Is that medication safe to take? A guide to Effexor XR interactions

Effexor XR interactions with other medications  

Here’s a table of drugs that can interact with Effexor XR. Keep in mind that this table doesn’t include all drugs that may interact with Effexor XR. Some of these interactions are described in detail in “Drug interactions in depth.”

Quick tip: Create a medication list of all prescription drugs, over-the-counter drugs, and supplements you take to share with your doctor and pharmacist.

When to avoid Effexor XR

Sometimes, certain factors or conditions could prevent your doctor from prescribing Effexor XR due to the risk of harm. These are known as contraindications. The contraindications of Effexor XR include:

Taking a monoamine oxidase inhibitor

Doctors typically will not prescribe Effexor XR in combination with a monoamine oxidase inhibitor (MAOI).

This is because taking Effexor XR with an MAOI can increase your risk of serotonin syndrome. With this syndrome, your body has a high level of the chemical serotonin. This can cause symptoms such as blood pressure changes, excessive sweating, and diarrhea. Serotonin syndrome can be life threatening in extreme cases.

Below are a few examples of MAOIs that can interact with Effexor XR:

• selegiline (Emsam)
• phenelzine (Nardil)
• methylene blue (Provayblue)
• linezolid (Zyvox)
• isocarboxazid (Marplan)

Before you start Effexor XR treatment, tell your doctor if you take an MAOI. They’ll likely have you stop the MAOI and wait at least 2 weeks to start Effexor XR treatment. Likewise, your doctor will typically have you wait at least 7 days to start an MAOI after stopping Effexor XR treatment.

Having had an allergic reaction to Effexor XR or any of its ingredients

If you have had an allergic reaction to Effexor XR or any of its ingredients, your doctor will likely not prescribe Effexor XR. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.

Note:Before you start treatment with Effexor XR, it’s important to tell your doctor if these contraindications apply to you. They can determine whether to prescribe Effexor XR.

Effexor XR interaction with alcohol

Your doctor may recommend that you not drink alcohol while taking Effexor XR. They may also advise you not to take any prescription or over-the-counter drugs that contain alcohol during Effexor XR treatment.

This is because drinking alcohol with Effexor XR may cause the medication to be released into your body faster than is typical. This could worsen the side effects of Effexor XR, such as sleepiness or dizziness.

Sometimes, the combination of alcohol and Effexor XR may also increase the risk of an overdose with Effexor XR.

If you have concerns about avoiding alcohol while you’re taking Effexor XR, talk with your doctor before starting treatment.

Drug interactions in depth

Here’s a closer look at certain drug interactions of Effexor XR.

Certain antipsychotics

Doctors prescribe antipsychotics to treat bipolar disorder, schizophrenia, and other mental health conditions.

Interaction result:Taking Effexor XR with certain antipsychotics may increase the risk of side effects from either drug.

Interaction explained:Certain antipsychotics may cause an irregular heart rhythm as a side effect. Rarely, Effexor XR may also cause this side effect. Combining these medications could further increase this risk.

Effexor XR may also slow the activity of an enzyme (protein) in your body that helps break down certain antipsychotics. This effect may lead to a high level of the antipsychotic drug in your body, increasing your risk of side effects.

Examples of antipsychotic drugs: Here are some antipsychotics that may interact with Effexor XR:

• ziprasidone (Geodon)
• risperidone (Risperdal, Risvan, others)
• olanzapine (Zyprexa)
• haloperidol (Haldol)
• aripiprazole (Abilify, Aristada, others)

Steps you or your doctor may take:Before starting Effexor XR treatment, tell your doctor if you’re taking an antipsychotic. They can advise you on whether it’s safe to take these medications together.

If your doctor prescribes Effexor XR with an antipsychotic, they may occasionally check your heart rhythm with an EKG. Your doctor will instruct you on managing any side effects if they happen.

To learn more about Effexor XR and antipsychotics, talk with your doctor or pharmacist.

Nonsteroidal anti-inflammatory drugs

Nonsteroidal anti-inflammatory drugs (NSAIDs) relieve fever, inflammation, and pain. Certain NSAIDs are available over the counter (OTC), meaning you don’t need a prescription to purchase them.

Interaction result: Taking Effexor XR with an NSAID could increase your risk of bleeding as a side effect of either drug.

Interaction explained: Effexor XR affects certain chemicals in your body, including serotonin. This chemical helps certain blood cells come together to form a blood clot. By affecting serotonin, Effexor XR may prevent these blood cells from clotting, which could increase your risk of bleeding.

NSAIDs also carry a risk of bleeding. So taking Effexor XR with an NSAID may further increase your risk of bleeding.

Examples of NSAIDs: Here are some NSAIDs that may interact with Effexor XR:

• naproxen (Aleve, Anaprox DS, others)
• meloxicam
• ibuprofen (Advil, Motrin)
• diclofenac (Cambia, Zipsor, others)
• celecoxib (Celebrex, Elyxyb)

Steps you or your doctor may take: Before starting treatment with Effexor XR, tell your doctor if you take an NSAID. They can tell you whether it’s safe to take these medications together.

It’s also important to talk with your doctor or pharmacist before taking any OTC pain reliever with Effexor XR. They can advise you on which OTC products contain NSAIDs and recommend which products are safe to take with Effexor XR.

To learn more about Effexor XR and NSAIDs, talk with your doctor or pharmacist.

Triptans

Triptans are prescribed to treat migraine episodes.

Interaction result: Taking Effexor XR with a triptan can increase the risk of serotonin syndrome.

Interaction explained: Effexor XR and triptans may increase the risk of serotonin syndrome when taken individually. Combining these medications may further increase this risk.

With serotonin syndrome, your body has a high level of the chemical serotonin. This can cause symptoms such as blood pressure changes, excessive sweating, and diarrhea. Serotonin syndrome can be life threatening in extreme cases.

Examples of triptan drugs: Here are some triptans that may interact with Effexor XR:

• zolmitriptan (Zomig)
• sumatriptan (Imitrex, Tosymra)
• rizatriptan (Maxalt, Maxalt-MLT)
• frovatriptan (Frova)
• eletriptan (Relpax)

Steps you or your doctor may take: Before taking Effexor XR, tell your doctor if you take a triptan drug. They can recommend whether it’s safe to take these drugs together.

If your doctor prescribes Effexor XR with a triptan, watch closely for symptoms of serotonin syndrome. Your doctor will tell you how to manage this side effect if it happens.

To learn more about Effexor XR and triptans, talk with your doctor or pharmacist.

Effexor XR and other interactions

Effexor XR may have other interactions, such as with supplements, foods, vaccines, or even lab tests. Read on for more details. Keep in mind that the following information does not include all other possible interactions with Effexor XR.

Effexor XR interactions with supplements

Effexor XR may interact with valerian root supplements, which some people take for sleep, anxiety, and other conditions. Taking Effexor XR with valerian root supplements could increase the effect of either product, which could lead to sleepiness.

Effexor XR interactions with herbs

Effexor XR may interact with St. John’s wort and L-tryptophan supplements. Some people take these supplements to treat mental health conditions.

Taking Effexor XR with St. John’s wort or L-tryptophan can increase your risk of serotonin syndrome as a side effect. With this condition, having a high level of the chemical serotonin in the body may lead to symptoms such as blood pressure changes, diarrhea, and excessive sweating. This condition can be life threatening in extreme cases.

Effexor XR interactions with lab tests

Effexor XR may interfere with the results of certain lab tests. Taking the medication may cause a false-positive result on a urine drug screening that tests for the presence of phencyclidine (PCP) or amphetamines. This means the test could show that you have PCP or amphetamines in your urine even if you do not. Such urine tests may be required by an employer or for other reasons.

Because of this, it’s important to tell the person giving you the test that you’re taking Effexor XR. They’ll recommend different tests to gather this information.

Effexor XR and health-related interactions

Certain medical conditions and other factors may increase the risk of interactions with Effexor XR. Health conditions or factors that might interact with Effexor XR include:

• Bipolar disorder: Effexor XR may trigger a manic or mixed episode in people with bipolar disorder. If you have bipolar disorder, talk with your doctor about whether Effexor XR is a safe treatment option.
• Liver or kidney problems: Before starting Effexor XR treatment, tell your doctor if you have a liver or kidney problem. They can tell you whether Effexor XR is a safe treatment option. Sometimes, your doctor may prescribe a lower Effexor XR dosage than is typical.
• Seizure conditions: Effexor XR may cause seizures as a side effect. It is unknown whether the drug is safe for people who have a seizure condition, such as epilepsy. If you have seizures, talk with your doctor before starting Effexor XR treatment.
• Low sodium levels: Your doctor may check the level of sodium in your blood before prescribing Effexor XR. If your sodium level is below the typical range, they may give you treatments to increase it before prescribing Effexor XR. This is because the drug may lower your sodium levels even further. Talk with your doctor about whether Effexor XR is the right treatment option for you.
• High blood pressure: If you have high blood pressure, talk with your doctor before taking Effexor XR. They’ll make sure your condition is well-managed before prescribing the drug. This is because Effexor XR may increase your blood pressure even further. Your doctor can recommend whether Effexor XR is the right treatment option.
• Narrow eye angles: Your doctor may advise you to have an eye exam before starting Effexor XR treatment. This is because the drug may cause dilated pupils, which could lead to closed-angle glaucoma in people with narrow eye angles. Closed-angle glaucoma is a medical emergency that can lead to vision loss. Your doctor can recommend whether Effexor XR is a safe treatment option.
• Allergic reaction: If you’ve had an allergic reaction to Effexor XR or any of its ingredients, your doctor will likely not prescribe Effexor XR. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.
• Breastfeeding: It is unknown whether it’s safe to take Effexor XR while breastfeeding. The drug passes into breast milk. However, there isn’t enough information to determine what effects the drug may have on a child who is breastfed. If you’re breastfeeding or planning to, talk with your doctor before taking Effexor XR. They can discuss treatment options and ways to feed your child.
• Pregnancy: There haven’t been enough clinical trials to determine whether Effexor XR is safe to take while pregnant. If you’re pregnant or planning to become pregnant, tell your doctor before starting Effexor XR. If it’s necessary to use Effexor XR while pregnant, you and your doctor should discuss the risks and benefits. They can advise you on the right treatment plan.
• Risk of suicidal thoughts and behaviors: Effexor XR has a boxed warning about the risk of suicidal thoughts and behaviors. This is a serious warning from the FDA. A boxed warning alerts doctors and patients about drug effects that may be dangerous. For details, see the boxed warning at the top of this article.

Note: If you’re prescribed Effexor XR during pregnancy, consider enrolling in the drug’s pregnancy registry. This registry collects information about any pregnancy issues that may be reported with the drug. To learn more, talk with your doctor. You can also call 844-405-6185 or 866-961-2388 or visit the registry website.

Next steps: Preventing interactions

You can take certain steps to help prevent interactions with Effexor XR. Your doctor and pharmacist are key resources, so reach out to them before starting treatment.

It’s also important to read the Effexor XR label and other paperwork that may come with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions.

You can also help prevent interactions with Effexor XR by taking it exactly as your doctor prescribes.