Velaxin capsules 150mg, No. 28

Depression (including in the presence of anxiety), treatment and prevention of relapse.

Inside, during meals. Each capsule should be swallowed whole and washed down with a liquid. Capsules must not be divided, crushed, chewed, or placed in water. The daily dose should be taken in one dose (morning or evening), each time at approximately the same time.

Depression. The recommended starting dose is 75 mg once a day.

If, according to the doctor, a higher dose is needed (severe depressive disorder or other conditions requiring hospital treatment), you can immediately prescribe 150 mg once a day. Subsequently, the daily dose can be increased by 75 mg at intervals of 2 weeks or more (but not more often than after 4 days), until the desired therapeutic effect is achieved. The maximum daily dose is 350 mg.

After achieving the desired therapeutic effect, the daily dose can be gradually reduced to the minimum effective level.

Supportive care and relapse prevention. Treatment for depression should be continued for at least 6 months. In stabilization therapy, as well as therapy to prevent relapse or new episodes of depression, doses that have been demonstrated to be effective are usually used. The doctor should regularly (at least once every 3 months) monitor the effectiveness of long-term therapy with VelaxinЃ.

Transfer of patients from VelaxinЃ tablets. Patients taking VelaxinЃ in the form of tablets can be switched to taking the drug in the form of prolonged-release capsules, with the appointment of an equivalent dose once a day. However, an individual dose adjustment may be required.

Renal failure With mild renal failure (GFR more than 30 ml / min), no dosage adjustment is required. With moderate renal failure (GFR 10-30 ml / min), the dose should be reduced by 50%. Due to the T1 / 2 lengthening of venlafaxine and EFA, these patients should take the entire dose once a day. It is not recommended to use venlafaxine in severe renal failure (GFR less than 10 ml / min), as reliable data on such therapy are not available. Patients on hemodialysis can receive 50% of the usual daily dose of venlafaxine after completing hemodialysis.

Liver failure. With mild hepatic impairment (PT less than 14 s), dosage adjustment is not required. With moderate hepatic impairment (PT from 14 to 18 s), the dose should be reduced by 50%. It is not recommended to use venlafaxine in severe hepatic impairment, as reliable data on such therapy are not available.

Elderly patients. By itself, the elderly age of the patient does not require a change in the dose, however (as with the appointment of other drugs), caution is required in the treatment of elderly patients, for example, due to the possibility of impaired renal function. The lowest effective dose should be used. When the dose is increased, the patient should be under close medical supervision.

Children and adolescents (under the age of 18). The safety and efficacy of venlafaxine in children and adolescents under 18 years of age has not been established.

Cancellation of the drug VelaxinЃ. As with other antidepressants, abrupt withdrawal of (especially high doses) venlafaxine may cause withdrawal symptoms (see 'Side Effects' and 'Special Instructions'). Therefore, before the complete withdrawal of the drug, a gradual dose reduction is recommended. If high doses have been used for more than 6 weeks, it is recommended to reduce doses for at least 2 weeks. The length of the period required to reduce the dose depends on the size of the dose, the duration of therapy, and the patient's response.

hypersensitivity to any component of the drug;

simultaneous administration of MAO inhibitors (see also 'Interaction');

severe impairment of renal and / or liver function (glomerular filtration rate (GFR) less than 10 ml / min, PT more than 18 s);

age up to 18 years (safety and effectiveness for this age group have not been proven);

pregnancy or suspected pregnancy;

lactation period (there are insufficient data from controlled studies).

With care: recent myocardial infarction, unstable angina pectoris, heart failure, coronary artery disease, ECG changes, incl. lengthening of the QT interval, electrolyte imbalance, arterial hypertension, tachycardia, history of convulsions, intraocular hypertension, angle-closure glaucoma, mania in history, predisposition to bleeding from the skin and mucous membranes, initially reduced body weight.