Venlafaxine drug interactions

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Contents 1 Drug-drug interactions 2 Drug-food/drug-herb interactions 3 References	This page is not completed and has not been reviewed for accuracy. You are reading a non-certified PubDrug document. This document is incomplete and not ready for final editing, review, and certification. Until this document is certified, any registered PubDrug user may edit its content. Authored by: Remangus 07:50, 28 November 2007 (PST) Certified by: certifier signature (four tildes)
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Drug-drug interactions

Severity level	Drug and description of interaction
4	duloxetine, dexfenfluramine, fenfluramine, selective serotonin reuptake inhibitors (SSRIs), monoamine oxidase inhibitors (MAOIs), nefazodone, phentermine, procarbazine, tryptophan Taking these medications together with venlafaxine may increase the risk of serotonin syndrome. This may progress to hyperthermia, coma, delirium, and death.[1]
3	amitriptyline[2], amphetamine, atomoxetine, buspirone, clomipramine, cocaine, desipramine, dexmethylphenidate, dextroamphetamine[3], doxepin, furazolidone, imipramine, isoniazid, INH, linezolid[4], melatonin, methylphenidate, metoclopramide, nortriptyline, pentazocine, propafenone, protriptyline, ritonavir, serotonin-receptor agonists, sibutramine, tramadol, trazodone-Taking these medications together with venlafaxine may increase the risk of serotonin syndrome. This may progress to hyperthermia, coma, delirium, and death.[1] clozapine, aripiprazole-concentrations of these medications may be increased by venlafaxine.[1]
2	cimetidine-decreased first-pass metabolism of venlafaxine, delavirdine, imatinib, STI-571-may decrease venlafaxine metabolism, dextromethorphan, haloperidol, lithium, phenothiazines, ranolazine, risperidone, warfarin-increased INR's have been noted, zolpidem-may lead to hallucinations, disorientation when administered together[1]
1	cevimeline-potential for increased concentrations of cevimeline via CYP, gefitinib-may increase venlafaxine concentrations via CYP, indinavir-may decrease effects of indinavir[5], fluconazole, itraconazole, ketoconazole, voriconazole-azole antifungals may all increase AUC of venlafaxine

Drug-food/drug-herb interactions

Severity level	Drug and description of interaction
4	St. John's Wort[6]-increased risk of serotonin syndrome
3	None known
2	Kava Kava, Piper methysticum; Valerian, Valeriana officinalis[7]-potential for additive CNS effects
1	None known

References

1. ↑ ^{1.0 1.1 1.2 1.3} Effexor XR [package insert]. Philadelphia,PA: Wyeth Inc.; September 2007
2. ↑ Perry NK. Venlafaxine-induced serotonin syndrome with relapse following amitriptyline. Postgrad Med J. 2000 Apr;76(894):254-6.
3. ↑ Prior FH, Isbister GK, Dawson AH, Whyte IM. Serotonin toxicity with therapeutic doses of dexamphetamine and venlafaxine. Med J Aust. 2002 Mar 4;176(5):240-1.
4. ↑ Jones SL, Athan E, O'Brien D. Serotonin syndrome due to co-administration of linezolid and venlafaxine. J Antimicrob Chemother. 2004 Jul;54(1):289-90.
5. ↑ Levin GM, Nelson LA, DeVane CL et al. A pharmacokinetic drug-drug interaction study of venlafaxine and indinavir. Psychopharmacol Bull 2001;35:62-71.
6. ↑ Uebelhack R, Franke L. In vitro effects of St. John's wort extract and hyperforin on 5 HT uptake and efflux in human blood platelets. Pharmacopsychiatry. 2001 Jul;34 Suppl 1:S146-7.
7. ↑ Miller LG. Herbal medicinals: selected clinical considerations focusing on known or peotential drug-herb interactions. Arch Intern Med 1998;158:2200-11.