ViePax 37.5 mg TABLETS
ViePax 75 mg TABLETS
Venlafaxine
Read all of this leaflet carefully before you start taking this medicine.
- Keep this leaflet. You may need to read it again.
- If you have any further questions, ask your doctor or pharmacist.
- This medicine has been prescribed for you. Do not pass it on to others. It may harm them, even if their symptoms are the same as yours.
- If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist.
In this leaflet:
- 1. What ViePax is and what it is used for
- 2. Before you take ViePax
- 3. How to take ViePax
- 4. Possible side effects
- 5. How to store ViePax
- 6. Further information
WHAT ViePax IS AND WHAT IT IS USED FOR
The name of your medicine is ViePax 37.5 mg Tablets or ViePax 75 mg Tablets (referred to as ViePax throughout this leaflet).
ViePax is an antidepressant that belongs to a group of medicines called serotonin and norepinephrine reuptake inhibitors (SNRIs). This group of medicines is used to treat depression and other conditions such as anxiety. It is thought that people who are depressed and/or anxious have lower levels of serotonin and noradrenaline in the brain. It is not fully understood how antidepressants work, but they may help by increasing the levels of serotonin and noradrenaline in the brain.
ViePax is a treatment for adults with depression. Treating depression properly is important to help you get better. If it is not treated, your condition may not go away and may become more serious and more difficult to treat.
BEFORE YOU TAKE ViePax
Do not take ViePax
- If you are allergic to venlafaxine or any of the other ingredients of ViePax.
- If you are also taking or have taken any time within the last 14 days any medicines known as irreversible monoamine oxidase inhibitors (MAOIs), used to treat depression or Parkinson’s disease. Taking an irreversible MAOI together with other medicines, including ViePax, can cause serious or even life-threatening side effects. Also, you must wait at least 7 days after you stop taking ViePax before you take any irreversible MAOI (see also the sections “Taking other medicines” including “Serotonin syndrome”).
Take special care with ViePax
- If you use other medicines that, if taken concomitantly with ViePax, could increase the risk of developing serotonin syndrome (see the section “Taking other medicines”).
- If you have eye problems, such as certain kinds of glaucoma (increased pressure in the eye).
- If you have a history of high blood pressure.
- If you have a history of heart problems.
- If you have a history of fits (seizures).
- If you have a history of low sodium levels in your blood (hyponatraemia).
- If you have a tendency to develop bruises or a tendency to bleed easily (history of bleeding disorders), or if you are taking other medicines that may increase the risk of bleeding.
- If your cholesterol levels get higher.
- If you have a history of, or if someone in your family has had, mania or bipolar disorder (feeling over-excited or euphoric).
- If you have a history of aggressive behaviour.
ViePax may cause a sensation of restlessness or an inability to sit or stand still. You should tell your doctor if this happens to you.
If any of these conditions apply to you, please talk with your doctor before taking ViePax.
Thoughts of suicide and worsening of your depression or anxiety
If you are depressed and/or anxious, you can sometimes have thoughts of harming or killing yourself. These may be increased when you first start taking antidepressants, since these medicines all take time to work, usually about two weeks, but sometimes longer.
You may be more likely to think like this:
- If you have previously had thoughts about killing yourself or harming yourself.
- If you are a young adult. Information from clinical trials has shown an increased risk of suicidal behaviour in young adults (less than 25 years old) with psychiatric conditions who were treated with an antidepressant.
If you have thoughts of harming or killing yourself at any time, contact your doctor or go to a hospital straight away.
You may find it helpful to tell a relative or close friend that you are depressed or anxious, and ask them to read this leaflet. You might ask them to tell you if they think your depression or anxiety is getting worse, or if they are worried about changes in your behaviour.
Dry mouth
Dry mouth is reported in 10% of patients treated with venlafaxine. This may increase the risk of caries. Therefore, you should take special care in your dental hygiene.
Use in children and adolescents under 18 years of age
ViePax should normally not be used for children and adolescents under 18 years. Also, you should know that patients under 18 have an increased risk of side effects, such as suicide attempt, suicidal thoughts and hostility (predominantly aggression, oppositional behaviour and anger) when they take this class of medicines. Despite this, your doctor may prescribe ViePax for patients under 18 because he/she decides that this is in their best interests. If your doctor has prescribed ViePax for a patient under 18, and you want to discuss this, please go back to your doctor. You should inform your doctor if any of the symptoms listed above develop or worsen when patients under 18 are taking ViePax. Also, the long-term safety effects concerning growth, maturation and cognitive and behavioural development of ViePax in this age group has not yet been demonstrated.
Taking other medicines
Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a prescription.
Do not start or stop taking any medicines, including those bought without a prescription, natural and herbal remedies, before checking with your doctor or pharmacist.
Your doctor should decide whether you can take ViePax with other medicines, such as:
- Monoamine oxidase inhibitors (MAOIs: see the section “Before you take ViePax”).
- Products associated with serotonin syndrome:
Serotonin syndrome, a potentially life-threatening condition (see “Possible Side Effects, Nervous system disorders”), which may occur with venlafaxine treatment, particularly when taken with other medicines. Examples of these medicines include:
- Triptans (used for migraine)
- Medicines to treat depression, for instance SNRI, SSRIs, tricyclics, or medicines containing lithium
- Medicines containing linezolid, an antibiotic (used to treat infections)
- Medicines containing moclobemide, a reversible MAOI (used to treat depression)
- Medicines containing sibutramine (used for weight loss)
- Medicines containing tramadol (a pain-killer)
- Products containing St. John’s Wort (also called Hypericum perforatum, a natural or herbal remedy used to treat mild depression)
- Products containing tryptophan (used for problems such as sleep and depression)
Signs and symptoms of serotonin syndrome may include a combination of the following:
restlessness, hallucinations, loss of coordination, fast heart beat, increased body temperature, fast changes in blood pressure, overactive reflexes, diarrhoea, coma, nausea, vomiting. Get medical care right away if you think serotonin syndrome is happening to you.
The following medicines may also interact with ViePax and should be used with caution. It is especially important to mention to your doctor or pharmacist if you are taking medicines containing:
- Ketoconazole (an antifungal medicine)
- Haloperidol or risperidone (to treat psychiatric conditions)
- Metoprolol (a beta blocker to treat high blood pressure and heart problems)
Taking ViePax with food and drink
ViePax should be taken with food (see section 3 “How to take ViePax”).
You should avoid alcohol while you are taking ViePax.
Pregnancy and breast-feeding
Tell your doctor if you become pregnant, or you are trying to become pregnant. You should use ViePax only after discussing the potential benefits and the potential risks to your unborn child with your doctor.
If you are taking ViePax during pregnancy, let your midwife and/or doctor know, as your baby might have some symptoms when it is born. These symptoms usually begin during the first 24 hours after the baby is born. They include not feeding properly and trouble with breathing. If your baby has these symptoms when it is born and you are concerned, contact your doctor and/or midwife who will be able to advise you.
ViePax passes into breast milk. There is a risk of an effect on the baby. Therefore, you should discuss the matter with your doctor, and he/she will decide whether you should stop breast-feeding or stop the therapy with ViePax.
Driving and using machines
Do not drive or use any tools or machines until you know how ViePax affects you.
Important information about some of the ingredients of ViePax
This product contains lactose. If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product.
HOW TO TAKE ViePax
Always take ViePax exactly as your doctor has told you. You should check with your doctor or pharmacist if you are not sure.
The usual recommended starting dose is 75 mg per day in divided doses. The dose can be raised by your doctor gradually and, if needed, even up to a maximum dose of 375 mg daily for depression.
Take ViePax at approximately the same time each day, in the morning and in the evening.
ViePax should be taken with food.
If you have liver or kidney problems, talk to your doctor, since your dose of ViePax may need to be different.
The 37.5mg tablets and 75mg tablets come in special "calendar" packs which help you remember to take your tablets when you should.
The following instructions will help you:
- 1. Remove a card.
- 2. Go to the correct day of the week.
- 3. Take the tablet from the card or part of the card, marked "AM", in the morning.
- 4. Your next tablet should be taken in the evening from the card or part of the card, marked "PM".
- 5. Continue taking a tablet every morning and evening.
- 6. When you have finished a card, move on to the next one.
Do not stop taking ViePax without talking to your doctor (see the section “If you stop taking ViePax”).
If you take more ViePax than you should
Call your doctor or pharmacist immediately if you take more than the amount of ViePax prescribed by your doctor.
The symptoms of a possible overdose may include a rapid heart beat, changes in level of alertness (ranging from sleepiness to coma), blurred vision, seizures or fits, and vomiting.
If you forget to take ViePax
If you miss a dose, take it as soon as you remember. However, if it is time for your next dose, skip the missed dose and take only a single dose as usual. Do not take more than the daily amount of ViePax that has been prescribed for you in one day.
If you stop taking ViePax
Do not stop taking your treatment or reduce the dose without the advice of your doctor even if you feel better. If your doctor thinks that you no longer need ViePax, he/she may ask you to reduce your dose slowly before stopping treatment altogether. Side effects are known to occur when people stop using ViePax, especially when ViePax is stopped suddenly or the dose is reduced too quickly. Some patients may experience symptoms such as tiredness, dizziness, light-headedness, headache, sleeplessness, nightmares, dry mouth, loss of appetite, nausea, diarrhoea, nervousness, agitation, confusion, ringing in the ears, tingling or rarely electric shock sensations, weakness, sweating, seizures, or flu-like symptoms.
Your doctor will advise you on how you should gradually discontinue ViePax treatment. If you experience any of these or other symptoms that are troublesome, ask your doctor for further advice.
If you have any further questions on the use of this product, ask your doctor or pharmacist.
Possible Side Effects
Like all medicines, ViePax can cause side effects, although not everybody gets them.
Allergic reactions
If any of the following happen, do not take more ViePax. Tell your doctor immediately, or go to the casualty department at your nearest hospital:
- Chest tightness, wheezing, trouble swallowing or breathing
- Swelling of the face, throat, hands, or feet
- Feeling nervous or anxious, dizziness, throbbing sensations, sudden reddening of the skin and/or a warm feeling
- Severe rash, itching, or hives (elevated patches of red or pale skin that often itch)
Serious side effects
If you notice any signs of the following, you may need urgent medical attention:
- Heart problems, such as fast or irregular heart rate, increased blood pressure
- Eye problems, such as blurred vision, dilated pupils
- Nerve problems, such as dizziness, pins and needles, movement disorder, seizures or fits
- Psychiatric problems, such as hyperactivity and euphoria
- Treatment withdrawal (see the section “How to take ViePax, if you stop taking ViePax”)
Complete side effect listing
The frequency (likelihood of occurring) of side effects is classified as follows:
Very common: Affects more than 1 user in 10
Common: Affects 1 to 10 users in 100
Uncommon: Affects 1 to 10 users in 1,000
Rare: Affects 1 to 10 users in 10,000
Not Known: Frequency cannot be estimated from the available data
- Blood disorders
Uncommon: bruising; black tarry stools (faeces) or blood in stools, which can be a sign of internal bleeding
Not known: reduced number of platelets in your blood, leading to an increased risk of bruising or bleeding; blood disorders which may lead to an increased risk of infection
- Metabolism/nutritional disorders
Common: weight loss; increased cholesterol
Uncommon: weight gain
Not known: slight changes in blood levels of liver enzymes; decrease in blood sodium levels; itchiness, yellow skin or eyes, dark urine, or flu-like symptoms, which are symptoms of inflammation of the liver (hepatitis); confusion, excessive water intake (known as SIADH); abnormal breast milk production
- Nervous system disorders
Very common: dry mouth; headache
Common: abnormal dreams; decreased libido; dizziness; increased muscle tonus (tension); insomnia; nervousness; pins and needles; sedation; tremor; confusion; feeling separated (or detached) from yourself and reality
Uncommon: lack of feeling or emotion; hallucinations; involuntary movement of the muscles; agitation; impaired coordination and balance
Rare: a sensation of restlessness or an inability to sit or stand still; seizures or fits; feeling over-excited or euphoric
Not known: a high temperature with rigid muscles, confusion or agitation, and sweating, or if you experience jerky muscle movements which you can't control, these may be symptoms of serious conditions known as neuroleptic malignant syndrome; euphoric feelings, drowsiness, sustained rapid eye movement, clumsiness, restlessness, feeling of being drunk, sweating or rigid muscles, which are symptoms of serotonergic syndrome; disorientation and confusion often accompanied by hallucination (delirium); stiffness, spasms and involuntary movements of the muscles; thoughts of harming or killing yourself
- Sight and hearing disorders
Common: blurred vision
Uncommon: altered taste sensation; ringing in the ears (tinnitus)
Not known: severe eye pain and decreased or blurred vision
- Heart or circulation disorders
Common: increase in blood pressure; flushing; palpitations
Uncommon: feeling dizzy (particularly when standing up too quickly), fainting, fast heartbeat
Not known: decrease in blood pressure; abnormal, rapid or irregular heart beat, which could lead to fainting
- Breathing disorders
Common: yawning
Not known: coughing, wheezing, shortness of breath and a high temperature, which are symptoms of inflammation of the lungs associated with an increase in white blood cells (pulmonary eosinophilia)
- Digestive disorders
Very common: nausea
Common: appetite decreased; constipation; vomiting
Uncommon: grinding of the teeth; diarrhoea
Not known: severe abdominal or back pains (which could indicate a serious problem in the gut, liver or pancreas)
- Skin disorders
Very common: sweating (including night sweats)
Uncommon: rash; abnormal hair loss
Not known: skin rash, which may lead to severe blistering and peeling of the skin; itching; mild rash
- Muscle disorders
Not known: unexplained muscle pain, tenderness or weakness (rhabdomyolysis)
- Urinary system disorders
Common: difficulties passing urine; increased frequency in urination
Uncommon: inability to pass urine
- Reproductive and sexual disorders
Common: abnormal ejaculation/orgasm (males); lack of orgasm; erectile dysfunction (impotence); menstrual irregularities such as increased bleeding or increased irregular bleeding
Uncommon: abnormal orgasm (females)
- General
Common: weakness (asthenia); chills
Uncommon: sensitivity to sunlight
Not known: swollen face or tongue, shortness of breath or difficulty breathing, often with skin rashes (this may be a serious allergic reaction)
ViePax sometimes causes unwanted effects that you may not be aware of, such as increases in blood pressure or abnormal heart beat; slight changes in blood levels or liver enzymes, sodium or cholesterol. More rarely, ViePax may reduce the function of platelets in your blood,
leading to an increased risk of bruising or bleeding. Therefore, your doctor may wish to do blood tests occasionally, particularly if you have been taking ViePax for a long time.
If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist.
HOW TO STORE ViePax
Keep out of the reach and sight of children.
Do not use ViePax after the expiry date, which is stated on the packaging.
This medicinal product does not require any special storage conditions.
Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required.
Further Information
What ViePax contains
The active substance is venlafaxine.
Each tablet contains either 37.5 mg or 75 mg venlafaxine as venlafaxine hydrochloride.
Other ingredients in these tablets are: lactose monohydrate, microcrystalline cellulose, sodium starch glycolate, povidone, magnesium stearate, ferric oxide yellow (E-172), ferric oxide red (E-172) and ferric oxide black (E-172).
What ViePax looks like and contents of the pack
ViePax 37.5 mg and ViePax 75 mg are mottled-beige, round tablets.
ViePax 37.5 mg and ViePax 75 mg come in calendar packs of 28 and 56 tablets.
Not all pack sizes may be marketed.
Marketing Authorisation Holder and Manufacturer:
This leaflet was last revised in October 2008.
1290723432
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