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When using antidepressant medications such as venlafaxine, it is crucial to be aware of potential risks and safety precautions. Below are important considerations and instructions to ensure safe use:

• Suicidal Thoughts and Behavior: Venlafaxine may increase the risk of suicidal thoughts or actions, particularly in individuals aged 24 and younger. Monitor for symptoms like new or worsening depression, suicidal ideation, aggression, or agitation, especially during the initial months of treatment or when the dosage is altered. Report any unusual mood or behavior changes to a healthcare provider immediately.

• Serotonin Syndrome: This rare but serious condition can occur if there is an excess of serotonin in the brain, especially when venlafaxine is combined with other serotonin-altering medications. Symptoms include rapid heart rate, sweating, muscle stiffness, fever, and confusion. Seek medical attention immediately if these symptoms arise.

• High Blood Pressure: Venlafaxine may cause an increase in blood pressure. Regular monitoring by your healthcare provider is advised, particularly if you have a history of high blood pressure or heart conditions. Maintain any current high blood pressure treatments and consider self-monitoring at home.

• Increased Bleeding Risk: Combining venlafaxine with aspirin, NSAIDs, or blood thinners can heighten the risk of bleeding. Report any unusual bruising, dark stools, or bleeding to your healthcare provider.

• Mania: Those with personal or family histories of bipolar disorder should exercise caution, as venlafaxine can trigger manic episodes. Be vigilant for symptoms like excessive excitement and overactivity, and consult your healthcare provider if they occur.

• Glaucoma Concerns: Venlafaxine can cause pupil dilation, potentially exacerbating glaucoma. If you have a history of glaucoma, discuss this with your healthcare provider.

• Withdrawal Symptoms: Abruptly discontinuing venlafaxine can lead to withdrawal symptoms such as nausea and dizziness. Gradually reduce the dose with professional guidance to mitigate these effects.

• Seizure Risk: Individuals with a history of seizures should inform their healthcare provider before starting venlafaxine. Discontinue use and seek medical advice if seizures develop.

• Low Sodium Levels: Older adults, those on diuretics, or those with low body fluids may experience low sodium levels. Symptoms like headaches or confusion require prompt medical attention.

• Lung Problems and Pneumonia: Although rare, venlafaxine has been linked to lung issues. Report any respiratory difficulties or chest discomfort to your healthcare provider.

• Sexual Side Effects: Venlafaxine may affect sexual function in both males and females. Discuss any concerns with your healthcare provider, who can offer potential solutions.

Contraindications:

• Avoid using venlafaxine if you are currently taking MAOIs, or have taken them in the last 14 days, or if you are receiving linezolid or intravenous methylene blue. Always consult with your healthcare provider if these conditions apply to you.

Common side effects:

• nausea
• drowsiness
• dizziness
• dry mouth
• loss of appetite
• trouble sleeping
• sweating
• weakness
• constipation
• nervousness
• yawning
• abnormal ejaculation

Less common but important to monitor:

• increased blood pressure
• easy bruising
• muscle cramps
• changes in sexual ability
• serotonin syndrome
• severe dizziness
• hallucinations
• fast heartbeat
• severe nausea or vomiting

Serious side effects:

• persistent cough
• shortness of breath
• chest pain
• severe headache
• vision changes
• seizures
• severe allergic reaction
• rash
• swelling
• difficulty breathing
• black stools
• vomit resembling coffee grounds

Interactions with high risk of serious adverse effects and should be avoided:

• MAO inhibitors (e.g., isocarboxazid, phenelzine, Selegiline)

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Drugs that increase serotonin (e.g., SSRIs such as Fluoxetine, SNRIs such as Duloxetine, Tryptophan, MDMA)
• Blood thinners (e.g., Warfarin, Dabigatran)
• Antiplatelet agents (e.g., Clopidogrel)
• NSAIDs (e.g., Ibuprofen, Naproxen)
• Aspirin
• Drowsiness-causing substances (e.g., opioids such as codeine, alcohol, sleep or anxiety medications such as Alprazolam, muscle relaxants such as Cyclobenzaprine, antihistamines such as diphenhydramine)
• Desvenlafaxine