英文药名: Effexor(Venlafaxine Tablets)

中文药名: 怡诺思（文拉法辛片）

生产厂家: Wyeth Ayerst Pharmaceuticals

药品名称和成分

怡诺思XR（文拉法辛片）

药理毒理

本品及其活性代谢物是神经系统5-羟色胺和去甲肾上腺素的再摄取的强抑制剂，使突触间隙中这两种单胺递质浓度增高，发挥抗抑郁作用。
药代动力学

口服吸收迅速而良好，单剂给药时，仅有12.6%进入循环，食物对本品及其代谢物的吸收无影响。t1/2平均为4小时，表观分布容积为6L/kg，主要在肝代谢，原药及其代谢物大部分由肾脏排泄。肾功能受损使万拉法辛与其代谢物大约降低55%，消除半衰期明显延长，因此，在肌酐清除率＜30ml/min的肾病病人中，使用本品时应注意调整剂量。对肝功能损害者必须减少剂量。
适应症

抑郁症。
用法用量

口服。开始剂量为一次25mg，一日2～3次，逐渐增至一日75～225mg，分2～3次口服。最高量为一日350mg。
如果您有任何疑问，请遵医嘱。
不良反应

可有胃肠道不适如恶心、厌食、腹泻等。亦可出现头痛、不安、无力、嗜睡、失眠、头晕或震颤等。少见不良反应有过敏性皮疹及性功能减退。可引起血压升高，且与剂量呈正相关。大剂量时可诱发癫痫。突然停药可见撤药综合症如失眠、焦虑、恶心、出汗、震颤、眩晕或感觉异常等。
禁忌

对本品过敏者禁用、正在服用单胺氧化酶抑制剂的患者禁用。
孕妇及哺乳期妇女用药

慎用。
儿童用药

慎用。
老年患者用药

慎用。
注意事项

1.闭角型青光眼、癫痫患者慎用。
2.严重心脏疾患、高血压、甲状腺疾病、血液病患者慎用。
3.肝肾功能不全者慎用或减少用量。
4.用药过程中应监测血压，血压升高应减量或停药。
5.停用时应逐渐减少剂量，已应用本品6周或更长时间者，应在2周内逐渐减量。
6.患者出现有转向躁狂发作倾向时应立即停药。
7.用药期间不宜驾驶车辆、操作机械或高空作业。
药物相互作用

1.与选择性5-羟色胺再摄取抑制剂或与单胺氧化酶抑制剂合用时，可引起高血压、僵硬、肌阵挛、不自主运动、焦虑不安、意识障碍乃至昏迷和死亡。因此，在由一种药物转换为另一种药物治疗时，需7～14日的洗净期。
2.与奎尼丁合用时，可使本品血药浓度升高。
3.与-受体阻滞剂普萘洛尔、美多洛尔、噻吗咯尔或与三环类抗抑郁药阿米替林、氯米帕明、丙咪嗪或与抗心律失常药普鲁帕酮，可待因和美沙芬等合用，可竞争性地抑制本品的代谢。
4.与西米替丁合用时，可使本品清除率降低。
药物过量

药物过量中毒指征为呆滞不动和昏睡。应对症治疗及支持疗法。
贮藏

密封，在干燥处保存。

 
Venlafaxine (Effexor)
Venlafaxine (Effexor) a bicyclic antidepressant that inhibits the reuptake of serotonin, norepinphrine, and dopamine. This drug is used in the treatment of depression but is also used to treat OCD ( obsessive-compulsive disorder) or Fibromyalgia (FMS).
 
Generic name: Venlafaxine Hydrochloride.
Type: Antidepressant.

Strengths:

Tables:
25 mg, 37.5 mg, 50 mg, 75 mg, 100 mg.
Dosages: Actual dosage must be determined by a physician.
Oral:
Start: 75 mg in three 25 mg doses daily.
Increases: In four day intervals, up to 225 mg daily as needed.
Maximum: 225 mg in 24 hours.
Normal dosage:
For Depression:
If under 18 years of age DO NOT USE.
18 to 60 years of age, 75 mg daily in two or three dose with food.
Over 60 years of age, Lower dosage increased cautiously.

For OCD:
If under 18 years of age DO NOT USE.
18 to 60 years of age, 75 mg daily in two or three dose with food. ( Larger dose may be needed )
Over 60 years of age, Lower dosage increased cautiously.

Problems with:
Liver Function: Must lower dosage ( at less 50% ), as needed with careful monitoring.
Kidney Function: Must lower dosage ( at less 25% ), as needed with careful monitoring.
Test:
Before taking: Blood pressure.
While taking: Blood pressure regularly.
Take With: With food.

Full Benefits In: In two weeks.

Missed Dose(s): If within one hour take, if over an hour skip and then continue on your normal schedule. Never Take a Double Dose.

If Stop Taking: Do not stop without consulting your physician and never abruptly.

Overdose symptoms include: Convulsions / seizure, fatigue, nausea, or vomiting.

Warnings

The habit-forming potential is low.

Do not take this drug if you are pregnant, try some non-drug alternatives.

Do not take this drug if planning to become pregnant. Do not take if you are breast-feeding.

Do not drink alcohol when taking this drug.

Do not give this drug to children under eighteen.If over sixty only use drug in small doses and with close monitoring of it's side effects.

Do not use if: You had negative reactions to this drug or any drug in this class in the past. If you have taken any MAO inhibitors in the last 14 days.

Do not use if you have any type of seizures. ( Epilepsy or convulsions )

Inform your Doctor if:

You had negative reactions to this drug or any drug in this class in the past.
if you have taken any MAO inhibitors in the last 14 days.
if you have a history of liver or kidney problems.
If you have a history of seizures, hyperlipdemia, hypomania, or mania.
if you are taking any other prescription or nonprescription drug.
if you plan to be under anesthesia or having any surgery in the next few months, also if you will be undergoing any medical tests.
Venlafaxine ( Symptoms or Effects )

Common: Anxiety, constipation, delayed orgasm, depression, difficulty breathing, dizziness, dry mouth, itching, loss of appetite, loss of strength, nausea, nervousness, problem urinating, sedation,skin rash, sleepiness / sleeplessness, sweating, tingling hands / feet, tremors, vomiting, unusual dreams, weight loss, and / or weakness.

Rare: Abnormal speech, bleeding / irritated gums, chest pain, dry skin, ear pain, hair loss, excessive salivation, migraines, seizures, sensitivity to sun, soft stools, stomach irritation, suicide attempts, taste disorders, tongue discoloring, thyroid changes, and / or problems with vision.

See physician always: Abnormal speech, bleeding / irritated gums, chest pain, depression, difficulty breathing, dry skin, ear pain, hair loss, excessive salivation, loss of strength, migraines, problem urinating, seizures, sensitivity to sun, soft stools, stomach irritation, suicide attempts, taste disorders, tongue discoloring, thyroid changes, tremors, problems with vision, and /or vomiting

See physician if severe: Anxiety, constipation, delayed orgasm, dizziness, dry mouth, itching, loss of appetite, nausea, nervousness, sedation, sleepiness / sleeplessness, sweating, tingling hands / feet, unusual dreams, weight loss, and / or weakness.

See physician NOW: Skin rash or vomiting.

Stop taking and see physician NOW: Seizures.