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Serotonin-Noradrenaline Reuptake Inhibitor (SNRI)

Venlafaxine

Brand names: Efexor XL

Venlafaxine is a serotonin-noradrenaline reuptake inhibitor (SNRI) used for depression and anxiety disorders.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

US labelling (FDA)

Reference — US labelling, may differ from UK

DOSAGE AND ADMINISTRATION Initial Treatment The recommended starting dose for venlafaxine tablets is 75 mg/day, administered in two or three divided doses, taken with food. Depending on tolerability and the need for further clinical effect, the dose may be increased to 150 mg/day. If needed, the dose should be further increased up to 225 mg/day. When increasing the dose, increments of up to 75 mg/day should be made at intervals of no less than 4 days. In outpatient settings there was no evidence of usefulness of doses greater than 225 mg/day for moderately depressed patients, but more severely depressed inpatients responded to a mean dose of 350 mg/day. Certain patients, including more …

Source: US FDA prescribing information (openFDA / DailyMed), label dated 2025-02-04. Accessed 2026-06-12. US dosing and indications can differ from UK practice — use UK sources for prescribing decisions.

Clinical monograph

How it works

It inhibits the reuptake of serotonin and, at higher doses, noradrenaline.

Prescribing in practice

  • Stopping it abruptly causes discontinuation symptoms — taper when stopping.
  • It can raise blood pressure in a dose-dependent way — monitor, especially at higher doses.
  • It is more toxic in overdose than SSRIs (consider this where overdose risk is a concern); serotonin syndrome can occur with other serotonergic drugs.

Monitoring

Monitor mood and suicidality (especially early and in younger adults), blood pressure and response.

Counselling the patient

  • Do not stop it suddenly.
  • Report worsening mood, agitation or restlessness early in treatment.
  • Your blood pressure may be checked.

Evidence & guidelines

An effective second-line antidepressant (NICE NG222/CG90), with blood-pressure monitoring and a taper on stopping.

Reference: NICE NG222 Depression; BAP Antidepressant Guidelines; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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