What is the starting dose of Effexor (Venlafaxine)?

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From the Guidelines

The starting dose of Effexor (Venlafaxine) should be 37.5 mg once daily for 4-7 days, then increased to 75 mg once daily if tolerated, as this approach helps minimize initial side effects and is supported by the most recent clinical guidelines. When initiating therapy with venlafaxine, it is essential to consider the patient's medical history, particularly cardiac disease, as venlafaxine can cause cardiac conduction abnormalities and blood pressure increases 1. The dosage may need to be adjusted based on the patient's response and tolerability, with a typical target dose ranging from 75-225 mg daily for depression and anxiety disorders. Some key points to consider when prescribing venlafaxine include:

  • Starting with a low dose and gradually increasing as needed and tolerated
  • Monitoring for common side effects such as nausea, headache, and dizziness
  • Tapering the dosage gradually when discontinuing treatment to avoid withdrawal symptoms
  • Being cautious when prescribing venlafaxine to patients with cardiac disease or other comorbidities that may be exacerbated by the medication 1. It is crucial to closely monitor patients and adjust the treatment plan as needed to ensure the best possible outcome in terms of morbidity, mortality, and quality of life.

From the FDA Drug Label

The recommended starting dose for venlafaxine tablets, USP is 75 mg/day, administered in two or three divided doses, taken with food. The starting dose of Effexor (Venlafaxine) is 75 mg/day, administered in two or three divided doses, taken with food 2.

From the Research

Starting Dose of Effexor (Venlafaxine)

The starting dose of Effexor (Venlafaxine) can be found in several studies:

  • In the study 3, the initial dose of venlafaxine was 37.5 mg twice daily.
  • The study 4 mentions that a young male patient with major depression started treatment with venlafaxine XR at 37.5 mg/d.
  • The study 5 states that outpatients with DSM-III-R major depression were randomly assigned to venlafaxine XR, 75 mg once daily, or venlafaxine IR, 37.5 mg twice daily.

Key Points

  • The initial dose of venlafaxine is typically 37.5 mg twice daily or 75 mg once daily for the extended release formulation.
  • The dose can be increased based on the patient's response to treatment, with some studies using doses up to 375 mg/day or more 6, 7.
  • It is essential to monitor patients for potential side effects, such as nausea, when starting or increasing the dose of venlafaxine 5.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

A double-blind comparison of venlafaxine and fluoxetine for treatment of major depression in outpatients.

Progress in neuro-psychopharmacology & biological psychiatry, 1996

Research

Dose-related paresthesias with venlafaxine.

Journal of pharmacy practice, 2013

Research

Once-daily venlafaxine extended release (XR) and venlafaxine immediate release (IR) in outpatients with major depression. Venlafaxine XR 208 Study Group.

Annals of clinical psychiatry : official journal of the American Academy of Clinical Psychiatrists, 1997

Research

Tolerability of high-dose venlafaxine in depressed patients.

Journal of psychopharmacology (Oxford, England), 2004

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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