► Axyven (venlafaxine) - Practical Medicine

Axyven (venlafaxine) - prolonged release tablets

The name of the preparation Character; dose; package Manufacturer Price 100% Price after refund In which pharmacy?
Axyven prolonged release tablets; 150 mg; 28 tabl. Axxon 45.37 0.00
Axyven prolonged release tablets; 37.5 mg; 28 tabl. Axxon 12.47 0.00
Axyven prolonged release tablets; 75 mg; 28 tabl. Axxon 24.09 0.00

Note: reimbursed drug prices are in line with the regulations in force from July 1, 2018.

The preparation contains the substance:venlafaxine

The drug is available on prescription

What is Axyven?

An antidepressant with a different structure than traditional antidepressants.

What does Axyven contain and how does it work?

The active substance in the preparation is venlafaxine . The mechanism of its action probably depends on enhancing the activity of neurotransmitters in the central nervous system. It inhibits the reuptake of serotonin and noradrenaline as well as (less) Dopamine by a cell before the synapse (a combination of nerve cells). This leads to an increase in the concentration of these mediators in the synaptic cleft, and thus to the amplification of the signal transmitted by them. Venlafaxine also reduces the reactivity of ß-adrenergic receptors to both acute stimuli (single administration) and long-term (repeated administration). Because venlafaxine does not showin vitroaffinity to the muscarinic, cholinergic, histamine H1 and 1-adrenergic receptors, does not cause adverse effects, such as cholinolytic, sedatives or cardiovascular reactions characteristic of other antidepressants. Venlafaxine does not have monoamine oxidase (MAO) inhibitory activity. There is no significant or reduced susceptibility to venlafaxine addiction.

When to use Axyven?

The preparation is indicated for the treatment of:
· Episodes of major depression and prevention of their recurrence
· Generalized anxiety disorder
· Social phobia
· Panic disorder with or without agoraphobia.

When not to use this preparation?

Unfortunately, even if there are indications to use the preparation, it can not always be used. You can not use the preparation if you are allergic (you are hypersensitive) to any of the ingredients.
Do not use the preparation in parallel with antidepressants from the monoamine oxidase (MAO) inhibitors group or in cases where MAO inhibitors have been administered during the last 14 days preceding venlafaxine treatment. You should wait at least 7 days after stopping venlafaxine before taking MAO inhibitors.
The preparation should not be used in children and adolescents up to 18 years of age.

When should you take extra care with Axyven?

Certain diseases and other circumstances may constitute a contraindication to use or indication to change the dosage of the preparation. In some situations it may be necessary to carry out specific check-ups.
Depression is associated with an increased risk of suicidal thoughts, self-injury and suicide (events related to suicide). The effects of the preparation may occur only after a few weeks of treatment, sometimes this time is longer. Patients should be under strict medical supervision until they recover. Other psychiatric disorders in which venlafaxine is prescribed may also be associated with an increased risk of suicidal behavior. In addition, these conditions can co-exist with severe depressive disorders. People treated with this preparation because of other than depression, as well as people who have attempted suicide, and those who have a significant degree of suicidal tendency before starting treatment should be closely monitored by a doctor. Also, during the change of dosage, the patient should be covered by special medical care. Patients and those around them should pay attention to any clinical sign of disease severity, suicidal behavior or thoughts or abnormal changes in behavior, and contact their physician immediately if they occur.
The preparation should not be used in treatment of children and adolescents under 18 years of age. If, based on clinical need, the physician decides to require treatment, the patient should be closely monitored for signs of suicidal symptoms. In addition, there is no data on the safety of long-term use of the drug in children and adolescents regarding growth, maturation and development of cognitive functions and behavior.
Do not suddenly discontinue the preparation due to the risk of withdrawal syndrome (symptoms include: dizziness, disturbances of sensation, including paresthesia, sleep disturbances, agitation, medication, nausea, vomiting, tremor, sweating, headache, diarrhea, palpitations). heart, emotional instability). The dose should be reduced gradually, after consulting your doctor, within a few weeks or months.
Caution should be exercised in people:
· In parallel with drugs that affect serotoninergic transmission (eg, triptans, selective MAO inhibitors like moclobemide, toloxatone, lysololide, selective serotonin reuptake inhibitors or lithium) due to the possibility of serotonin syndrome; its symptoms include: changes in mental state (eg agitation, hallucinations, coma), autonomic instability (eg, labile blood pressure, tachycardia, hyperthermia), neuromuscular disorders and / or gastrointestinal symptoms (nausea, vomiting, diarrhea) ; Serotonin syndrome is a health risk and if it occurs, you should contact your doctor immediately
· With elevated intraocular pressure or with an increased risk of glaucoma with occlusive angle of vision
· In whom co-morbid diseases may increase due to increased blood pressure (eg cardiac dysfunction) or following an accelerated heart rate
with unstable coronary heart disease or stable cardiac disease that may increase the risk of ventricular arrhythmia (eg a recent myocardial infarction)
· With convulsive seizures; in each case of seizures, the drug should be discontinued (after consultation with a physician)
· In the elderly, because they may reduce the concentration of sodium ions in the blood (hyponatraemia) as a result of abnormal secretion of antidiuretic hormone; this applies particularly to people who use diuretics in parallel or with a reduced volume of blood resulting from other causes
· With a greater tendency to bleed (older people, predisposed to bleeding or taking other drugs that increase the risk of bleeding eg anticoagulants and platelet inhibitors)
· With bipolar disorder in a family history or interview (due to the possibility of an episode of mania or hypomania)
· With diabetes, because the use of the preparation affects glycemic control, it may be necessary to adjust the dose of oral antidiabetic agents and / or insulin
· With aggressive behavior (possible episodes of aggression, especially at the beginning and after discontinuation of treatment).
In the case of rash, urticaria or other allergic reactions, treatment with Axyven should be discontinued.
Dry mouth can occur during treatment, which may increase the risk of caries, especially oral hygiene.
It is not recommended to use the product and products that reduce weight in parallel; Venlafaxine is not indicated for the treatment of obesity.
During treatment, psychomotor agitation (akathisia) may occur, characterized by a sense of internal anxiety and psychomotor stimulation with the impossibility of standing or sitting calmly, usually in connection with subjectively experienced exhaustion. These symptoms most often occur within the first few weeks of treatment. Increasing the dose in people with akathisia symptoms may be harmful.
Due to possible cardiotoxicity of the preparation, ECG and blood pressure measurement should be performed before starting treatment. These tests should be repeated regularly during treatment. In case of acute and uncontrolled hypertension, the doctor will probably recommend discontinuation of the preparation.
Due to the possible increase in cholesterol levels during treatment, your doctor may recommend regular check-ups.
Due to the fact that the tablets of the preparation do not deform and do not change significantly in the gastrointestinal tract of their shape, it should not usually be given to people with pre-existing severe narrowing of the gastrointestinal tract or persons with dysphagia or having a significant difficulty swallowing tablets. There are rare reports of obstruction associated with drug use in the form of unchanged controlled-release products in patients with known narrowing of the gastrointestinal tract.
Due to the fact that the tablets are a controlled release product, the drug can only be used by those who are able to swallow the tablet whole.
Information on additional components of the preparation:
The preparation contains sucrose; should not be used in people with rare hereditary problems of fructose intolerance, sucrase-isomaltase deficiency or malabsorption of Glucose -galactose.
Does this preparation affect the ability to drive vehicles?
Although no psychomotor effects have been found in studies, caution should be exercised when driving a motor vehicle or operating machinery.

Dosage of Axyven

The preparation is in the form of prolonged-release tablets. It is intended for oral use. Do not exceed the recommended doses because it will not increase the effectiveness of the drug and may harm your health and life. If you have any doubts regarding the use of the preparation, consult a physician.
Episodes of severe depression.
Adults, orally. The starting and recommended dose is 75 mg / day. If, after 2 to 4 weeks, the doctor finds an improvement in the patient's condition, but it is not satisfactory, he will probably recommend increasing the dose to 150 mg / day and then to 225 mg / day. The maximum dose is 375 mg / day. If the improvement does not occur at all, the doctor will probably recommend discontinuation of the preparation and inform you about further treatment. Treatment should be continued for at least 4 to 6 weeks
Short-term treatment of generalized anxiety disorders
Adults, orally. The starting dose is 75 mg / day, it can be increased by 75 mg every 4 days, up to a dose of 225 mg / day. The effectiveness of treatment lasting over 8 weeks has not been proven.
Panic disorder syndrome
Adults, orally. The recommended dose is 75 mg / day. Treatment should be started at 37.5 mg / day for the first 4 to 7 days, after which the dose should be increased to 75 mg / day (under the supervision of a physician).In people who do not show a sufficient response, your doctor will probably recommend increasing the dose by 75 mg at intervals of about 2 weeks, but not shorter than 4 days; the maximum dose is 225 mg. Patients with a panic drug syndrome usually require long-term treatment (at least 6 months).
People with kidney or liver damage may need to start treatment with venlafaxine in immediate-release pharmaceutical forms.
In patients with severe renal insufficiency and in patients undergoing hemodialysis, the total daily dose should be reduced by 50%. In people with mild and moderate renal impairment, caution should be exercised, the physician will consider reducing the dose of the preparation.
In patients with mild and moderate liver damage, the daily dose should be reduced by 50% or more, the decision is made by the physician individually for each patient.
There are no data on patients with severe liver damage.
In elderly patients, treatment should be started at the lowest recommended dose.
Do not use the preparation in children and adolescents up to 18 years of age.
The preparation should be used during a meal, once a day, at about the same time, in the morning or in the evening. Each capsule should be swallowed whole and taken with liquid. Capsules should not be divided, crushed, chewed, lived or dissolved in water.

Can Axyven be used during pregnancy and breastfeeding?

During pregnancy, do not use any medicine without consulting your doctor!
It is very important to consult a physician before taking any medicine during pregnancy (and also during breastfeeding) and to explain beyond any doubt the potential risks and benefits of using the medicine. If you are pregnant or plan to become pregnant, please inform the doctor prescribing the prescription for this medicine.
It should not be used during pregnancy unless the expected benefit to the mother is greater than the likely risk to the baby.
You should not breast-feed while using the preparation.

Can I use other preparations in parallel?

Tell your doctor about all medicines you have recently taken, including those that are over the counter.
Do not use the preparation in parallel with monoamine oxidase (MAO) inhibitors. Venlafaxine can be used after 14 days from the end of treatment with MAO inhibitors; MAO inhibitors can be introduced for treatment 7 days after the end of venlafaxine.
Use in parallel with serotonin receptor agonists (triptans), selective serotonin reuptake inhibitors (SSRIs), serotonin and noradrenaline reuptake inhibitors, lithium, tramadol, drugs that impair serotonin metabolism or serotonin precursors (eg tryptophan supplements) may cause the onset of serotonin syndrome.
Venlafaxine may increase the concentration of lithium used in parallel, and a physician may need to adjust the dosage.
Caution is advised in electroconvulsive patients, as prolonged seizure activity has been reported in this group of patients.
Caution should be exercised when using other drugs affecting the central nervous system (venlafaxine increases the plasma levels of haloperidaz used in parallel, clozapine).
Cimetidine inhibits the first-pass metabolism of venlafaxine, but has no significant effect on its elimination. This interaction may be more severe in the elderly or with liver failure.
Caution should be used when associating with CYP2D6 inhibitory drugs, cytochrome P-450 (eg quinine, paroxetine, Fluoxetine , fluvoxamine, perphenazine, Haloperidol , levomepromazine). Patients treated with CYP2D6 substrates should be used with caution. In patients metabolising slowly with CYP2D6 or receiving CYP3A3 / 4 inhibitors (eg ketoconazole, Erythromycin , Itraconazole , ritonavir, atazanavir, Clarithromycin ), venlafaxine may be expected to increase.
Caution should be exercised when taking medications that increase the risk of bleeding in parallel (anticoagulants, Warfarin , Acetylsalicylic acid and other NSAIDs ).
Parallel use with weight-reducing medications is not recommended.
Due to the possibility of a so-called malignant neuroleptic syndrome, caution should be used when using the preparation in parallel with neuroleptic drugs.
There was no interaction with alcohol, however, it is not recommended to consume it during treatment.

What side effects can occur?

Like all medicines, Axyven can also cause side effects, although it will not occur in all patients who use this medicine. Remember that the expected benefits of using the drug are usually greater than the damage resulting from the occurrence of side effects.
Very often you may experience: dizziness, headache, nausea, dry mouth, excessive sweating (including night sweats).
The following may occur: increased appetite, confusion, depersonalization, lack of orgasm, decreased libido, nervousness, insomnia, unusual dreams, drowsiness, tremors, paresthesia, hypertonia (increased muscle tone), blurred vision (including blurred vision, mydiasis, abnormalities accommodation), tinnitus, palpitations, hypertension, vasodilatation, vomiting, diarrhea, constipation, urination disorders (pollakiuria, problems with the start of micturition), menstrual bleeding disorders associated with the severity of bleeding or the severity of irregular bleeding (eg menorrhagia, uterine haemorrhage), ejaculation disorders, orgasm disorders, asthenia, fatigue, chills, increased cholesterol.
Uncommon: hallucinations, feelings of detachment from reality, agitation, orgasm disorders (in women), apathy, hypomania, bruxism, akathisia / psychomotor restlessness, syncope, myoclonic muscle contraction, coordination disorders, balance disorders,
taste disorder, tachycardia, orthostatic hypotension, Gastrointestinal bleeding , angioneurotic edema , hypersensitivity reactions, weight gain, weight loss, ecchymosis, rash, alopecia, urinary retention.
Rarely may occur: mania, convulsions, incontinence.
In addition, thrombocytopenia, blood dyscrasias (including agranulocytosis, aplastic anemia, neutropenia and pancytopenia), anaphylactic reaction, abnormal secretion of antidiuretic hormone, hyponatremia, suicidal thoughts and suicidal behavior, delirium, aggression, malignant syndrome may occur with unknown frequency. neuroleptic syndrome, serotonin syndrome, extrapyramidal reactions including dystonia and dyskinesia, tardive dyskinesia, glaucoma with a closed angle of view, vertigo, ventricular fibrillation, ventricular tachycardia (includingtorsade de pointes), hypotension, bleeding (mucous membrane bleeding), pulmonary eosinophilia, pancreatitis, hepatitis, abnormalities in liver function tests, Stevens and Johnson syndrome, erythema multiforme, toxic epidermal necrolysis, pruritus, urticaria, rhabdomyolysis (rhabdomyolysis) ), prolonged QT interval in ECG, prolonged bleeding time, increased prolactin in the blood.

Other preparations on the Polish market containing venlafaxine

Alventa (prolonged-release capsules)
Alventa (prolonged-release capsules, hard)
Efectin ER 37.5 (prolonged release capsules)
Efectin ER 75 (prolonged release capsules)
Efectin ER 150 (prolonged-release capsules)
Efevelon SR (prolonged-release capsules, hard)
Faxigen XL 37.5 mg (prolonged-release capsules, hard)
Faxigen XL 75 mg (prolonged-release capsules, hard)
Faxigen XL 150 mg (prolonged-release capsules, hard)
ER faxolet (prolonged-release capsules, hard)
Lafactin (prolonged-release capsules, hard)
Olwexya (prolonged-release capsules)
Oriven (prolonged-release capsules, hard)
Prefaxine (prolonged-release capsules, hard)
Symfaxin ER (prolonged-release capsules, hard)
Velafax (tablets)
Velaxin ER 37.5 (prolonged release capsules, hard)
Velaxin ER 75 (prolonged-release capsules, hard)
Velaxin ER 150 (prolonged-release capsules, hard)
Venlafaxine Bluefish XL (prolonged-release capsules, hard)
Venlectine (prolonged-release capsules)