Animal studies have proved adverse effects but may be safe for humans
How it works
Mechanism information is still being processed. Check the DailyMed link in the sidebar for the official prescribing information.
Dosing & administration
Dosing varies by indication and patient profile. Always follow your institution's current prescribing guidelines.
Renal impairment
Consult protocols for adjustment.
Liver impairment
Consult protocols for adjustment.
Use during pregnancy
1st trimester
Caution. Some data suggest modest increase in cardiac defects. Use when benefits outweigh risks.
2nd trimester
Caution. Use lowest effective dose.
3rd trimester
Caution. Monitor neonate for withdrawal (irritability, high-pitched cry, feeding difficulties) — may be more pronounced and prolonged than with SSRIs.
Clinical note
SNRI used for depression, anxiety, and panic disorder. Large cohort data are largely reassuring for MCM but some studies suggest a small increase in risk of cardiovascular defects and postpartum hemorrhage. More prominent neonatal withdrawal syndrome than SSRIs due to norepinephrine reuptake inhibition — neonatal adaptation syndrome may be more severe and longer lasting. Pulmonary hypertension of the newborn (PPHN) risk similar to SSRIs (small absolute risk).
Breastfeeding
Caution. Significant breast milk transfer; active metabolite (O-desmethylvenlafaxine) also present. Monitor infant for agitation and poor weight gain.
