When This Medicine Should Not Be Used:
This medicine is not right for everyone. Do not use it if you had an allergic reaction to venlafaxine.

How to Use This Medicine:
Long Acting Capsule, Tablet, Long Acting Tablet

• Take your medicine as directed. Your dose may need to be changed several times to find what works best for you.
• It is best to take the extended-release form at the same time each day (either in the morning or evening).
• It is best to take this medicine with food or milk.
• Swallow the extended-release capsule whole. Do not crush, break, or chew it. Do not place the capsule in a liquid.
• If you cannot swallow the extended-release capsule, you may open it and pour the medicine into a small amount of soft food such as pudding, yogurt, or applesauce. Stir this mixture well and swallow it without chewing.
• This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.
• Missed dose: Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.
• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Do not use this medicine if you have used an MAO inhibitor (MAOI), such as methylene blue or linezolid, within the past 14 days. Do not take an MAO inhibitor for at least 7 days after you stop this medicine.
• Some medicines can affect how venlafaxine works. Tell your doctor if you are using the following:
  
  • Buspirone, cimetidine, fentanyl, ketoconazole, lithium, metoprolol, St John's wort, tramadol, tryptophan supplements, or warfarin
  • A diuretic (water pill), a tricyclic antidepressant, a triptan medicine for migraine headaches, medicine to lose weight (such as phentermine), or an NSAID pain or arthritis medicine (such as aspirin, celecoxib, diclofenac, ibuprofen, naproxen)
• Tell your doctor if you use anything else that makes you sleepy. Some examples are allergy medicine, narcotic pain medicine, and alcohol.

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding, or if you have kidney disease, liver disease, glaucoma, heart disease, high blood pressure, or thyroid problems. Tell your doctor if you have a history of seizures or heart attack.
• For some children, teenagers, and young adults, this medicine may increase mental or emotional problems. This may lead to thoughts of suicide and violence. Talk with your doctor right away if you have any thoughts or behavior changes that concern you. Tell your doctor if you or anyone in your family has a history of bipolar disorder or suicide attempts.
• This medicine may cause the following problems:
  
  • Serotonin syndrome (when taken with certain medicines)
  • Low sodium levels (more common in elderly patients and those who take diuretics or become dehydrated)
  • Increased cholesterol levels
  • Increased blood pressure
  • Bleeding problems (more likely when taken with aspirin, other NSAIDs, or warfarin)
  • Interstitial lung disease and eosinophilic pneumonia
• This medicine may make you dizzy or drowsy. Do not drive or do anything that could be dangerous until you know how this medicine affects you.
• Do not stop using this medicine suddenly. Your doctor will need to slowly decrease your dose before you stop it completely.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Anxiety, restlessness, fever, sweating, muscle spasms, nausea, vomiting, diarrhea, seeing or hearing things that are not there
• Blistering, peeling, red skin rash
• Chest pain, cough, trouble breathing
• Confusion, weakness, and muscle twitching
• Eye pain, vision changes, seeing halos around lights
• Fast or pounding heartbeat
• Feeling more excited or energetic than usual
• Headache, trouble concentrating, memory problems, unsteadiness
• Seizures
• Trouble sleeping, nervousness, unusual dreams
• Unusual behavior, thoughts of hurting yourself or others
• Unusual bleeding or bruising

If you notice these less serious side effects, talk with your doctor:

• Dry mouth
• Headache
• Mild nausea, constipation, vomiting, loss of appetite, weight loss
• Sexual problems
• Sleepiness or unusual drowsiness

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088