Interactions

Drug-Drug

• Concurrent use with MAO inhibitors may result in serious, potentially fatal reactions (wait at least 2 wk after stopping MAO inhibitor before initiating venlafaxine; wait at least 1 wk after stopping venlafaxine before starting MAO inhibitors)

• Concurrent use with alcohol or other CNS depressants , including sedatives/hypnotics , antihistamines , and opioid analgesics in depressed patients is not recommended

• Drugs that affect serotonergic neurotransmitter systems, including linezolid , tramadol , and triptans, ↑ risk of serotonin syndrome.

• Lithium may have ↑ serotonergic effects with venlafaxine; use cautiously in patients receiving venlafaxine

• ↑ blood levels and may ↑ effects of desipramine and haloperidol

• Cimetidine may ↑ the effects of venlafaxine (may be more pronounced in geriatric patients, those with hepatic or renal impairment, or those with pre-existing hypertension)

• Ketoconazole may ↑ the effects of venlafaxine

• ↑ risk of bleeding with NSAIDS , aspirin , clopidogrel , or warfarin

• Concomitant use of kava-kava , valerian , chamomile , or hops can ↑ CNS depression

• ↑ risk of serotinergic side effects including serotonin syndrome with St. John's wort and SAMe

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