venlafaxine, interaction

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Venlafaxine - Interactions and Warnings

Clinicians should be aware of the risk of serotonin syndrome when the patient receives not only a combination of 2 antidepressants, but also the single potent serotonergic agent venlafaxine.
- Ann Pharmacother 2003 Feb;37(2):209-11 -- Serotonin syndrome induced by low-dose venlafaxine. -- Pan JJ, Shen WW.

Further studies are needed to substantiate or refute this apparent drug-drug interaction. Until such time, venlafaxine should be used cautiously in patients receiving indinavir.
- Psychopharmacol Bull 2001 Spring;35(2):62-71 -- A pharmacokinetic drug-drug interaction study of venlafaxine and indinavir. -- Levin GM, Nelson LA, DeVane CL, Preston SL, Eisele G, Carson SW.

Bupropion had an effect on the pharmacokinetics of venlafaxine.
- J Clin Psychiatry 2002 Mar;63(3):181-6 -- Combining bupropion SR with venlafaxine, paroxetine, or fluoxetine: a preliminary report on pharmacokinetic, therapeutic, and sexual dysfunction effects. -- Kennedy SH, McCann SM, Masellis M, McIntyre RS, Raskin J, McKay G, Baker GB.

Clinicians should be aware of a risk of serotonin syndrome with serious extrapyramidal reactions in patients receiving sertraline or venlafaxine when metoclopramide is coadministered even in a single, conventional dose.
- Ann Pharmacother 2002 Jan;36(1):67-71 -- Serotonin syndrome caused by selective serotonin reuptake-inhibitors-metoclopramide interaction. -- Fisher AA, Davis MW.

There is a potentially dangerous interaction between venlafaxine and propafenone. Serum levels of venlafaxine should be monitored if propafenone is added.
- Int J Psychiatry Med 2001;31(4):427-32 -- An organic psychosis due to a venlafaxine-propafenone interaction. -- Pfeffer F, Grube M.

Clinical seizures after venlafaxine treatment have occasionally been reported when the drug was used at very high doses or in combination with other medications.
- Braz J Med Biol Res 2002 Apr;35(4):469-72 -- Proconvulsant effects of high doses of venlafaxine in pentylenetetrazole-convulsive rats. -- Santos JG Jr, Do Monte FH, Russi M, Agustine PE, Lanziotti VM.

A case of venlafaxine-induced serotonin syndrome is described with relapse following the introduction of amitriptyline, despite a 2-week period between the discontinuation of one drug and the commencement of the other. Electroencephalography may play an important part in diagnosis. With the increasing use of selective serotonin re-uptake inhibitors, greater awareness of the serotonin syndrome is necessary. Furthermore, the potential for drug interactions which may lead to the syndrome needs to be recognised.
- Postgrad Med J 2000 Apr;76(894):254-6 -- Venlafaxine-induced serotonin syndrome with relapse following amitriptyline. -- Perry NK.

The effect of cimetidine coadministration is not expected to result in clinically important alterations in the response to venlafaxine in patients with depression. This may not be true, however, for patients with compromised hepatic metabolic function.
- J Clin Pharmacol 1998 May;38(5):467-74 -- The influence of cimetidine on the disposition kinetics of the antidepressant venlafaxine. -- Troy SM, Rudolph R, Mayersohn M, Chiang ST.

Not recommended if you are pregnant, planning to be or breastfeeding. Consult with your physician before using herbs and supplements with this medication to avoid dangerous or lethal interactions.

last update: November 2008

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