Venlafaxine Stella 75mg treatment of severe depression (2 blisters x 14 tablets)

Dosage form Box of 2 blisters x 14 tablets
Specifications Vendafaxine

Ingredient

Composition information	Content
Vendafaxine	75mg

Uses

indications

venlafaxine stella is indicated in the following cases:

Treatment of severe depression.

Preventing the recurrence of severe severe.

Treatment of disorders Lan spread.

Treatment of social anxiety disorders.

Treatment of panic disorders, with or without fear of space.

Pharmacology

Venlafaxine's antidepressant mechanism in humans is thought to be due to neurotransmitter activity in the central nervous system. Pre-clinical studies show that Venlafaxine and its active metabolites, O-DesmethidvenlaFaxine (ODV), are strong inhibitors that re-collection of serotonin and norepinephrin in neuron neuron and weaken the re-collection of dopamine.

In vitro, Venlafaxine and ODV do not have significant affinity for receptors Muscarin, histamine or (alpha) -1 adrenergic. The pharmacological activity on these receptors is thought to be related to various effects such as cholinergic resistance, sedation and cardiovascular effects as seen in other mental drugs. Venlafaxine and ODV do not have the activity of inhibiting monoamine oxidase (Mao).

pharmacokinetics

venlafaxine easily absorbed through the gastrointestinal tract. After drinking, the drug experienced the first metabolism in the liver mainly into an active ODV metabolite; ODV formation is coordinated by the Cytochrome P450 ISOENZYM CYP2D6 system. ISOENZYM CYP3A4 also participates in the metabolism of Venlafaxine. Other metabolites include N-Desmethidvenlafaxine and N, O-Didesmethylfaxine.

After taking Venlafaxine capsules quickly released, the peak concentration of the plasma of Venlafaxine and ODV achieved in 2 hours and 3 hours respectively. When using the venlafaxine tablet, the peak concentration of venlafaxine and ODV is achieved in about 5.5 hours and 9 hours respectively. When using Venlafaxine tablets to release fast or prolonged release with the same daily dose, the absorption speed of the prolonged release will be slower than the fast release but the same level of absorption.

Food does not affect the bioavailability of Venlafaxine and ODV. 27% Venlafaxine and 30% ODV are associated with plasma proteins. Venlafaxine and ODV waste time is about 5 hours and 11 hours respectively. Venlafaxine eliminates the urine, mainly in the form of metabolites, sometimes in the form of freedom or combination; About 2% are eliminated through feces.

Before taking Venlafaxine Stella 75mg treatment of severe depression (2 blisters x 14 tablets)

How to use

oral medication.

Dosage

severe depression:

The recommended starting dose is 75 mg, once a day. Patients who do not respond to the starting dose of 75 mg/day may increase the dose to a maximum dose of 375 mg/day. Increasing dose can be done for 2 weeks or more.

Disseminated anxiety disorders:

The recommended starting dose is 75 mg, once a day. Patients who do not respond to the starting dose of 75 mg/day may increase the dose to a maximum dose of 225 mg/day. Increasing dose can be done for 2 weeks or more.

Social anxiety disorders:

The recommended dose is 75 mg once a day. There is no evidence that higher doses bring more benefits.

However, patients do not respond to the starting dose of 75 mg/day, may increase the dose to a maximum dose of 225 mg/day. Increasing the dose may be done for 2 weeks or more.

Panic disorder:

Dosage recommended 37.5 mg/day for 7 days (using the venlafaxine stella 37.5 mg hard capsules). Then increase the dose to 75 mg/day. Patients who do not respond to a dose of 75 mg/day may increase to a maximum dose of 225 mg/day. Increasing the dose can be done for 2 weeks or more.

Elderly:

Be careful in treating the elderly. Always use the lowest dose effectively and the patient must be carefully monitored when increasing the dose.

Patients with liver failure:

For patients with mild to moderate liver failure: 50%dose should be reduced.

For patients with severe liver failure: It is necessary to consider the potential benefits and the risk of treatment.

Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.What to do when overdose?

Symptoms

Overdose of Venlafaxine occurs mainly when combined with alcohol and/or other drugs. Abnormal electrocardiogram (such as extending the QT range, blocking branches, extending the QRS), sinus tachycardia and ventricular, slow heart rate, lowering blood pressure, awake face (from drowsiness to coma), Ly muscle, epilepsy, dizziness, liver necrosis and death have been reported.

Handling

Ensure good airway, oxygen and ventilation. Monitor heart rate and survival signs. If necessary, gastric lavage with large gastric catheter has an appropriate airway protection that can be indicated if done early when taking the medication or new symptoms. Should use activated carbon. Because the distribution of the drug is large, the method of rapid diuretics, appraisal, absorbing the adsorbent and changing blood is not beneficial. There is still no specific detoxifying substance for vendafaxine.

What to do when you forget 1 dose? If it is nearly time to take the next dose, skip the forgotten dose and take medicine at the next recommended dose. Do not take double dose to compensate for the forgotten dose.

Side Effects

When using venlafaxine stella , you may experience unwanted effects (ADR).

The most common, ADR ≥ 1/10

Nausea, headache , insomnia, drowsiness, dry mouth , dizziness, constipation, impaired sexual function, depression, foul tissue, panic.

common, 1/100

Anorexia, diarrhea, indigestion, abdominal pain, anxiety, frequent urination, visual disorders, vasodilation, vomiting, tremor, abnormal feeling, chills or fever, chest drum, increased weight, increased cholesterol serum, agitated, mighty, confused, arthritis , muscle pain, tinnitus, itching, difficulty breathing and skin rash. Hypertension depends on the dose also appears in some patients.

Uncommon, 1/1000

Increasing liver enzymes can recover, hypotension Standing, fainting, arrhythmia, tachycardia, mucosal bleeding, blood bruises, hallucinations, grinding teeth at sleep, muscle spasms, muscle conditioning, hair loss, taste change, urinary tract, menstruality, vein and light sensitive reactions.

Rare (1/10,000

Convulsions, increased milk secretion, hemorrhage include gastrointestinal bleeding, anaphylaxis, hepatitis, diverse roses, stevens-johnson syndrome, loss of air conditioning, speech disorders, perinoite disorders including mental mental mental illness and non-sitting, active manic or mild manic.

Other rare undesirable reactions include blood organs such as granulocytes, anemia, neutropenia, hypotension and thrombocytopenia, extending QT and torsion, ventricular or ventricular tachycardia, pattern, delusion, pancreatitis and eosinants in the lungs.

Aggressive behavior appears when treating with Venlafaxine, especially at the beginning and the stop treatment. The intention of suicide has been reported, especially in children. Sodium hypoglycemia can be lowered due to an inappropriate excretion of anti -diuretic hormones related to the use of antidepressants, especially in the elderly.

Instructions on how to handle ADR

When experiencing side effects of the drug, it is necessary to stop using and notify the doctor or go to the nearest medical facility for timely treatment.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

contraindicated

venlafaxine stella contraindicated in the following cases:

Patients with hypersensitivity to Venlafaxine Hydrochloride or any excipients of the drug.

Patients taking Monoamin oxidase inhibitors (IMAO).

Be cautious when using

Patients with a recent history of myocardial infarction or the condition is likely to be severe when the heart rate increases. Due to the risk of dosage hypertension, blood pressure monitoring should be monitored.

Need to check serum cholesterol when long -term treatment.

Be cautious when using vendafaxine for patients with liver or kidney failure to fit and adjust the dose when needed.

venlafaxine is used with patients with a history of epilepsy and avoiding for people with unstable illnesses; Should stop the drug in any patient developing seizures or increasing epilepsy frequency.

Be cautious with patients with a history of bleeding disorders, mild or manic. Patients with glaucoma or at risk of closed angle glaucome should be closely monitored.

Report immediately to the doctor if there are manifestations of rash, urticaria or allergic reactions related to Venlafaxine.

Patients, especially the elderly, need to be cautious with the risk of being dizzy, unstable due to lowering blood pressure.

Symptoms due to stopping or reducing the doses of Venlafaxine suddenly include fatigue, drowsiness, headache, vomiting, vomiting, anorexia, chest drum, dizziness, dry mouth, diarrhea, insomnia, agitation, anxiety, tension, confusion, mild, abnormal, sweating and dizziness.

The ability to drive and operate machinery

Like other antidepressants, Venlafaxine can impair the ability to work and if any effects occur, patients should not drive or operate machinery.

Pregnancy

research on mice shows that when the mother mouse uses medication from pregnancy until the milk is stopped, there is a decrease in mass and increase the premature death of the baby rat and also increase death in the mice in the first 5 days of breastfeeding. There is no complete and accurate research on pregnant women. Because animal research is not always predicted on humans, it is only used during pregnancy when it is really necessary.

breastfeeding period

venlafaxine and ODV excreted through breast milk. Due to the risk of serious unwanted effects for breastfeeding children, it is recommended to decide or stop breastfeeding or stop using the drug, after considering the importance of the drug for the mother.

Drug interaction

CYP3A4 inhibitors: simultaneous use Venlafaxine with CYP3A4 inhibitors (Atazanavir, Clarithromycin , indinir, iTraconazol, voriconzol, posaconazole, ketoconazole ritonavir , Saquinavir and Telithromycin) may increase the concentration of Venlafaxine and O-Desmethidvenlafaxine. Therefore, it is necessary to be cautious when the patient is taking treatment therapy simultaneously inhibitors CYP3A4 and Venlafaxine.

Lithi: Serotonin syndrome can occur when using simultaneously venlafaxine and lithium.

Monoamine inhibitors of oxidase: Some serious undesirable reactions have been reported in new patients who stop using monoamine inhibitors (IMAO) and start using Venlafaxine or vice versa. These reactions include tremor, muscle vibration, sweating, nausea, vomiting, flushing, dizziness, increased body temperature with the same characteristics as malignant neuroleptic syndrome, epilepsy and death. Therefore, do not use Venlafaxine in combination with Mao inhibitors or within at least 14 days after stopping using Mao inhibitors. Based on Venlafaxine's semi -exhaust time, after stopping using Venlafaxine for at least 7 days to start using Mao inhibitors.

Central nerve stimulants: Be careful when combining Venlafaxine with other central nervous stimulants.

Storage

Store in closed packaging, dry place. The temperature does not exceed 30 ° C.

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