyond 60 mg/day. | Serotonin-norepinephrine reuptake inhibitor (SNRI). | CYP1A2, CYP2D6 | Single-dose mean 12 h; Single-dose range 8–17 h; Steady-state mean 12 h | No | — | - Blood pressure and heart rate at baseline and periodically, especially during titration and at higher doses.
- Liver-injury symptoms (jaundice, dark urine, abdominal pain, pruritus), particularly in patients with alcohol use disorder or hepatic disease; LFTs are obtained when clinically indicated.
- Sodium in older adults or diuretic users if symptoms suggest hyponatremia (confusion, fatigue, falls).
- Medication reconciliation for serotonergic combinations and for CYP2D6 substrates (TCAs, antipsychotics, beta-blockers, tamoxifen).
| No | 2025-10-05 |
|---|