Venlafaxine Hydrochloride

Concomitant use with linezolid (MAOI) increases risk of serotonin syndrome. Contraindicated in patients taking linezolid.

Concomitant use is contraindicated. Avoid MAOIs 14 days before starting venlafaxine and 7 days after stopping.

Concomitant use with intravenous methylene blue (MAOI) increases risk of serotonin syndrome. Contraindicated in patients taking intravenous methylene blue.

Concomitant use increases risk of serotonin syndrome. Contraindicated in patients taking MAOIs.

Safety and efficacy in combination not established. Coadministration not recommended.

Concomitant use not recommended due to serotonergic effects.

Increased risk of upper gastrointestinal bleeding due to impaired serotonin reuptake affecting platelet hemostasis.

Concomitant use increases risk of serotonin syndrome. Monitor for symptoms and consider discontinuation if serotonin syndrome occurs.

Concomitant use may potentiate bleeding risk. Monitor closely for bleeding.

Concomitant use increases risk of serotonin syndrome. Monitor for symptoms and consider discontinuation if serotonin syndrome occurs.

Venlafaxine decreases haloperidol clearance by 42%, increases AUC by 70%, and increases Cmax by 88%, resulting in significantly elevated haloperidol exposure.

Concomitant use increases risk of serotonin syndrome. Monitor for symptoms and consider discontinuation if serotonin syndrome occurs.

Increased risk of upper gastrointestinal bleeding due to impaired serotonin reuptake affecting platelet hemostasis.

Concomitant use may potentiate bleeding risk. Monitor closely for bleeding.

Potential for serotonin syndrome. Careful patient observation advised, particularly during treatment initiation and dose increases.

Potential for serotonin syndrome when coadministered. Careful patient observation advised, particularly during treatment initiation and dose increases.

Concomitant use increases risk of serotonin syndrome. Monitor for symptoms and consider discontinuation if serotonin syndrome occurs.

Potential for serotonin syndrome when combined with serotonergic drugs. Careful patient observation advised.

Concomitant use increases risk of serotonin syndrome. Monitor for symptoms and consider discontinuation if serotonin syndrome occurs.

Altered anticoagulant effects including increased bleeding. Patients should be carefully monitored when venlafaxine is initiated or discontinued.

Concomitant use may potentiate bleeding risk. Closely monitor for bleeding when initiating or discontinuing venlafaxine.

Risk of concomitant use has not been systematically evaluated. Caution is advised.

Cimetidine reduces venlafaxine oral clearance by 43% and increases AUC and Cmax by 60%. Caution advised in patients with hypertension, elderly patients, or those with hepatic dysfunction.

Risk of concomitant use has not been systematically evaluated. Caution is advised.

Increases venlafaxine and O-desmethylvenlafaxine AUC and Cmax. Caution when using venlafaxine with CYP2D6 and CYP3A4 inhibitors.

Increases Cmax and AUC of venlafaxine and O-desmethylvenlafaxine, potentially increasing toxicity risk. Consider dose reduction.

( 7.7 ) Metoprolol: Possibly reduced blood pressure lowering effect despite increased metoprolol plasma levels. Caution should be exercised with co-administration of venlafaxine and metoprolol. Metoprolol - Concomitant administration of venlafaxine (50 mg every 8 hours for 5 days) and metoprolol (100 mg every 24 hours for 5 days) to 18 healthy male subjects in a pharmacokinetic interaction study for both drugs resulted in an increase of plasma concentrations of metoprolol by approximately 30-40% without altering the plasma concentrations of its active metabolite, α‑hydroxymetoprolol.

Diazepam did not affect venlafaxine or ODV pharmacokinetics, and venlafaxine did not affect diazepam pharmacokinetics or psychomotor effects.

This finding was confirmed in vivo by clinical drug interaction studies in which venlafaxine did not inhibit the metabolism of several CYP3A4 substrates, including alprazolam, diazepam, and terfenadine.

Venlafaxine also did not have any effect on the pharmacokinetics of diazepam or its active metabolite, desmethyldiazepam, or affect the psychomotor and psychometric effects induced by diazepam.

Indinavir In a study of 9 healthy volunteers, venlafaxine administered under steady-state conditions at 150 mg/day resulted in a 28% decrease in the AUC of a single 800 mg oral dose of indinavir and a 36% decrease in indinavir C max . Indinavir did not affect the pharmacokinetics of venlafaxine and ODV.

In vivo , venlafaxine 75 mg by mouth every 12 hours did not alter the pharmacokinetics of a single 500 mg dose of tolbutamide or the CYP2C9 mediated formation of 4-hydroxy-tolbutamide.