Updated prescribing advice for venlafaxine (MHRA, 2014)
specialist supervision is needed for severely depressed or hospitalised patients who require venlafaxine doses of 300 mg daily or more
cardiac contra-indications are more targeted towards high-risk groups
as previously, patients with uncontrolled hypertension should not take venlafaxine, and blood pressure monitoring is recommended for all patients
concomitant SSRI use should be restricted to specialist use
other drug interactions are a possibility, particularly CYP3A4 inhibitors and CYP2D6 inhibitors
these interacting drugs should only be prescribed when strictly indicated
when doses of 225mg are required, it is more cost-efficient to prescribe M/R capsules as 1 x 75mg + 1 x 150mg or as 3 x 75mg. If patients are unable or unwilling to use multiple capsules, prescribing as Vensir XL® 225mg capsules is most cost-efficient.