Venlafaxine drug administration

Venlafaxine is approved by the U.S. Food and Drug Administration for the treatment of both major depression and generalized anxiety disorder. Preliminary data suggest that it might also have a role in the treatment of chronic pain conditions and perhaps other disorders against which SSRIs are effective. Serotonin reuptake inhibition is prominent at lower doses of venlafaxine at higher doses, inhibition of norepinephrine reuptake becomes more significant. 

Venlafaxine presentation to the Food and Drug Administration Psychopharmacology Advisory Committee. Washington, DC, April 1993. 

Kilic S, Ergin H, Baydinc YC. Venlafaxine extended release for the treatment of patients with premature ejaculation a pilot, single-blind, placebo-controlled, fixed dose crossover study on short-term administration of an antidepressant drug. Int J Androl 2005 28 47-52. 

PROPAFENONE I. ANTIARRHYTHMICS - disopyra-mide, procainamide 2. ANTIBIOTICS - macrolides (especially azithromycin, clarithromycin, parenteral erythromycin, telithromycin), quinolones (especially moxifloxacin), quinupristin/ dalfopristin 3. ANTICANCER AND IMMUNOMODULATING DRUGS -arsenic trioxide 4. ANTIDEPRESSANTS - TCAs, venlafaxine 5. ANTIEMETICS-dolasetron 6. ANTIFUNGALS-fluconazole, posaconazole, voriconazole 7. ANTIHISTAMINES - terfenadine, hydroxyzine, mizolastine 8. ANTI-M ALARIALS - artemether with lumefantrine, chloroquine, hydroxychloroquine, mefloquine, quinine 9. ANTIPROTOZOALS - pentamidine isetionate 10. ANTIPSYCHOTICS-atypicals, phenothiazines, pimozide II. BETA-BLOCKERS - sotalol 12. BRONCHODILATORS -parenteral bronchodilators 13. CNS STIMULANTS - atomoxetine Risk of ventricular arrhythmias, particularly torsades de pointes Additive effect these drugs prolong the Q-T interval. Also, amitriptyline, clomipramine and desipramine levels may be t by propafenone. Amitriptyline and clomipramine may t propafenone levels. Propafenone and these TCAs inhibit CYP2D6-mediated metabolism of each other Avoid co-administration... 

LITHIUM OTHER-VENLAFAXINE Possible risk of serotonin syndrome Additive effect Be aware of the possibility of serotonin syndrome. Also need to monitor lithium levels with appropriate dose adjustments during co-administration >- For signs and symptoms of serotonin toxicity, see Clinical Features of Some Adverse Drug Interactions, Serotonin toxicity and serotonin syndrome... 

Drugs used in the treatment of depression and psychosis can alter the metabolism of terfenadine. When the antidepressant venlafaxine was given to steady state (37.5 mg bd for 3 days and then 75 mg bd for 5 days), the pharmacokinetics of a single dose of terfenadine 120 mg were not altered and there were no changes in the electrocardiogram (13). The authors concluded that cardiotoxicity is unlikely to arise with co-administration of terfenadine and venlafaxine. 

At steady state, venlafaxine weakly inhibits the metabolism of risperidone however, this interaction is unlikely to be of clinical significance. Co-administration of milnacipran and levomepromazine increases the milnacipran plasma concentration because of a modification of the apparent total clearance of the drug. 

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