Chemical: Drug
venlafaxine

last updated 02/07/2014

1. DPWG Guideline for venlafaxine and CYP2D6

Summary

For CYP2D6 poor (PM) and intermediate metabolizers (IM), select an alternative to venlafaxine or adjust dose to clinical response and monitor patient's plasma metabolite level. For CYP2D6 ultrarapid metabolizers(UM), titrate dose to a maximum of 150% of the normal dose or select an alternative to venlafaxine.

Annotation

The Royal Dutch Pharmacists Association - Pharmacogenetics Working Group has evaluated therapeutic dose recommendations for venlafaxine based on CYP2D6 genotypes [Article:21412232]. For PM and IM genotypes, they state that there are not sufficient data to allow calculation of dose adjustment, and they recommend selecting an alternative drug or adjusting dose to clinical response and monitoring (O-desmethyl)venlafaxine plasma concentration. For UM genotypes, they recommend titrating dose to a maximum of 150% of the normal dose(based on venlafaxine and (O-desmethyl)venlafaxine plasma concentration) or selecting an alternative drug.

Phenotype (Genotype)Therapeutic Dose RecommendationLevel of EvidenceClinical Relevance
PM (two inactive (*3-*8, *11-*16, *19-*21, *38, *40, *42) alleles)Insufficient data to allow calculation of dose adjustment. Select alternative drug (e.g., citalopram, sertraline) or adjust dose to clinical response and monitor (O-desmethyl)venlafaxine plasma concentration.Published controlled studies of good quality* relating to phenotyped and/or genotyped patients or healthy volunteers, and having relevant pharmacokinetic or clinical endpoints.Clinical effect (S): long-standing discomfort (48-168 hr) without permanent injury e.g. failure of therapy with tricyclic antidepressants, atypical antipsychotic drugs; extrapyramidal side effects; parkinsonism; ADE resulting from increased bioavailability of tricyclic antidepressants, metoprolol, propafenone (central effects e.g. dizziness); INR 4.5-6.0; neutropenia 1.0-1.5x109/l; leucopenia 2.0-3.0x109/l; thrombocytopenia 50-75x109/l.
IM (two decreased-activity (*9, *10, *17, *29, *36, *41) alleles or carrying one active (*1, *2, *33, *35) and one inactive (*3-*8, *11-*16, *19-*21, *38, *40, *42) allele, or carrying one decreased-activity (*9, *10, *17, *29, *36, *41) allele and one inactive (*3-*8, *11-*16, *19-*21, *38, *40, *42) allele)Insufficient data to allow calculation of dose adjustment. Select alternative drug (e.g., citalopram, sertraline) or adjust dose to clinical response and monitor (O-desmethyl)venlafaxine plasma concentration.Published controlled studies of good quality* relating to phenotyped and/or genotyped patients or healthy volunteers, and having relevant pharmacokinetic or clinical endpoints.Clinical effect (S): long-standing discomfort (48-168 hr) without permanent injury e.g. failure of therapy with tricyclic antidepressants, atypical antipsychotic drugs; extrapyramidal side effects; parkinsonism; ADE resulting from increased bioavailability of tricyclic antidepressants, metoprolol, propafenone (central effects e.g. dizziness); INR 4.5-6.0; neutropenia 1.0-1.5x109/l; leucopenia 2.0-3.0x109/l; thrombocytopenia 50-75x109/l.
UM (a gene duplication in absence of inactive (*3-*8, *11-*16, *19-*21, *38, *40, *42) or decreased-activity (*9, *10, *17, *29, *36, *41) alleles)Be alert to decreased venlafaxine and increased (O-desmethyl)venlafaxine plasma concentration. Titrate dose to a maximum of 150% of the normal dose or select alternative drug (e.g., citalopram, sertraline).Published controlled studies of good quality* relating to phenotyped and/or genotyped patients or healthy volunteers, and having relevant pharmacokinetic or clinical endpoints.Minor clinical effect (S): QTc prolongation (<450 ms female, <470 ms male); INR increase < 4.5. Kinetic effect (S).
  • *See Methods or [Article:18253145] for definition of "good quality."
  • S: statistically significant difference.
  • Please see attached PDF for detailed information about the evaluated studies: Venlafaxine CYP2D6


last updated 09/01/2016

1. FDA Label for venlafaxine and CYP2D6

Informative PGx
Full label available at DailyMed

Genes and/or phenotypes found in this label

  • Anxiety Disorders
    • Indications & usage section, Warnings section, Adverse reactions section, Precautions section
    • source: PHONT
  • Death
    • Warnings section, Precautions section
    • source: PHONT
  • Depression
    • Indications & usage section, Warnings section, Adverse reactions section, Precautions section
    • source: PHONT
  • Depression, Postpartum
    • Indications & usage section, Warnings section, Adverse reactions section, Precautions section
    • source: PHONT
  • Depressive Disorder
    • Indications & usage section, Warnings section, Adverse reactions section, Precautions section
    • source: PHONT
  • Depressive Disorder, Major
    • Indications & usage section, Warnings section, Adverse reactions section, Precautions section
    • source: PHONT
  • Obsessive-Compulsive Disorder
    • Warnings section
    • source: PHONT
  • CYP1A2
    • Drug interactions section
    • source: U.S. Food and Drug Administration
  • CYP2C19
    • Drug interactions section
    • source: U.S. Food and Drug Administration
  • CYP2C9
    • Drug interactions section
    • source: U.S. Food and Drug Administration
  • CYP2D6
    • metabolism/PK, Drug interactions section
    • source: U.S. Food and Drug Administration
  • CYP3A4
    • metabolism/PK, Drug interactions section
    • source: U.S. Food and Drug Administration

PharmGKB contains no Clinical Variants that meet the highest level of criteria.

To see more Clinical Variants with lower levels of criteria, click the button at the bottom of the page.

Clinical Annotation for rs2032583 (ABCB1), amitriptyline, antidepressants, citalopram, fluvoxamine, paroxetine, sertraline, venlafaxine, Depression, Depressive Disorder and Depressive Disorder, Major (level 3 Efficacy)

Level of Evidence
Level 3
Type
Efficacy
Variant
rs2032583
Genes
ABCB1
Phenotypes
Depression, Depressive Disorder, Depressive Disorder, Major
OMB Race
White
Race Notes
One study in mostly German patients, the other unknown race.

To see the rest of this clinical annotation please register or sign in.

Disclaimer: The PharmGKB's clinical annotations reflect expert consensus based on clinical evidence and peer-reviewed literature available at the time they are written and are intended only to assist clinicians in decision-making and to identify questions for further research. New evidence may have emerged since the time an annotation was submitted to the PharmGKB. The annotations are limited in scope and are not applicable to interventions or diseases that are not specifically identified.

The annotations do not account for individual variations among patients, and cannot be considered inclusive of all proper methods of care or exclusive of other treatments. It remains the responsibility of the health-care provider to determine the best course of treatment for a patient. Adherence to any guideline is voluntary, with the ultimate determination regarding its application to be made solely by the clinician and the patient. PharmGKB assumes no responsibility for any injury or damage to persons or property arising out of or related to any use of the PharmGKB clinical annotations, or for any errors or omissions.

? = Mouse-over for quick help

The table below contains information about pharmacogenomic variants on PharmGKB. Please follow the link in the "Variant" column for more information about a particular variant. Each link in the "Variant" column leads to the corresponding PharmGKB Variant Page. The Variant Page contains summary data, including PharmGKB manually curated information about variant-drug pairs based on individual PubMed publications. The PMIDs for these PubMed publications can be found on the Variant Page.

The tags in the first column of the table indicate what type of information can be found on the corresponding Variant Page.

Links in the "Gene" column lead to PharmGKB Gene Pages.

List of all variant annotations for venlafaxine

Gene ? Variant?
(147)
Alternate Names ? Chemicals ? Alleles ?
(+ chr strand)
Function ? Amino Acid?
Translation
No VIP available CA VA CYP2C19 *1 N/A N/A N/A
No VIP available CA VA CYP2C19 *2 N/A N/A N/A
No VIP available No VIP available VA CYP2C19 *3 N/A N/A N/A
No VIP available No VIP available VA CYP2C19 *17 N/A N/A N/A
No VIP available CA VA CYP2D6 *1 N/A N/A N/A
No VIP available No VIP available VA CYP2D6 *1xN N/A N/A N/A
No VIP available No VIP available VA CYP2D6 *2 N/A N/A N/A
No VIP available No VIP available VA CYP2D6 *2xN N/A N/A N/A
No VIP available CA VA CYP2D6 *3 N/A N/A N/A
No VIP available CA VA CYP2D6 *4 N/A N/A N/A
No VIP available CA VA CYP2D6 *5 N/A N/A N/A
No VIP available CA VA CYP2D6 *6 N/A N/A N/A
No VIP available No VIP available VA CYP2D6 *9 N/A N/A N/A
No VIP available CA VA CYP2D6 *10 N/A N/A N/A
No VIP available No VIP available VA CYP2D6 *17 N/A N/A N/A
No VIP available CA VA CYP2D6 *41 N/A N/A N/A
No VIP available No VIP available VA CYP2D6 *87 N/A N/A N/A
No VIP available No VIP available VA CYP2D6 *88 N/A N/A N/A
No VIP available No VIP available VA CYP2D6 *89 N/A N/A N/A
No VIP available No VIP available VA CYP2D6 *90 N/A N/A N/A
No VIP available No VIP available VA CYP2D6 *91 N/A N/A N/A
No VIP available No VIP available VA CYP2D6 *93 N/A N/A N/A
No VIP available No VIP available VA CYP2D6 *94 N/A N/A N/A
No VIP available No VIP available VA CYP2D6 *95 N/A N/A N/A
No VIP available No VIP available VA CYP2D6 *97 N/A N/A N/A
No VIP available No VIP available VA CYP2D6 *98 N/A N/A N/A
No VIP available No VIP available VA SLC6A4 HTTLPR long form (L allele) N/A N/A N/A
No VIP available No VIP available VA SLC6A4 HTTLPR short form (S allele) N/A N/A N/A
No VIP available CA VA
rs10036156 NC_000005.10:g.170788634T>C, NC_000005.9:g.170215638T>C, NM_001291985.1:c.19T>C, NM_014211.2:c.19T>C, NP_001278914.1:p.Leu7=, NP_055026.1:p.Leu7=, XM_005265871.1:c.19T>C, XM_005265872.1:c.-100T>C, XM_005265872.2:c.-100T>C, XM_005265873.1:c.19T>C, XM_005265874.1:c.19T>C, XM_011534502.1:c.19T>C, XM_011534503.1:c.19T>C, XM_011534504.1:c.19T>C, XM_011534505.1:c.19T>C, XM_011534506.1:c.19T>C, XP_005265928.1:p.Leu7=, XP_005265930.1:p.Leu7=, XP_005265931.1:p.Leu7=, XP_011532804.1:p.Leu7=, XP_011532805.1:p.Leu7=, XP_011532806.1:p.Leu7=, XP_011532807.1:p.Leu7=, XP_011532808.1:p.Leu7=, rs57333818
T > C
SNP
L7L
No VIP available CA VA
rs10248420 NC_000007.13:g.87164986A>G, NC_000007.14:g.87535670A>G, NG_011513.1:g.182579T>C, NM_000927.4:c.2481+788T>C, rs56939197
A > G
SNP
No VIP available CA VA
rs10280101 NC_000007.13:g.87153585A>C, NC_000007.14:g.87524269A>C, NG_011513.1:g.193980T>G, NM_000927.4:c.2686-3393T>G, rs56546728, rs57009801
A > C
SNP
No VIP available CA VA
rs1045642 NC_000007.13:g.87138645A>G, NC_000007.14:g.87509329A>G, NG_011513.1:g.208920T>C, NM_000927.4:c.3435T>C, NP_000918.2:p.Ile1145=, rs10239679, rs11568726, rs117328163, rs17210003, rs2229108, rs386513066, rs60023214, rs9690664
A > G
SNP
I1145I
No VIP available No Clinical Annotations available VA
rs1076560 NC_000011.10:g.113412966C>A, NC_000011.9:g.113283688C>A, NG_008841.1:g.67314G>T, NM_000795.3:c.811-83G>T, NM_016574.3:c.724-83G>T, XM_005271425.1:c.811-83G>T, XM_005271426.1:c.808-83G>T, rs1800500
C > A
SNP
No VIP available CA No Variant Annotations available
rs10879346 NC_000012.11:g.72351835C>T, NC_000012.12:g.71958055C>T, NG_008279.1:g.24210C>T, NM_173353.3:c.608+8400C>T, XM_005268642.1:c.626+8400C>T, XM_011537899.1:c.14+8400C>T, XR_245894.1:n.613-3498C>T, XR_245894.2:n.709-3498C>T, rs59716601
C > T
SNP
No VIP available No Clinical Annotations available VA
rs1128503 NC_000007.13:g.87179601A>G, NC_000007.14:g.87550285A>G, NG_011513.1:g.167964T>C, NM_000927.4:c.1236T>C, NP_000918.2:p.Gly412=, rs116989428, rs17276907, rs2032587, rs2229105, rs28365046, rs386518005, rs58257317
A > G
SNP
G412G
No VIP available CA VA
rs11983225 NC_000007.13:g.87161520T>C, NC_000007.14:g.87532204T>C, NG_011513.1:g.186045A>G, NM_000927.4:c.2482-707A>G
T > C
SNP
No VIP available CA VA
rs12720067 NC_000007.13:g.87169356C>T, NC_000007.14:g.87540040C>T, NG_011513.1:g.178209G>A, NM_000927.4:c.2320-695G>A, rs17276510, rs60504551
C > T
SNP
No VIP available CA VA
rs130058 NC_000006.11:g.78173281T>A, NC_000006.12:g.77463564T>A, NM_000863.2:c.-161A>T, XR_942706.1:n.545-10962T>A, XR_942707.1:n.545-10962T>A, XR_942708.1:n.545-10962T>A, XR_942709.1:n.545-10962T>A, rs17273665
T > A
SNP
No VIP available CA VA
rs1360780 NC_000006.11:g.35607571T>C, NC_000006.12:g.35639794T>C, NG_012645.2:g.93790A>G, NM_001145775.2:c.106-2636A>G, NM_001145776.1:c.106-2636A>G, NM_001145777.1:c.106-2636A>G, NM_004117.3:c.106-2636A>G, XR_926743.1:n.287+5974T>C, rs58091271
T > C
SNP
No VIP available CA VA
rs1487278 NC_000012.11:g.72400851T>C, NC_000012.12:g.72007071T>C, NG_008279.1:g.73226T>C, NM_173353.3:c.1068+12506T>C, XM_005268642.1:c.1086+12506T>C, XM_011537899.1:c.474+12506T>C, rs61103738
T > C
SNP
No VIP available No Clinical Annotations available VA
rs1799971 NC_000006.11:g.154360797A>G, NC_000006.12:g.154039662A>G, NG_021208.1:g.34162A>G, NM_000914.4:c.118A>G, NM_001008503.2:c.118A>G, NM_001008504.3:c.118A>G, NM_001008505.2:c.118A>G, NM_001145279.3:c.397A>G, NM_001145280.3:c.-11+28644A>G, NM_001145281.2:c.47+29103A>G, NM_001145282.2:c.118A>G, NM_001145283.2:c.118A>G, NM_001145284.3:c.118A>G, NM_001145285.2:c.118A>G, NM_001145286.2:c.118A>G, NM_001285522.1:c.118A>G, NM_001285523.1:c.118A>G, NM_001285524.1:c.397A>G, NP_000905.3:p.Asn40Asp, NP_001008503.2:p.Asn40Asp, NP_001008504.2:p.Asn40Asp, NP_001008505.2:p.Asn40Asp, NP_001138751.1:p.Asn133Asp, NP_001138754.1:p.Asn40Asp, NP_001138755.1:p.Asn40Asp, NP_001138756.1:p.Asn40Asp, NP_001138757.1:p.Asn40Asp, NP_001138758.1:p.Asn40Asp, NP_001272451.1:p.Asn40Asp, NP_001272452.1:p.Asn40Asp, NP_001272453.1:p.Asn133Asp, NR_104348.1:n.252A>G, NR_104349.1:n.252A>G, NR_104350.1:n.252A>G, NR_104351.1:n.252A>G, XM_005267002.1:c.304A>G, XM_006715497.2:c.304A>G, XM_011535849.1:c.397A>G, XP_005267059.1:p.Asn102Asp, XP_006715560.1:p.Asn102Asp, XP_011534151.1:p.Asn133Asp, XR_245534.1:n.304A>G, XR_245535.1:n.304A>G, XR_245536.1:n.304A>G, XR_245537.1:n.304A>G, rs17181017, rs52818856, rs61596185
A > G
SNP
N40D
No VIP available No Clinical Annotations available VA
rs1800497 NC_000011.10:g.113400106G>A, NC_000011.9:g.113270828G>A, NG_012976.1:g.17316G>A, NM_178510.1:c.2137G>A, NP_848605.1:p.Glu713Lys, XM_011542736.1:c.2170G>A, XM_011542737.1:c.2140G>A, XM_011542738.1:c.1948G>A, XP_011541038.1:p.Glu724Lys, XP_011541039.1:p.Glu714Lys, XP_011541040.1:p.Glu650Lys, rs117686243, rs4134623, rs4245144, rs59538675
G > A
SNP
E713K
No VIP available No Clinical Annotations available VA
rs1954787 NC_000011.10:g.120792654T>C, NC_000011.9:g.120663363T>C, NG_042194.1:g.285909T>C, NM_001282470.2:c.83-10039T>C, NM_001282473.2:c.83-10039T>C, NM_014619.4:c.83-10039T>C, XM_005271519.1:c.83-10039T>C, XM_005271520.1:c.83-10039T>C, XM_011542783.1:c.83-10039T>C, XM_011542784.1:c.83-10039T>C, XM_011542785.1:c.83-10039T>C, rs17245727, rs60428773
T > C
SNP
No VIP available CA VA
rs1992647 NC_000005.10:g.161684168G>A, NC_000005.9:g.161111174G>A, NM_000811.2:c.-1822G>A
G > A
SNP
No VIP available CA VA
rs2032582 NC_000007.13:g.87160618A>C, NC_000007.13:g.87160618A>T, NC_000007.14:g.87531302A>C, NC_000007.14:g.87531302A>T, NG_011513.1:g.186947T>A, NG_011513.1:g.186947T>G, NM_000927.4:c.2677T>A, NM_000927.4:c.2677T>G, NP_000918.2:p.Ser893Ala, NP_000918.2:p.Ser893Thr, rs10228331, rs2229106, rs386553610, rs57135550, rs9641018
A > C
SNP
S893A
No VIP available CA VA
rs2032583 NC_000007.13:g.87160561A>G, NC_000007.14:g.87531245A>G, NG_011513.1:g.187004T>C, NM_000927.4:c.2685+49T>C, rs386553611, rs58572471
A > G
SNP
No VIP available CA VA
rs2235015 NC_000007.13:g.87199564C>A, NC_000007.14:g.87570248C>A, NG_011513.1:g.148001G>T, NM_000927.4:c.287-25G>T, rs59310468
C > A
SNP
No VIP available CA VA
rs2235040 NC_000007.13:g.87165750C>T, NC_000007.14:g.87536434C>T, NG_011513.1:g.181815G>A, NM_000927.4:c.2481+24G>A, rs10383656, rs386562018, rs59503449, rs60553448
C > T
SNP
No VIP available CA VA
rs2235067 NC_000007.13:g.87149922C>T, NC_000007.14:g.87520606C>T, NG_011513.1:g.197643G>A, NM_000927.4:c.2786+170G>A, rs10345072, rs17149713, rs386562030, rs57277203
C > T
SNP
No VIP available No Clinical Annotations available VA
rs2550948 NC_000005.10:g.1450329C>T, NC_000005.9:g.1450444C>T, NG_015885.1:g.100G>A, NT_187547.1:g.59444G>A, rs10070282, rs61611069
C > T
SNP
No VIP available No Clinical Annotations available VA
rs25531 NC_000017.10:g.28564346T>C, NC_000017.11:g.30237328T>C, NG_011747.2:g.3609A>G, NM_001045.5:c.-1936A>G, XM_005258025.1:c.-1810A>G, XR_934652.1:n.-225T>C, XR_934653.1:n.-225T>C, XR_934654.1:n.165+258T>C, XR_934655.1:n.-225T>C, rs2020931, rs35593448
T > C
SNP
No VIP available No Clinical Annotations available VA
rs28363170 NC_000005.10:g.1393747_1393748insGGGGGCCCTGCATGCGTCCTGGGGTAGTACACGCTCCAGT, NC_000005.9:g.1393862_1393863insGGGGGCCCTGCATGCGTCCTGGGGTAGTACACGCTCCAGT, NG_015885.1:g.56681_56682insACTGGAGCGTGTACTACCCCAGGACGCATGCAGGGCCCCC, NM_001044.4:c.*987_*988insACTGGAGCGTGTACTACCCCAGGACGCATGCAGGGCCCCC, NT_187547.1:g.120261_120262insACTGGAGCGTGTACTACCCCAGGACGCATGCAGGGCCCCC
- > GGGGGCCCTGCATGCGTCCTGGGGTAGTACACGCTCCAGT
indel
No VIP available CA VA
rs367543000 NC_000022.10:g.42524214G>A, NC_000022.10:g.42524214G>C, NC_000022.10:g.42524214G>T, NC_000022.11:g.42128212G>A, NC_000022.11:g.42128212G>C, NC_000022.11:g.42128212G>T, NG_008376.3:g.6780C>A, NG_008376.3:g.6780C>G, NG_008376.3:g.6780C>T, NM_000106.5:c.805C>A, NM_000106.5:c.805C>G, NM_000106.5:c.805C>T, NM_001025161.2:c.652C>A, NM_001025161.2:c.652C>G, NM_001025161.2:c.652C>T, NP_000097.3:p.Arg269=, NP_000097.3:p.Arg269Gly, NP_000097.3:p.Arg269Ter, NP_001020332.2:p.Arg218=, NP_001020332.2:p.Arg218Gly, NP_001020332.2:p.Arg218Ter, NT_187682.1:g.50553G>A, NT_187682.1:g.50553G>C, NT_187682.1:g.50553G>T, NW_004504305.1:g.50539G>A, NW_004504305.1:g.50539G>C, NW_004504305.1:g.50539G>T, NW_009646208.1:g.13778G>A, NW_009646208.1:g.13778G>C, NW_009646208.1:g.13778G>T, XM_005278353.1:c.661C>A, XM_005278353.1:c.661C>G, XM_005278353.1:c.661C>T, XM_005278354.1:c.505C>A, XM_005278354.1:c.505C>G, XM_005278354.1:c.505C>T, XM_005278354.3:c.505C>A, XM_005278354.3:c.505C>G, XM_005278354.3:c.505C>T, XM_011529966.1:c.805C>A, XM_011529966.1:c.805C>G, XM_011529966.1:c.805C>T, XM_011529967.1:c.805C>A, XM_011529967.1:c.805C>G, XM_011529967.1:c.805C>T, XM_011529968.1:c.805C>A, XM_011529968.1:c.805C>G, XM_011529968.1:c.805C>T, XM_011529969.1:c.661C>A, XM_011529969.1:c.661C>G, XM_011529969.1:c.661C>T, XM_011529970.1:c.652C>A, XM_011529970.1:c.652C>G, XM_011529970.1:c.652C>T, XM_011529971.1:c.661C>A, XM_011529971.1:c.661C>G, XM_011529971.1:c.661C>T, XM_011529972.1:c.805C>A, XM_011529972.1:c.805C>G, XM_011529972.1:c.805C>T, XM_011547541.1:c.505C>A, XM_011547541.1:c.505C>G, XM_011547541.1:c.505C>T, XM_011547750.1:c.661C>A, XM_011547750.1:c.661C>G, XM_011547750.1:c.661C>T, XM_011547751.1:c.589C>A, XM_011547751.1:c.589C>G, XM_011547751.1:c.589C>T, XM_011547756.1:c.-1823G>A, XM_011547756.1:c.-1823G>C, XM_011547756.1:c.-1823G>T, XM_011548819.1:c.505C>A, XM_011548819.1:c.505C>G, XM_011548819.1:c.505C>T, XP_005278410.1:p.Arg221=, XP_005278410.1:p.Arg221Gly, XP_005278410.1:p.Arg221Ter, XP_005278411.1:p.Arg169=, XP_005278411.1:p.Arg169Gly, XP_005278411.1:p.Arg169Ter, XP_011528268.1:p.Arg269=, XP_011528268.1:p.Arg269Gly, XP_011528268.1:p.Arg269Ter, XP_011528269.1:p.Arg269=, XP_011528269.1:p.Arg269Gly, XP_011528269.1:p.Arg269Ter, XP_011528270.1:p.Arg269=, XP_011528270.1:p.Arg269Gly, XP_011528270.1:p.Arg269Ter, XP_011528271.1:p.Arg221=, XP_011528271.1:p.Arg221Gly, XP_011528271.1:p.Arg221Ter, XP_011528272.1:p.Arg218=, XP_011528272.1:p.Arg218Gly, XP_011528272.1:p.Arg218Ter, XP_011528273.1:p.Arg221=, XP_011528273.1:p.Arg221Gly, XP_011528273.1:p.Arg221Ter, XP_011528274.1:p.Arg269=, XP_011528274.1:p.Arg269Gly, XP_011528274.1:p.Arg269Ter, XP_011545843.1:p.Arg169=, XP_011545843.1:p.Arg169Gly, XP_011545843.1:p.Arg169Ter, XP_011546052.1:p.Arg221=, XP_011546052.1:p.Arg221Gly, XP_011546052.1:p.Arg221Ter, XP_011546053.1:p.Arg197=, XP_011546053.1:p.Arg197Gly, XP_011546053.1:p.Arg197Ter, XP_011547121.1:p.Arg169=, XP_011547121.1:p.Arg169Gly, XP_011547121.1:p.Arg169Ter, XR_430455.2:n.-1659G>A, XR_430455.2:n.-1659G>C, XR_430455.2:n.-1659G>T, XR_952745.1:n.1962C>A, XR_952745.1:n.1962C>G, XR_952745.1:n.1962C>T
G > A
G > C
G > T
SNP
R269*/G/R
No VIP available CA VA
rs3761554 NC_000023.10:g.122317244T>C, NC_000023.11:g.123183391T>C, NG_009377.2:g.4149T>C, NM_000828.4:c.-1145T>C, NM_001256743.1:c.-1145T>C, NM_007325.4:c.-1145T>C, XM_005262406.1:c.-841T>C, rs60630449
T > C
SNP
No VIP available CA VA
rs3761555 NC_000023.10:g.122316437T>C, NC_000023.11:g.123182584T>C, NG_009377.2:g.3342T>C, NM_000828.4:c.-1952T>C, NM_001256743.1:c.-1952T>C, NM_007325.4:c.-1952T>C, XM_005262406.1:c.-1648T>C, rs386585686, rs57158618
T > C
SNP
No VIP available No Clinical Annotations available VA
rs3800373 NC_000006.11:g.35542476C>A, NC_000006.12:g.35574699C>A, NG_012645.2:g.158885G>T, NM_001145775.2:c.*1136G>T, NM_001145776.1:c.*1136G>T, NM_004117.3:c.*1136G>T, XR_242006.1:n.180-18331C>A, XR_242006.2:n.433-18331C>A, XR_242008.1:n.201-18331C>A, rs386586584, rs60032290
C > A
SNP
No VIP available CA VA
rs3810651 NC_000023.10:g.151821277T=, NC_000023.10:g.151821277T>A, NC_000023.11:g.152652814A>T, NG_015965.2:g.19632A=, NG_015965.2:g.19632A>T, NM_018558.3:c.1432A=, NM_018558.3:c.1432A>T, NP_061028.3:p.Ile478=, NP_061028.3:p.Ile478Phe, NW_003871103.3:g.86797A=, NW_003871103.3:g.86797A>T, XM_011531184.1:c.1158+1032A>T, XR_938524.1:n.144-13020T>A, XR_938525.1:n.144-13020T>A, XR_938526.1:n.144-13020T>A, XR_938527.1:n.144-16827T>A, rs52810409
T > A
SNP
I478F
No VIP available CA VA
rs3892097 NC_000022.10:g.42524947C=, NC_000022.10:g.42524947C>T, NC_000022.11:g.42128945C=, NC_000022.11:g.42128945C>T, NG_008376.3:g.6047G=, NG_008376.3:g.6047G>A, NM_000106.5:c.506-1A>G, NM_000106.5:c.506-1G>A, NM_001025161.2:c.353-1A>G, NM_001025161.2:c.353-1G>A, NT_187682.1:g.51286C=, NT_187682.1:g.51286C>T, NW_004504305.1:g.51272T=, NW_004504305.1:g.51272T>C, NW_009646208.1:g.14511C=, NW_009646208.1:g.14511C>T, XM_005278353.1:c.363-2A>G, XM_005278353.1:c.363-2G>A, XM_005278354.1:c.207-2A>G, XM_005278354.1:c.207-2G>A, XM_005278354.3:c.207-2A>G, XM_005278354.3:c.207-2G>A, XM_011529966.1:c.506-1A>G, XM_011529966.1:c.506-1G>A, XM_011529967.1:c.506-1A>G, XM_011529967.1:c.506-1G>A, XM_011529968.1:c.506-1A>G, XM_011529968.1:c.506-1G>A, XM_011529969.1:c.363-2A>G, XM_011529969.1:c.363-2G>A, XM_011529970.1:c.353-1A>G, XM_011529970.1:c.353-1G>A, XM_011529971.1:c.363-2A>G, XM_011529971.1:c.363-2G>A, XM_011529972.1:c.506-1A>G, XM_011529972.1:c.506-1G>A, XM_011547541.1:c.207-2A>G, XM_011547541.1:c.207-2G>A, XM_011547750.1:c.363-2A>G, XM_011547750.1:c.363-2G>A, XM_011547751.1:c.290-1A>G, XM_011547751.1:c.290-1G>A, XM_011547756.1:c.-1090C>T, XM_011547756.1:c.-1090T>C, XM_011548819.1:c.207-2A>G, XM_011548819.1:c.207-2G>A, XR_430455.2:n.-926C>T, XR_430455.2:n.-926T>C, XR_952745.1:n.1663-1A>G, XR_952745.1:n.1663-1G>A, rs1800716, rs28371711, rs60082401, rs606231227
C > T
SNP
No VIP available CA VA
rs4148739 NC_000007.13:g.87161049T>C, NC_000007.14:g.87531733T>C, NG_011513.1:g.186516A>G, NM_000927.4:c.2482-236A>G, rs10381901, rs117890992
T > C
SNP
No VIP available CA VA
rs4148740 NC_000007.13:g.87152103A>G, NC_000007.14:g.87522787A>G, NG_011513.1:g.195462T>C, NM_000927.4:c.2686-1911T>C, rs10380430
A > G
SNP
No VIP available CA VA
rs4244285 NC_000010.10:g.96541616G>A, NC_000010.11:g.94781859G>A, NG_008384.2:g.24154G>A, NM_000769.1:c.681G>A, NM_000769.2:c.681G>A, NP_000760.1:p.Pro227=, rs116940633, rs17879456, rs60361278
G > A
SNP
P227P
No VIP available CA VA
rs4680 NC_000022.10:g.19951271G>A, NC_000022.11:g.19963748G>A, NG_011526.1:g.27009G>A, NM_000754.3:c.472G>A, NM_001135161.1:c.472G>A, NM_001135162.1:c.472G>A, NM_007310.2:c.322G>A, NP_000745.1:p.Val158Met, NP_001128633.1:p.Val158Met, NP_001128634.1:p.Val158Met, NP_009294.1:p.Val108Met, NR_039918.1:n.-5G>A, XM_005261229.1:c.472G>A, XM_011529885.1:c.586G>A, XM_011529886.1:c.586G>A, XM_011529887.1:c.472G>A, XM_011529888.1:c.472G>A, XM_011529889.1:c.472G>A, XM_011529890.1:c.472G>A, XM_011529891.1:c.472G>A, XP_005261286.1:p.Val158Met, XP_011528187.1:p.Val196Met, XP_011528188.1:p.Val196Met, XP_011528189.1:p.Val158Met, XP_011528190.1:p.Val158Met, XP_011528191.1:p.Val158Met, XP_011528192.1:p.Val158Met, XP_011528193.1:p.Val158Met, rs1131157, rs11544671, rs165688, rs17295216, rs17349704, rs17818178, rs17849308, rs17850006, rs2070104, rs3177905, rs3190784, rs3747070, rs58002978
G > A
SNP
V158M
No VIP available CA VA
rs4713916 NC_000006.11:g.35669983A>G, NC_000006.12:g.35702206A>G, NG_012645.2:g.31378T>C, NM_001145775.2:c.-20+18122T>C, rs17230143, rs35464630, rs9470083
A > G
SNP
No VIP available CA VA
rs502434 NC_000023.10:g.122537277T>C, NC_000023.11:g.123403426T>C, NG_009377.2:g.224184T>C, NM_000828.4:c.1200T>C, NM_007325.4:c.1200T>C, NP_000819.3:p.Asn400=, NP_015564.4:p.Asn400=, XM_005262406.1:c.1200T>C, XM_005262407.1:c.669T>C, XP_005262463.1:p.Asn400=, XP_005262464.1:p.Asn223=, XR_938574.1:n.5217+33824A>G, rs17259428, rs2228594
T > C
SNP
N400N
No VIP available CA VA
rs5030655 NC_000022.10:g.42525086delA, NC_000022.11:g.42129084delA, NG_008376.3:g.5908delT, NM_000106.5:c.454delT, NM_001025161.2:c.353-140delT, NP_000097.3:p.Trp152Glyfs, NT_187682.1:g.51425delA, NW_004504305.1:g.51411delA, NW_009646208.1:g.14650delA, XM_005278353.1:c.363-141delT, XM_005278354.1:c.155delT, XM_005278354.3:c.155delT, XM_011529966.1:c.454delT, XM_011529967.1:c.454delT, XM_011529968.1:c.454delT, XM_011529969.1:c.311delT, XM_011529970.1:c.353-140delT, XM_011529971.1:c.311delT, XM_011529972.1:c.454delT, XM_011547541.1:c.155delT, XM_011547750.1:c.311delT, XM_011547751.1:c.238delT, XM_011547756.1:c.-951delA, XM_011548819.1:c.155delT, XP_005278411.1:p.Val52Glyfs, XP_011528268.1:p.Trp152Glyfs, XP_011528269.1:p.Trp152Glyfs, XP_011528270.1:p.Trp152Glyfs, XP_011528271.1:p.Val104Glyfs, XP_011528273.1:p.Val104Glyfs, XP_011528274.1:p.Trp152Glyfs, XP_011545843.1:p.Val52Glyfs, XP_011546052.1:p.Val104Glyfs, XP_011546053.1:p.Trp80Glyfs, XP_011547121.1:p.Val52Glyfs, XR_430455.2:n.-787delA, XR_952745.1:n.1611delT, rs11568727, rs28371709
A > -
A > A
indel
W152G
No VIP available No Clinical Annotations available VA
rs57098334
(AGCCCACCC)9 > (AGCCCACCC)10
(AGCCCACCC)9 > (AGCCCACCC)12
microsatellite
No VIP available No Clinical Annotations available VA
rs6313 NC_000013.10:g.47469940G>A, NC_000013.11:g.46895805G>A, NG_013011.1:g.6230C>T, NM_000621.4:c.102C>T, NM_001165947.2:c.160+869C>T, NP_000612.1:p.Ser34=, rs17367493, rs3742280, rs386602276, rs57425741
G > A
SNP
S34S
No VIP available CA VA
rs7787082 NC_000007.13:g.87157051G>A, NC_000007.14:g.87527735G>A, NG_011513.1:g.190514C>T, NM_000927.4:c.2685+3559C>T, rs10352064, rs17333784, rs56434207, rs56854239
G > A
SNP
No VIP available CA VA
rs7997012 NC_000013.10:g.47411985A>G, NC_000013.11:g.46837850A>G, NG_013011.1:g.64185T>C, NM_000621.4:c.614-2211T>C, NM_001165947.2:c.362-2211T>C, rs60567994
A > G
SNP
Alleles, Functions, and Amino Acid Translations are all sourced from dbSNP 147

Overview

Generic Names
  • Venlafaxina [INN-Spanish]
  • Venlafaxine [INN:Ban]
  • Venlafaxinum [INN-Latin]
Trade Names
  • Effexor
  • Effexor XR
  • Elafax
Brand Mixture Names

PharmGKB Accession Id

PA451866

Type(s):

Drug

Description

Venlafaxine (Effexor) is an antidepressant of the serotonin-norepinephrine reuptake inhibitor (SNRI) class first introduced by Wyeth in 1993. It is prescribed for the treatment of clinical depression and anxiety disorders. Due to the pronounced side effects and suspicions that venlafaxine may significantly increase the risk of suicide it is not recommended as a first line treatment of depression. However, it is often effective for depression not responding to SSRIs. Venlafaxine was the sixth most widely-used antidepressant based on the amount of retail prescriptions in the US (17.1 million) in 2006. Wikipedia

Source: Drug Bank

Pharmacogenetics

Pharmacokinetics

The drug has a single chiral center and exists as a racemic mixture of R- and S-enantiomers [Article:7729333]. Venlafaxine undergoes extensive first pass metabolism via cytochrome CYP2D6 to form the major metabolite O-demethylvenlafaxine [Articles:7633018, 16958828, 11098412]. In vitro studies also found a minor effect of CYP2C9 and CYP2C19 in the formation of O-demethylvenlafaxine [Article:10192828]. The minor metabolites, N-demethylvenlafaxine and N,O-demethylvenlafaxine, are generated by several CYP isoenzymes including CYP3A4, CYP2C9, CYP2C19 [Articles:16958828, 10192828, 11098412]. In in vitro experiments, venlafaxine showed little or no inhibition of CYP2D6, CYP1A2, CYP2C19, CYP3A4 and ABCB1 [Article:19629022].

Pharmacodynamics

Venlafaxine shows a dual reuptake inhibition of serotonin and noradrenaline by blocking the serotonin (SLC6A4) and norepinephrine (SLC6A2) transporters [Article:11750180]. It also inhibits to a lesser extent the reuptake of dopamine (SLC6A3) [Article:7729333]. O-demethylvenlafaxine has similar potency to inhibit reuptake of serotonin and noradrenaline compared to the parent compound [Article:1487561]. N-demethylvenlafaxine and N,O-didemethylvenlafaxine were considerably less potent inhibitors for serotonin and noradrenaline reuptake [Article:3790168].

Pharmacogenomics

A study in patients with depressive disorders receiving antidepressants (amitriptyline, paroxetine, venlafaxine, or citalopram) found that variants in the ABCB1 gene influence treatment outcome [Article:18215618]. CYP2D6 metabolizer status might affect venlafaxine response or risk of adverse events [Article:16958828].

In patients with obsessive-compulsive disorder variants in SLC6A4, serotonin receptor 1B (HTR1B), and serotonin receptor 2A (HTR2A) genes are studied in association with efficacy of venlafaxine treatment [Article:17503984]. The 5-HTTLPR polymorphism in the SLC6A4 gene was associated with response in the venlafaxine-treated patients [Article:17503984]. Variants in the FK506 binding protein 5 gene (FKBP5) and a variant in the tryptophan hydroxylase 2 gene (TPH2) are associated with treatment response in patients receiving venlafaxine [Articles:18597649, 18496129]. For further pharmacogenetics information, see PGx Research tab for venlafaxine.

Source: PharmGKB

Indication

For the management of major depressive disorder (MDD), generalized anxiety disorder (GAD), social anxiety disorder (social phobia), panic disorder with or without agoraphobia, and vasomotor symptoms in women with breast cancer and in postmenopausal women.

Source: Drug Bank

Other Vocabularies

Information pulled from DrugBank has not been reviewed by PharmGKB.

Pharmacology, Interactions, and Contraindications

Mechanism of Action

The exact mechanism of action of venlafaxine is unknown, but appears to be associated with the its potentiation of neurotrasmitter activity in the CNS. Venlafaxine and its active metabolite, O-desmethylvenlafaxine (ODV), inhibit the reuptake of both serotonin and norepinephrine with a potency greater for the 5-HT than for the NE reuptake process. Both venlafaxine and the ODV metabolite have weak inhibitory effects on the reuptake of dopamine but, unlike the tricyclics and similar to SSRIs, they are not active at histaminergic, muscarinic, or alpha(1)-adrenergic receptors.

Source: Drug Bank

Pharmacology

Venlafaxine, an antidepressant agent structurally and pharmacologically unrelated to other antidepressants and agents used to treat generalized anxiety disorder, is used to treat melancholia, generalized anxiety disorder (GAD), panic disorder, post-traumatic stress disorder, and hot flashes in breast cancer survivors.

Source: Drug Bank

Food Interaction

Avoid St.John's Wort.|Avoid alcohol.|Take with food.

Source: Drug Bank

Absorption, Distribution, Metabolism, Elimination & Toxicity

Biotransformation

Undergoes extensive first pass metabolism in the liver to its major, active metabolite, ODV, and two minor, less active metabolites, N-desmethylvenlafaxine and N,O-didesmethylvenlafaxine. Formation of ODV is catalyzed by cytochrome P450 (CYP) 2D6, whereas N-demethylation is catalyzed by CYP3A4, 2C19 and 2C9. ODV possesses antidepressant activity that is comparable to that of venlfaxine.

Source: Drug Bank

Protein Binding

venlafaxine, 27%; ODV, 30%

Source: Drug Bank

Absorption

Bioavailability is 45% following oral administration.

Source: Drug Bank

Half-Life

5 hours

Source: Drug Bank

Toxicity

Most patients overdosing with venlafaxine develop only mild symptoms. However, severe toxicity is reported with the most common symptoms being CNS depression, serotonin toxicity, seizure, or cardiac conduction abnormalities. Venlafaxine's toxicity appears to be higher than other SSRIs, with a fatal toxic dose closer to that of the tricyclic antidepressants than the SSRIs. Doses of 900 mg or more are likely to cause moderate toxicity. Deaths have been reported following large doses.

Source: Drug Bank

Clearance

  • 1.3 +/- 0.6 L/h/kg

Source: Drug Bank

Route of Elimination

Renal elimination of venlafaxine and its metabolites is the primary route of excretion.

Source: Drug Bank

Volume of Distribution

Source: Drug Bank

Chemical Properties

Chemical Formula

C17H27NO2

Source: Drug Bank

Isomeric SMILES

CN(C)CC(c1ccc(cc1)OC)C2(CCCCC2)O

Source: OpenEye

Canonical SMILES

COC1=CC=C(C=C1)C(CN(C)C)C1(O)CCCCC1

Source: Drug Bank

Average Molecular Weight

277.4018

Source: Drug Bank

Monoisotopic Molecular Weight

277.204179113

Source: Drug Bank

SMILES

COC1=CC=C(C=C1)C(CN(C)C)C1(O)CCCCC1

Source: Drug Bank

InChI String

InChI=1S/C17H27NO2/c1-18(2)13-16(17(19)11-5-4-6-12-17)14-7-9-15(20-3)10-8-14/h7-10,16,19H,4-6,11-13H2,1-3H3

Source: Drug Bank

PharmGKB Curated Pathways

Pathways created internally by PharmGKB based primarily on literature evidence.

  1. Venlafaxine Pathway, Pharmacokinetics
    Stylized cells depicting the metabolism and mechanism of action of venlafaxine.

Genes that are associated with this drug in PharmGKB's database based on (1) variant annotations, (2) literature review, (3) pathways or (4) information automatically retrieved from DrugBank, depending on the "evidence" and "source" listed below.

Curated Information ?

Drug Targets

Gene Description
HTR1A (source: Drug Bank )
HTR1B (source: Drug Bank )
HTR2A (source: Drug Bank )
SLC6A2 (source: Drug Bank )
SLC6A3 (source: Drug Bank )
SLC6A4 (source: Drug Bank )

Drug Interactions

Interaction Description
almotriptan - venlafaxine Increased risk of CNS adverse effects (source: Drug Bank )
almotriptan - venlafaxine Increased risk of CNS adverse effects (source: Drug Bank )
dexfenfluramine - venlafaxine Risk of serotoninergic syndrome (source: Drug Bank )
diethylpropion - venlafaxine Risk of serotoninergic syndrome (source: Drug Bank )
eletriptan - venlafaxine Increased risk of CNS adverse effects (source: Drug Bank )
eletriptan - venlafaxine Increased risk of CNS adverse effects (source: Drug Bank )
fenfluramine - venlafaxine Risk of serotoninergic syndrome (source: Drug Bank )
fenfluramine - venlafaxine Risk of serotoninergic syndrome (source: Drug Bank )
frovatriptan - venlafaxine Increased risk of CNS adverse effects (source: Drug Bank )
isocarboxazid - venlafaxine Possible severe adverse reaction with this combination (source: Drug Bank )
isocarboxazid - venlafaxine Possible severe adverse reaction with this combination (source: Drug Bank )
linezolid - venlafaxine Combination associated with possible serotoninergic syndrome (source: Drug Bank )
linezolid - venlafaxine Combination associated with possible serotoninergic syndrome (source: Drug Bank )
mazindol - venlafaxine Risk of serotoninergic syndrome (source: Drug Bank )
mazindol - venlafaxine Risk of serotoninergic syndrome (source: Drug Bank )
metoclopramide - venlafaxine Possible serotoninergic syndrome with this combination (source: Drug Bank )
metoclopramide - venlafaxine Possible serotoninergic syndrome with this combination (source: Drug Bank )
naratriptan - venlafaxine Increased risk of CNS adverse effects (source: Drug Bank )
naratriptan - venlafaxine Increased risk of CNS adverse effects (source: Drug Bank )
phenelzine - venlafaxine Possible severe adverse reaction with this combination (source: Drug Bank )
phenelzine - venlafaxine Possible severe adverse reaction with this combination (source: Drug Bank )
phentermine - venlafaxine Risk of serotoninergic syndrome (source: Drug Bank )
phenylpropanolamine - venlafaxine Risk of serotoninergic syndrome (source: Drug Bank )
propafenone - venlafaxine Propafenone increases the effect and toxicity of venlafaxine (source: Drug Bank )
propafenone - venlafaxine Propafenone increases the effect and toxicity of venlafaxine (source: Drug Bank )
quinupristin - venlafaxine This combination presents an increased risk of toxicity (source: Drug Bank )
rasagiline - venlafaxine Possible severe adverse reaction with this combination (source: Drug Bank )
telithromycin - venlafaxine Telithromycin may reduce clearance of Venlafaxine. Consider alternate therapy or monitor for changes in the therapeutic/adverse effects of Venlafaxine if Telithromycin is initiated, discontinued or dose changed. (source: Drug Bank )
tramadol - venlafaxine Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome. (source: Drug Bank )
tranylcypromine - venlafaxine Increased risk of serotonin syndrome. Concomitant therapy should be avoided. A significant washout period, dependent on the half-lives of the agents, should be employed between therapies. (source: Drug Bank )
trazodone - venlafaxine Increased risk of serotonin syndrome. The 2D6 inhibitor, Trazodone, may also increase the efficacy of Venlafaxine by decreasing Venlafaxine metabolism and clearance. Monitor for symptoms of serotonin syndrome and changes in Venlafaxine efficacy if Trazodone is initiated, discontinued or dose changed. (source: Drug Bank )
trazodone - venlafaxine Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome. (source: Drug Bank )
trimipramine - venlafaxine Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome. (source: Drug Bank )
triprolidine - venlafaxine The CNS depressants, Triprolidine and Venlafaxine, may increase adverse/toxic effects due to additivity. Monitor for increased CNS depressant effects during concomitant therapy. (source: Drug Bank )
triprolidine - venlafaxine The CNS depressants, Triprolidine and Venlafaxine, may increase adverse/toxic effects due to additivity. Monitor for increased CNS depressant effects during concomitant therapy. (source: Drug Bank )
venlafaxine - almotriptan Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome. (source: Drug Bank )
venlafaxine - amitriptyline Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome. (source: Drug Bank )
venlafaxine - amoxapine Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome. (source: Drug Bank )
venlafaxine - amprenavir Amprenavir, a CYP3A4 inhibitor, may decrease the metabolism and clearance of Venlafaxine, a CYP3A4 substrate. Monitor for changes in therapeutic/adverse effects of Venlafaxine if Amprenavir is initiated, discontinued, or dose changed. (source: Drug Bank )
venlafaxine - atazanavir Atazanavir, a CYP3A4 inhibitor, may decrease the metabolism and clearance of Venlafaxine, a CYP3A4 substrate. Monitor for changes in therapeutic/adverse effects of Venlafaxine if Atazanavir is initiated, discontinued, or dose changed. (source: Drug Bank )
venlafaxine - bromocriptine Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome. (source: Drug Bank )
venlafaxine - buspirone Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome. (source: Drug Bank )
venlafaxine - cabergoline Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome. (source: Drug Bank )
venlafaxine - chlorpromazine Chlorpromazine, a CYP2D6 inhibitor, may decrease the metabolism and clearance of Venlafaxine, a CYP2D6 substrate. Monitor for changes in therapeutic/adverse effects of Venlafaxine if Chlorpromazine is initiated, discontinued, or dose changed. (source: Drug Bank )
venlafaxine - cinacalcet Cinacalcet, a CYP2D6 inhibitor, may decrease the metabolism and clearance of Venlafaxine, a CYP2D6 substrate. Monitor for changes in therapeutic/adverse effects of Venlafaxine if Cinacalcet is initiated, discontinued, or dose changed. (source: Drug Bank )
venlafaxine - citalopram Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome. (source: Drug Bank )
venlafaxine - clarithromycin Clarithromycin, a CYP3A4 inhibitor, may decrease the metabolism and clearance of Venlafaxine, a CYP3A4 substrate. Monitor for changes in therapeutic/adverse effects of Venlafaxine if Clarithromycin is initiated, discontinued, or dose changed. (source: Drug Bank )
venlafaxine - clomipramine Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome. (source: Drug Bank )
venlafaxine - cocaine Cocaine, a CYP2D6 inhibitor, may decrease the metabolism and clearance of Venlafaxine, a CYP2D6 substrate. Monitor for changes in therapeutic/adverse effects of Venlafaxine if Cocaine is initiated, discontinued, or dose changed. (source: Drug Bank )
venlafaxine - conivaptan Conivaptan, a CYP3A4 inhibitor, may decrease the metabolism and clearance of Venlafaxine, a CYP3A4 substrate. Monitor for changes in therapeutic/adverse effects of Venlafaxine if Conivaptan is initiated, discontinued, or dose changed. (source: Drug Bank )
venlafaxine - darunavir Darunavir, a CYP3A4 inhibitor, may decrease the metabolism and clearance of Venlafaxine, a CYP3A4 substrate. Monitor for changes in therapeutic/adverse effects of Venlafaxine if Darunavir is initiated, discontinued, or dose changed. (source: Drug Bank )
venlafaxine - delavirdine Delaviridine, a CYP2D6 and CYP3A4 inhibitor, may decrease the metabolism and clearance of Venlafaxine, a CYP2D6 and CYP3A4 substrate. Monitor for changes in therapeutic/adverse effects of Venlafaxine if Delavirdine is initiated, discontinued, or dose changed. (source: Drug Bank )
venlafaxine - desipramine Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome. (source: Drug Bank )
venlafaxine - dextromethorphan Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome. (source: Drug Bank )
venlafaxine - dihydroergotamine Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome. (source: Drug Bank )
venlafaxine - dipivefrin Venlafaxine may increase the tachycardic and vasopressor effects of dipivefrin. Consider alternate therapy or monitor for increased sympathomimetic effects, such as increased blood pressure, chest pain and headache. (source: Drug Bank )
venlafaxine - doxepin Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome. (source: Drug Bank )
venlafaxine - duloxetine Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome. (source: Drug Bank )
venlafaxine - eletriptan Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome. (source: Drug Bank )
venlafaxine - ephedrine Venlafaxine may increase the tachycardic and vasopressor effects of ephedrine. Consider alternate therapy or monitor for increased sympathomimetic effects, such as increased blood pressure, chest pain and headache. (source: Drug Bank )
venlafaxine - epinephrine Venlafaxine may increase the tachycardic and vasopressor effects of epinephrine. Consider alternate therapy or monitor for increased sympathomimetic effects, such as increased blood pressure, chest pain and headache. (source: Drug Bank )
venlafaxine - ergonovine Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome. (source: Drug Bank )
venlafaxine - ergotamine Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome. (source: Drug Bank )
venlafaxine - escitalopram Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome. (source: Drug Bank )
venlafaxine - fluoxetine Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome. (source: Drug Bank )
venlafaxine - fluvoxamine Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome. (source: Drug Bank )
venlafaxine - fosamprenavir Fosamprenavir, a CYP3A4 inhibitor, may decrease the metabolism and clearance of Venlafaxine, a CYP3A4 substrate. Monitor for changes in therapeutic/adverse effects of Venlafaxine if Fosamprenavir is initiated, discontinued, or dose changed. (source: Drug Bank )
venlafaxine - frovatriptan Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome. (source: Drug Bank )
venlafaxine - furazolidone Increased risk of serotonin syndrome. Ensure adequate washout period between therapies to avoid toxicity. Concurrent therapy should be avoided. (source: Drug Bank )
venlafaxine - imatinib Imatinib, a CYP3A4 inhibitor, may decrease the metabolism and clearance of Venlafaxine, a CYP3A4 substrate. Monitor for changes in therapeutic/adverse effects of Venlafaxine if Imatinib is initiated, discontinued, or dose changed. (source: Drug Bank )
venlafaxine - imipramine Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome. (source: Drug Bank )
venlafaxine - indinavir Indinavir, a CYP3A4 inhibitor, may decrease the metabolism and clearance of Venlafaxine, a CYP3A4 substrate. Monitor for changes in therapeutic/adverse effects of Venlafaxine if Indinavir is initiated, discontinued, or dose changed. (source: Drug Bank )
venlafaxine - isocarboxazid Increased risk of serotonin syndrome. Ensure adequate washout period between therapies to avoid toxicity. Concurrent therapy should be avoided. (source: Drug Bank )
venlafaxine - isoniazid Isoniazid, a CYP3A4 inhibitor, may decrease the metabolism and clearance of Venlafaxine, a CYP3A4 substrate. Monitor for changes in therapeutic/adverse effects of Venlafaxine if Isoniazid is initiated, discontinued, or dose changed. (source: Drug Bank )
venlafaxine - itraconazole Itraconaole, a CYP3A4 inhibitor, may decrease the metabolism and clearance of Venlafaxine, a CYP3A4 substrate. Monitor for changes in therapeutic/adverse effects of Venlafaxine if Itraconazole is initiated, discontinued, or dose changed. (source: Drug Bank )
venlafaxine - ketoconazole Ketoconazole, a CYP3A4 inhibitor, may decrease the metabolism and clearance of Venlafaxine, a CYP3A4 substrate. Monitor for changes in therapeutic/adverse effects of Venlafaxine if Ketoconazole is initiated, discontinued, or dose changed. (source: Drug Bank )
venlafaxine - linezolid Increased risk of serotonin syndrome. Ensure adequate washout period between therapies to avoid toxicity. Concurrent therapy should be avoided. (source: Drug Bank )
venlafaxine - lithium Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome. (source: Drug Bank )
venlafaxine - lopinavir Lopinavir, a CYP2D6 and CYP3A4 inhibitor, may decrease the metabolism and clearance of Venlafaxine, a CYP2D6 and CYP3A4 substrate. Monitor for changes in therapeutic/adverse effects of Venlafaxine if Lopinavir is initiated, discontinued, or dose changed. (source: Drug Bank )
venlafaxine - maprotiline Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome. (source: Drug Bank )
venlafaxine - meperidine Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome. (source: Drug Bank )
venlafaxine - methylergonovine Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome. (source: Drug Bank )
venlafaxine - miconazole Miconazole, a CYP2D6 and CYP3A4 inhibitor, may decrease the metabolism and clearance of Venlafaxine, a CYP2D6 and CYP3A4 substrate. Monitor for changes in therapeutic/adverse effects of Venlafaxine if Miconazole is initiated, discontinued, or dose changed. (source: Drug Bank )
venlafaxine - milnacipran Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome. (source: Drug Bank )
venlafaxine - mirtazapine Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome. (source: Drug Bank )
venlafaxine - moclobemide Increased risk of serotonin syndrome. Ensure adequate washout period between therapies to avoid toxicity. Concurrent therapy should be avoided. (source: Drug Bank )
venlafaxine - naratriptan Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome. (source: Drug Bank )
venlafaxine - nefazodone Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome. (source: Drug Bank )
venlafaxine - nelfinavir Nelfinavir, a CYP3A4 inhibitor, may decrease the metabolism and clearance of Venlafaxine, a CYP3A4 substrate. Monitor for changes in therapeutic/adverse effects of Venlafaxine if Nelfinavir is initiated, discontinued, or dose changed. (source: Drug Bank )
venlafaxine - nicardipine Nicardipine, a CYP3A4 inhibitor, may decrease the metabolism and clearance of Venlafaxine, a CYP3A4 substrate. Monitor for changes in therapeutic/adverse effects of Venlafaxine if Nicardipine is initiated, discontinued, or dose changed. (source: Drug Bank )
venlafaxine - norepinephrine Venlafaxine may increase the tachycardic and vasopressor effects of Norepinephrine. Consider alternate therapy or monitor for increased sympathomimetic effects, such as increased blood pressure, chest pain and headache. (source: Drug Bank )
venlafaxine - nortriptyline Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome. (source: Drug Bank )
venlafaxine - paroxetine Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome. (source: Drug Bank )
venlafaxine - pergolide Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome. (source: Drug Bank )
venlafaxine - phenelzine Increased risk of serotonin syndrome. Ensure adequate washout period between therapies to avoid toxicity. Concurrent therapy should be avoided. (source: Drug Bank )
venlafaxine - posaconazole Posaconazole, a CYP3A4 inhibitor, may decrease the metabolism and clearance of Venlafaxine, a CYP3A4 substrate. Monitor for changes in therapeutic/adverse effects of Venlafaxine if Posaconazole is initiated, discontinued, or dose changed. (source: Drug Bank )
venlafaxine - procarbazine Increased risk of serotonin syndrome. Ensure adequate washout period between therapies to avoid toxicity. Concurrent therapy should be avoided. (source: Drug Bank )
venlafaxine - promethazine Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome. (source: Drug Bank )
venlafaxine - protriptyline Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome. (source: Drug Bank )
venlafaxine - pseudoephedrine Venlafaxine may increase the tachycardic and vasopressor effects of Pseudoephedrine. Consider alternate therapy or monitor for increased sympathomimetic effects, such as increased blood pressure, chest pain and headache. (source: Drug Bank )
venlafaxine - quinidine Quinidine, a CYP2D6 and CYP3A4 inhibitor, may decrease the metabolism and clearance of Venlafaxine, a CYP2D6 and CYP3A4 substrate. Monitor for changes in therapeutic/adverse effects of Venlafaxine if Quinidine is initiated, discontinued, or dose changed. (source: Drug Bank )
venlafaxine - rasagiline Increased risk of serotonin syndrome. Ensure adequate washout period between therapies to avoid toxicity. Concurrent therapy should be avoided. (source: Drug Bank )
venlafaxine - ritonavir Ritonavir, a CYP2D6 and CYP3A4 inhibitor, may decrease the metabolism and clearance of Venlafaxine, a CYP2D6 and CYP3A4 substrate. Monitor for changes in therapeutic/adverse effects of Venlafaxine if Ritonavir is initiated, discontinued, or dose changed. (source: Drug Bank )
venlafaxine - rizatriptan Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome. (source: Drug Bank )
venlafaxine - s-adenosylmethionine Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome. (source: Drug Bank )
venlafaxine - saquinavir Saquinavir, a CYP3A4 inhibitor, may decrease the metabolism and clearance of Venlafaxine, a CYP3A4 substrate. Monitor for changes in therapeutic/adverse effects of Venlafaxine if Saquinavir is initiated, discontinued, or dose changed. (source: Drug Bank )
venlafaxine - selegiline Increased risk of serotonin syndrome. Ensure adequate washout period between therapies to avoid toxicity. Concurrent therapy should be avoided. (source: Drug Bank )
venlafaxine - sertraline Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome. (source: Drug Bank )
venlafaxine - sibutramine Increased risk of serotonin syndrome. Concurrent therapy should be avoided. (source: Drug Bank )
venlafaxine - sumatriptan Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome. (source: Drug Bank )
venlafaxine - telithromycin Telithromycin, a CYP3A4 inhibitor, may decrease the metabolism and clearance of Venlafaxine, a CYP3A4 substrate. Monitor for changes in therapeutic/adverse effects of Venlafaxine if Telithromycin is initiated, discontinued, or dose changed. (source: Drug Bank )
venlafaxine - terbinafine Terbinafine, a CYP2D6 inhibitor, may decrease the metabolism and clearance of Venlafaxine, a CYP2D6 substrate. Monitor for changes in therapeutic/adverse effects of Venlafaxine if Terbinafine is initiated, discontinued, or dose changed. (source: Drug Bank )
venlafaxine - tramadol Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome. (source: Drug Bank )
venlafaxine - tranylcypromine Increased risk of serotonin syndrome. Ensure adequate washout period between therapies to avoid toxicity. Concurrent therapy should be avoided. (source: Drug Bank )
venlafaxine - trazodone Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome. (source: Drug Bank )
venlafaxine - trimipramine Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome. (source: Drug Bank )
venlafaxine - voriconazole Voriconazole, a CYP3A4 inhibitor, may decrease the metabolism and clearance of Venlafaxine, a CYP3A4 substrate. Monitor for changes in therapeutic/adverse effects of Venlafaxine if Voriconazole is initiated, discontinued, or dose changed. (source: Drug Bank )
venlafaxine - zolmitriptan Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome. (source: Drug Bank )
voriconazole - venlafaxine Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of venlafaxine by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of venlafaxine if voriconazole is initiated, discontinued or dose changed. (source: Drug Bank )
zolmitriptan - venlafaxine Use of two serotonin modulators, such as zolmitriptan and venlafaxine, increases the risk of serotonin syndrome. Consider alternate therapy or monitor for serotonin syndrome during concomitant therapy. (source: Drug Bank )

Curated Information ?

EvidenceDisease
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Anxiety Disorders
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Arrhythmias, Cardiac
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neuropathic pain
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Vomiting

Relationships from National Drug File - Reference Terminology (NDF-RT)

May Treat
Contraindicated With

Publications related to venlafaxine: 79

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Effect of CYP2D6 variants on venlafaxine metabolism in vitro. Xenobiotica; the fate of foreign compounds in biological systems. 2016. Zhan Yun-Yun, et al. PubMed
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Pharmacogenetics and Treatment Response in Narcolepsy Type 1: Relevance of the Polymorphisms of the Drug Transporter Gene ABCB1. Clinical neuropharmacology. 2016. Moresco Monica, et al. PubMed
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The influences of CYP2D6 genotypes and drug interactions on the pharmacokinetics of venlafaxine: exploring predictive biomarkers for treatment outcomes. Psychopharmacology. 2015. Jiang Fen, et al. PubMed
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Clinical applications of CYP genotyping in psychiatry. Journal of neural transmission (Vienna, Austria : 1996). 2015. Spina Edoardo, et al. PubMed
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The Influence of C3435T Polymorphism of the ABCB1 Gene on Genetic Susceptibility to Depression and Treatment Response in Polish Population - Preliminary Report. International journal of medical sciences. 2015. Jeleń Agnieszka Maria, et al. PubMed
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A call for accurate pharmacogenetic labeling: telling it like it is. JAMA internal medicine. 2014. Burke Wylie, et al. PubMed
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Impact of age on serum concentrations of venlafaxine and escitalopram in different CYP2D6 and CYP2C19 genotype subgroups. European journal of clinical pharmacology. 2014. Waade Ragnhild Birkeland, et al. PubMed
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The genetics of pro-arrhythmic adverse drug reactions. British journal of clinical pharmacology. 2014. Petropoulou Evmorfia, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available VA No VIP available No VIP available
Lack of influence of DAT1 and DRD2 gene variants on antidepressant response in generalized anxiety disorder. Human psychopharmacology. 2014. Saung Wint Thu, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available VA No VIP available No VIP available
Serotonin toxicity from antidepressant overdose and its association with the T102C polymorphism of the 5-HT2A receptor. The pharmacogenomics journal. 2014. Cooper J M, et al. PubMed
No Dosing Guideline available No Drug Label available CA No Variant Annotation available No VIP available No VIP available
ABCB6, ABCB1 and ABCG1 genetic polymorphisms and antidepressant response of SSRIs in Chinese depressive patients. Pharmacogenomics. 2013. Huang Xiaoye, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
PharmGKB summary: venlafaxine pathway. Pharmacogenetics and genomics. 2013. Sangkuhl Katrin, et al. PubMed
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Pharmacogenetic polymorphisms and response to escitalopram and venlafaxine over 8 weeks in major depression. Human psychopharmacology. 2013. Ng Chee, et al. PubMed
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Cytochrome P450 2D6 Poor Metabolism, Curvilinearity, and Response: An Intriguing Observation Requiring Integration of Psychopharmacology Into Pharmacogenetics. Journal of clinical psychopharmacology. 2013. Al Hadithy Asmar F, et al. PubMed
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Novel CYP2D6 and CYP2C19 variants identified in a patient with adverse reactions towards venlafaxine monotherapy and dual therapy with nortriptyline and fluoxetine. Pharmacogenetics and genomics. 2013. Chua Eng Wee, et al. PubMed
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Challenges in pharmacogenetics. European journal of clinical pharmacology. 2013. Cascorbi Ingolf, et al. PubMed
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Association analysis between the A118G polymorphism in the OPRM1 gene and treatment response to venlafaxine XR in generalized anxiety disorder. Human psychopharmacology. 2013. Cooper Alissa J, et al. PubMed
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Pharmacokinetic model incorporating mechanism-based inactivation of CYP2D6 can explain both non-linear kinetics and drug interactions of paroxetine. International journal of clinical pharmacology and therapeutics. 2013. Mikami Akiko, et al. PubMed
No Dosing Guideline available No Drug Label available CA No Variant Annotation available No VIP available No VIP available
Pharmacogenetics in major depression: a comprehensive meta-analysis. Progress in neuro-psychopharmacology & biological psychiatry. 2013. Niitsu Tomihisa, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available VA No VIP available No VIP available
Catechol-O-methyltransferase genotype as modifier of superior responses to venlafaxine treatment in major depressive disorder. Psychiatry research. 2013. Hopkins Seth C, et al. PubMed
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Influence of CYP2D6 and CYP2C19 gene variants on antidepressant response in obsessive-compulsive disorder. The pharmacogenomics journal. 2013. Brandl E J, et al. PubMed
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Influence of genetic polymorphisms in the glutamatergic and GABAergic systems and their interactions with environmental stressors on antidepressant response. Pharmacogenomics. 2013. Pu Mengjia, et al. PubMed
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Cytochrome P450-mediated drug metabolism in the brain. Journal of psychiatry & neuroscience : JPN. 2012. Miksys Sharon, et al. PubMed
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Interaction between polymorphisms in serotonin transporter (SLC6A4) and serotonin receptor 2A (HTR2A) genes predict treatment response to venlafaxine XR in generalized anxiety disorder. The pharmacogenomics journal. 2012. Lohoff F W, et al. PubMed
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Variation in the catechol-O-methyltransferase (COMT) gene and treatment response to venlafaxine XR in generalized anxiety disorder. Psychiatry research. 2012. Narasimhan Sneha, et al. PubMed
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ABCB1 gene variants influence tolerance to selective serotonin reuptake inhibitors in a large sample of Dutch cases with major depressive disorder. The pharmacogenomics journal. 2012. de Klerk O L, et al. PubMed
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Serotonin receptor 2A (HTR2A) gene polymorphism predicts treatment response to venlafaxine XR in generalized anxiety disorder. The pharmacogenomics journal. 2011. Lohoff F W, et al. PubMed
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Pharmacogenetic testing: time for clinical practice guidelines. Clinical pharmacology and therapeutics. 2011. Amstutz U, et al. PubMed
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Pharmacogenetics: From Bench to Byte- An Update of Guidelines. Clinical pharmacology and therapeutics. 2011. Swen J J, et al. PubMed
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Clinical and genetic correlates of suicidal ideation during antidepressant treatment in a depressed outpatient sample. Pharmacogenomics. 2011. Perroud Nader, et al. PubMed
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Systematic review of pharmacoeconomic studies of pharmacogenomic tests. Pharmacogenomics. 2010. Beaulieu Mathieu, et al. PubMed
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Meta-analysis of FKBP5 gene polymorphisms association with treatment response in patients with mood disorders. Neuroscience letters. 2010. Zou Yan-Feng, et al. PubMed
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Coprescription of tamoxifen and medications that inhibit CYP2D6. Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 2010. Sideras Kostandinos, et al. PubMed
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Polymorphisms in GRIK4, HTR2A, and FKBP5 show interactive effects in predicting remission to antidepressant treatment. Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology. 2010. Horstmann Sonja, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Composite functional genetic and comedication CYP2D6 activity score in predicting tamoxifen drug exposure among breast cancer patients. Journal of clinical pharmacology. 2010. Borges Silvana, et al. PubMed
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FKBP5 polymorphisms and antidepressant response in geriatric depression. American journal of medical genetics. Part B, Neuropsychiatric genetics : the official publication of the International Society of Psychiatric Genetics. 2010. Sarginson Jane E, et al. PubMed
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Pharmacogenetic considerations in the treatment of psychiatric disorders. Expert opinion on pharmacotherapy. 2010. Lohoff Falk W, et al. PubMed
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Selective serotonin reuptake inhibitors and breast cancer mortality in women receiving tamoxifen: a population based cohort study. BMJ (Clinical research ed.). 2010. Kelly Catherine M, et al. PubMed
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Monoamine transporter gene polymorphisms affect susceptibility to depression and predict antidepressant response. Psychopharmacology. 2009. Min Wenjiao, et al. PubMed
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Depressive effect of an antidepressant: therapeutic failure of venlafaxine in a case lacking CYP2D6 activity. Annals of clinical biochemistry. 2009. Wijnen P A H M, et al. PubMed
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The effect of decontamination procedures on the pharmacokinetics of venlafaxine in overdose. Clinical pharmacology and therapeutics. 2009. Kumar V V P, et al. PubMed
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ADME pharmacogenetics: current practices and future outlook. Expert opinion on drug metabolism & toxicology. 2009. Grossman Iris. PubMed
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Response to serotonin reuptake inhibitors in OCD is not influenced by common CYP2D6 polymorphisms. International journal of psychiatry in clinical practice. 2009. Van Nieuwerburgh Filip C W, et al. PubMed
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Beta2-adrenoceptors are essential for desipramine, venlafaxine or reboxetine action in neuropathic pain. Neurobiology of disease. 2009. Yalcin Ipek, et al. PubMed
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Functional pharmacogenetics/genomics of human cytochromes P450 involved in drug biotransformation. Analytical and bioanalytical chemistry. 2008. Zanger Ulrich M, et al. PubMed
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Drug target identification using side-effect similarity. Science (New York, N.Y.). 2008. Campillos Monica, et al. PubMed
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Common genetic variations in human brain-specific tryptophan hydroxylase-2 and response to antidepressant treatment. Pharmacogenetics and genomics. 2008. Tzvetkov Mladen Vassilev, et al. PubMed
No Dosing Guideline available No Drug Label available CA No Variant Annotation available No VIP available No VIP available
The FKBP5-gene in depression and treatment response--an association study in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) Cohort. Biological psychiatry. 2008. Lekman Magnus, et al. PubMed
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Effect of terbinafine and voriconazole on the pharmacokinetics of the antidepressant venlafaxine. Clinical pharmacology and therapeutics. 2008. Hynninen V-V, et al. PubMed
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Semi-quantitative CYP2D6 gene doses in relation to metabolic ratios of psychotropics. European journal of clinical pharmacology. 2008. Hinrichs John W J, et al. PubMed
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Serum concentrations of venlafaxine and its metabolites O-desmethylvenlafaxine and N-desmethylvenlafaxine in heterozygous carriers of the CYP2D6*3, *4 or *5 allele. European journal of clinical pharmacology. 2008. Hermann M, et al. PubMed
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Genetic variants in FKBP5 affecting response to antidepressant drug treatment. Pharmacogenomics. 2008. Kirchheiner Julia, et al. PubMed
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Polymorphisms in the drug transporter gene ABCB1 predict antidepressant treatment response in depression. Neuron. 2008. Uhr Manfred, et al. PubMed
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Tricyclic antidepressant pharmacology and therapeutic drug interactions updated. British journal of pharmacology. 2007. Gillman P K. PubMed
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Clinical response and risk for reported suicidal ideation and suicide attempts in pediatric antidepressant treatment: a meta-analysis of randomized controlled trials. JAMA : the journal of the American Medical Association. 2007. Bridge Jeffrey A, et al. PubMed
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Genetic variability at HPA axis in major depression and clinical response to antidepressant treatment. Journal of affective disorders. 2007. Papiol Sergi, et al. PubMed
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Cytochrome P450 2D6 genotype variation and venlafaxine dosage. Mayo Clinic proceedings. Mayo Clinic. 2007. McAlpine Donald E, et al. PubMed
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A 40-basepair VNTR polymorphism in the dopamine transporter (DAT1) gene and the rapid response to antidepressant treatment. The pharmacogenomics journal. 2007. Kirchheiner J, et al. PubMed
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The DRD2 TaqI-B polymorphism and its relationship to smoking abstinence and withdrawal symptoms. The pharmacogenomics journal. 2007. Robinson J D, et al. PubMed
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A poor metabolizer for cytochromes P450 2D6 and 2C19: a case report on antidepressant treatment. CNS spectrums. 2006. Johnson Maria, et al. PubMed
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CYP2D6 genotype and venlafaxine-XR concentrations in depressed elderly. International journal of geriatric psychiatry. 2006. Whyte Ellen M, et al. PubMed
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CYP2D6 polymorphism and clinical effect of the antidepressant venlafaxine. Journal of clinical pharmacy and therapeutics. 2006. Shams M E E, et al. PubMed
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Serotonin transporter polymorphisms and side effects in antidepressant therapy--a pilot study. Pharmacogenomics. 2006. Popp Johannes, et al. PubMed
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Depressive symptoms as first manifestation of posterior cortical atrophy. The American journal of psychiatry. 2006. Wolf Robert Christian, et al. PubMed
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Metabolic ratios of psychotropics as indication of cytochrome P450 2D6/2C19 genotype. Therapeutic drug monitoring. 2005. van der Weide Jan, et al. PubMed
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The dual transporter inhibitor duloxetine: a review of its preclinical pharmacology, pharmacokinetic profile, and clinical results in depression. Current pharmaceutical design. 2005. Bymaster Frank P, et al. PubMed
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Polymorphisms in FKBP5 are associated with increased recurrence of depressive episodes and rapid response to antidepressant treatment. Nature genetics. 2004. Binder Elisabeth B, et al. PubMed
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Breastfeeding during maternal antidepressant treatment with serotonin reuptake inhibitors: infant exposure, clinical symptoms, and cytochrome p450 genotypes. The Journal of clinical psychiatry. 2004. Berle Jan Øystein, et al. PubMed
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Increased incidence of CYP2D6 gene duplication in patients with persistent mood disorders: ultrarapid metabolism of antidepressants as a cause of nonresponse. A pilot study. European journal of clinical pharmacology. 2004. Kawanishi Chiaki, et al. PubMed
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Role of CYP2D6 in the stereoselective disposition of venlafaxine in humans. Pharmacogenetics. 2003. Eap Chin B, et al. PubMed
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The role of noradrenaline and selective noradrenaline reuptake inhibition in depression. European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology. 2002. Brunello N, et al. PubMed
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Comparative affinity of duloxetine and venlafaxine for serotonin and norepinephrine transporters in vitro and in vivo, human serotonin receptor subtypes, and other neuronal receptors. Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology. 2001. Bymaster F P, et al. PubMed
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The impact of the CYP2D6 and CYP2C19 genotypes on venlafaxine pharmacokinetics in a Japanese population. European journal of clinical pharmacology. 2000. Fukuda T, et al. PubMed
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Seizures associated with therapeutic doses of venlafaxine and trimipramine. The Annals of pharmacotherapy. 2000. Schlienger R G, et al. PubMed
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Venlafaxine serum levels and CYP2D6 genotype. Therapeutic drug monitoring. 2000. Veefkind A H, et al. PubMed
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Science, medicine, and the future: Pharmacogenetics. BMJ (Clinical research ed.). 2000. Wolf C R, et al. PubMed
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Effect of the CYP2D6*10 genotype on venlafaxine pharmacokinetics in healthy adult volunteers. British journal of clinical pharmacology. 1999. Fukuda T, et al. PubMed
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Influence of CYP2D6 activity on the disposition and cardiovascular toxicity of the antidepressant agent venlafaxine in humans. Pharmacogenetics. 1999. Lessard E, et al. PubMed
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The cytochrome P450 2D6 (CYP2D6) enzyme polymorphism: screening costs and influence on clinical outcomes in psychiatry. Clinical pharmacology and therapeutics. 1996. Chen S, et al. PubMed

LinkOuts

Web Resource:
Wikipedia
National Drug Code Directory:
0378-4881-01
DrugBank:
DB00285
ChEBI:
9943
KEGG Compound:
C07187
PubChem Compound:
5656
PubChem Substance:
193901
46504593
Drugs Product Database (DPD):
2237279
ChemSpider:
5454
Therapeutic Targets Database:
DAP000054
FDA Drug Label at DailyMed:
2c3f8268-ef43-d58c-7da6-dd44f8feb3be

Clinical Trials

These are trials that mention venlafaxine and are related to either pharmacogenetics or pharmacogenomics.

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Sources for PharmGKB drug information: DrugBank, PubChem.