Is venlafaxine (Extended Release) ER the same as venlafaxine (Extended Release) XR?

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Venlafaxine ER and XR Are the Same Medication

Yes, venlafaxine ER (Extended Release) and venlafaxine XR (Extended Release) refer to the same formulation—these are simply different naming conventions used interchangeably for the extended-release version of venlafaxine. 1, 2

Nomenclature Clarification

  • The terms "ER" and "XR" both designate the extended-release formulation of venlafaxine, which uses microencapsulation technology to deliver the medication over approximately 24 hours 1, 2
  • This is distinct from the immediate-release (IR) formulation, which requires twice or three times daily dosing 1, 3
  • The extended-release version allows for once-daily dosing regardless of whether it's labeled ER or XR 2, 3

Key Pharmacokinetic Properties of Extended-Release Formulations

  • Extended-release venlafaxine has lower maximum plasma concentrations (Cmax) and achieves peak levels at a later time (higher Tmax) compared to immediate-release 1
  • The longer apparent elimination half-life makes it suitable for once-daily administration 1
  • Absolute bioavailability is between 40-45% and is similar for both conventional and extended-release formulations 2

Clinical Advantages of Extended-Release Over Immediate-Release

  • The extended-release formulation produces significantly less nausea and dizziness at treatment initiation compared to immediate-release, with a 63% decrease in nausea intensity 1, 2
  • Nausea incidence is highest during the first 2 weeks with extended-release, with low likelihood of developing nausea thereafter 3
  • Extended-release demonstrated superior efficacy to immediate-release at week 12 across all efficacy variables (HAM-D, MADRS, CGI severity scales) 3
  • The once-daily dosing improves ease of use and may enhance medication compliance 1

Formulation Variations (Tablets vs Capsules)

  • Extended-release venlafaxine is available as both tablets and capsules, which are bioequivalent when taken with food 4
  • The tablet formulation uses osmotic pressure to deliver venlafaxine at a controlled rate over 24 hours 4
  • All doses of extended-release tablets met FDA bioequivalence criteria compared to capsules in the fed state 4

References

3
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

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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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