EFECTIN  ER 150 mg. 28 tablets

PFIZER
EFECTIN  ER 150 mg. 28 tablets
€ 29.00
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WHAT EFECTIN  ER  ER AND WHAT IT IS USED FOR?

EFECTIN  ER  antidepressant that belongs to a group of medicines called reuptake inhibitors of serotonin and norepinephrine (SNRIs). This group of drugs used for the treatment of depression and other conditions such as anxiety disorders. It is believed that people who are depressed and / or anxious have lower levels of serotonin and noradrenaline in the brain. Is not fully understood how antidepressants work, but they may help by increasing the levels of serotonin and noradrenaline in the brain.

ER is EFECTIN  ER  for the treatment of adults with depression. EFECTIN  ER  ER is also indicated for the treatment of adults with the following anxiety disorders: generalized anxiety disorder, social anxiety disorder (fear or avoidance of social situations) and panic disorder (panic attacks). Treating depression or anxiety disorders is important to feel better. If not treated, your condition may not go away and may become more serious and more difficult to treat.

2. BEFORE YOU TAKE EFECTIN  ER  ER

Do not take EFECTIN  ER  ER
• If you are allergic to venlafaxine or any of the other ingredients of this medicine (See pt. 6 for further information).
• If you are also taking or have taken within the last 14 days any medicines known as irreversible monoamine oxidase inhibitors (MAOIs), used to treat depression or Parkinson's disease. Taking an irreversible MAOI together with other medicines, including EFECTIN  ER  ER, can cause serious or even life-threatening side effects. Also, you must wait at least 7 days after you stop taking EFECTIN  ER  ER, before you take any MAOI (see also the section "Taking other medicines" and information on "Serotonin syndrome" in it).

Take special care with EFECTIN  ER  ER

If any of these apply to you, please tell your doctor before taking EFECTIN  ER  ER:

• If you use other medicines that taken together with EFECTIN  ER  ER could increase the risk of developing serotonin syndrome (see. Section "Taking other medicines").
• If you have eye problems such as certain kinds of glaucoma (increased pressure in the eye).
• If you have a history of high blood pressure.
• If you have a history of heart problems.
• If you have a history of seizures (convulsions).
• If you have a history of low sodium levels in the blood (hyponatremia).
• If you have a tendency to develop bruises or a tendency to bleed easily (history of bleeding disorders), or if you are taking other medicines that may increase the risk of bleeding, for example. warfarin (a drug that is used to reduce blood clotting).
• If you have a history of, or if someone in your family has had, mania or bipolar disorder (feeling over-excited or euphoric).
• If you have a history of aggressive behavior.

EFECTIN  ER  ER may cause a sensation of restlessness or inability to sit or stand during the first few weeks of treatment. You should tell your doctor if this happens to you.
Thoughts of suicide and worsening of your depression or anxiety disorder.
If you are depressed and / or have anxiety disorders can sometimes have thoughts of harming or killing themselves. These may be increased when you start taking antidepressants for the first time since these medicines all take time before they begin to work, usually about two weeks but sometimes longer.

You most likely think so:

• If you have previously had thoughts of harming or killing themselves.
• If you are young. Information from clinical trials has shown an increased risk of suicidal behavior in young adults (under 25 years) with psychiatric conditions who were treated with an antidepressant.

If you have thoughts of harming or killing yourself at any time, contact your doctor or go to hospital.

It may be helpful to tell a relative or close friend that you are depressed or have an anxiety disorder, and ask them to read this leaflet.

Dry mouth

Dry mouth was reported in 10% of patients treated with venlafaxine. This may increase the risk of caries. Therefore you should pay special attention to the hygiene of your teeth.

diabetes mellitus

Blood glucose levels can change as a result of the application of possibly effective ER. This may require dose adjustment of your antidiabetic the therapeutic.

Use in children and adolescents under 18 years of age

EFECTIN  ER  ER should normally not be used for children and adolescents under 18 years. Also you should know that patients under 18 have an increased risk of side effects, such as suicide attempt, suicidal thoughts and hostility (predominantly aggression, oppositional behavior and anger) when they take this class of drugs. Despite this, your doctor may prescribe this medicine for patients under 18 because he / she decides that this is in their best interest. If your doctor has prescribed this medicine for a patient under 18 and you want to discuss this, please go back to your doctor. You should tell your doctor if you develop or worsen any of the above symptoms when patients under 18 are taking EFECTIN  ER  ER. Furthermore, long-term effects of this drug on the safety of growth, maturation and cognitive development and behavior in this age group have not yet been demonstrated.

Taking other medicines

Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a prescription.

Your doctor should decide whether you can take EFECTIN  ER  ER with other medicines.

Do not start or stop taking any medicines, including those without a prescription, natural and herbal remedies, before checking with your doctor or pharmacist.

• Monoamine oxidase inhibitors used to treat depression or Parkinson's disease should not be taken with EFECTIN  ER  EYa.Uvedomete your doctor if during the last 14 days you are taking these drugs. (MAOIs: see. Section "Before you take EFECTIN  ER  ER")

• Serotonin syndrome:

potentially life-threatening condition or symptoms of neuroleptic malignant syndrome (NMS) (see. "Possible Side Effects"), may occur with venlafaxine treatment, particularly when taken with other drugs. Examples of such drugs include:

Triptans (used for migraine)

Other medicines to treat depression, for instance SNRIs, SSRIs, tricyclics, or medicines containing lithium

Medicines containing linezolid, an antibiotic (used to treat infections)

Medicines containing moclobemide, a MAOI (used to treat depression)

• Medicines containing sibutramine (used for weight loss)

• Medicines containing tramadol (a painkiller)

• Products containing St. John's Wort (also called Hypericum perforatum, which is natural or herbal remedy used to treat mild depression)

• Products containing tryptophan (used for problems such as sleep and depression)

• Antipsychotic drugs (used to treat diseases with symptoms such as hearing, seeing or feeling things that are not there, mistaken beliefs, unusual suspiciousness, unclear reasoning or uncommunicative)

Signs and symptoms of serotonin syndrome may include a combination of the following: restlessness, hallucinations, loss of coordination, fast heart beat, increased body temperature, fast changes in blood pressure, overactive reflexes, diarrhea, coma, nausea, vomiting.

In its worst form, serotonin syndrome can resemble neuroleptic malignant syndrome (NMS). Signs and symptoms of NMS include a combination of fever, fast heart beat, sweating, severe muscle stiffness, confusion, increased muscle enzymes (determined by a blood test).

Tell your doctor immediately or seek medical help at the nearest hospital, if you think serotonin syndrome.

The following medicines may also interact with ER EFECTIN  ER  and should be used with caution. It is especially important to mention to your doctor or pharmacist if you are taking medicines containing:

• Ketoconazole (an antifungal medicine)
• Haloperidol or risperidone (to treat psychiatric conditions)
• metoprolol (a beta blocker for the treatment of high blood pressure and cardiac problems)

Taking EFECTIN  ER  ER with food and drink

EFECTIN  ER  ER should be taken with food (see. Section 3 "HOW TO TAKE EFECTIN  ER  ER").
You should avoid alcohol while taking EFECTIN  ER  ER. Pregnancy and lactation

Tell your doctor if you are pregnant or if you are trying to become pregnant. You can use the ER EFECTIN  ER  only after discussing the potential benefits and potential risks to your unborn child with your doctor.

Make sure your midwife and / or doctor knows you are taking EFECTIN  ER  ER. Medicines similar to your (SSRIs - selective inhibitors of serotonin reuptake) when taken during pregnancy may increase the risk of serious illness in babies, called persistent pulmonary hypertension of the newborn (PPHN), in which the baby breathes rapid and appears bluish. These symptoms usually begin during the first 24 hours after the baby is born. If this happens to your baby should immediately contact your midwife and / or doctor.

If you are taking this medicine during pregnancy, other symptoms that can occur in your baby after birth, is an eating disorder, in addition to breathing problems. If your baby has these symptoms when it is born and you are concerned, contact your doctor and / or midwife who will be able to advise you.

EFECTIN  ER  ER passes into breast milk. There is a risk of an effect on the baby. Therefore, you should discuss this with your doctor and he / she will decide whether you should stop breast-feeding or stop the therapy with this medicine.

Driving and using machines

Do not drive or use any tools or machines until you know how this medication affects you.

3. HOW TO TAKE EFECTIN  ER  ER?

Always take EFECTIN  ER  ER just as you have been told your doctor. If you are not sure, ask your doctor or pharmacist.

The usual recommended starting dose for treatment of depression, generalized anxiety disorder and social anxiety disorder is 75 mg per day. The dose may be increased gradually by the doctor and, if needed, even up to a maximum of 375 mg daily for depression. If you are being treated for panic disorder, your doctor will start with a lower dose (37,5 mg) and then increase the dose gradually. The maximum dose for generalized anxiety disorder, social anxiety disorder and panic disorder is 225 mg / day.

Take EFECTIN  ER  ER at approximately the same time each day in the morning or evening. The capsules should be swallowed whole with fluid and not opened, crushed, chewed or dissolved.

EFECTIN  ER  ER should be taken with food.

If you have liver or kidney problems, talk to your doctor as you may need your dose is changed.

Do not stop taking this medication without consulting your doctor (see. Section "If you stop taking EFECTIN  ER  ER").

If you take more dose EFECTIN  ER  ER

Call your doctor immediately or pharmacist if you take more dose of this medicine as prescribed by your doctor.

The symptoms of a possible overdose may include a rapid heart beat, changes in level of alertness (ranging from somnolence to coma), blurred vision, seizures or fits, and vomiting.

If you forget to take EFECTIN  ER  ER

If you miss a dose, take it as soon as you remember. However, if it is time for your next dose, skip the missed dose and take only a single dose as usual. Do not take more than the daily amount EFECTIN  ER  ER, which affords you have been prescribed for a day.

If you stop taking EFECTIN  ER  ER

Do not stop taking your treatment or reduce the dose without the advice of your doctor even if you feel better. If your doctor thinks that you no longer need a EFECTIN  ER  ER, he / she may ask you to slowly reduce your dose before stopping treatment altogether. It is known that side effects occur when people stop using this medicine, especially when stopped suddenly or the dose is reduced too quickly. Some patients may experience symptoms such as fatigue, dizziness, lightheadedness, headache, sleeplessness, nightmares, dry mouth, loss of appetite, nausea, diarrhea, nervousness, agitation, confusion, ringing in the ears, tingling or rarely sensations electric shock, weakness, sweating, seizures or flu-like symptoms.

Your doctor will advise you on how you should gradually discontinue treatment with EFECTIN  ER  ER. If you experience any of these or other symptoms that are troublesome, ask your doctor for further advice.

If you have any further questions on the use of this product, ask your doctor or pharmacist.

4. POSSIBLE SIDE EFFECTS

Like all medicines, EFECTIN  ER  ER can cause side effects, although not everybody gets them.

If any of these effects, do not take EFECTIN  ER  ER. Tell your doctor or go to the emergency room of the nearest hospital:

• Chest tightness, wheezing, trouble swallowing or breathing
• Swelling of the face, throat, hands, or feet
• Feeling nervous or anxious, dizziness, throbbing sensations, sudden reddening of the skin and / or a feeling of warmth
• Severe rash, itching or hives (elevated patches of red or pale skin that often itch)
• Signs and symptoms of serotonin syndrome may include restlessness, hallucinations, loss of coordination, fast heart beat, increased body temperature, fast changes in blood pressure, overactive reflexes, diarrhea, coma, nausea, vomiting.

In its worst form, serotonin syndrome can resemble neuroleptic malignant syndrome (NMS). Signs and symptoms of NMS include a combination of fever, fast heart beat, sweating, severe muscle stiffness, confusion, increased muscle enzymes (determined by a blood test).

Other side effects that you should tell your doctor:

• Cough, wheezing, shortness of breath and fever
• black tarry stools (faeces) or blood in the stool
• Yellow skin or eyes, dark urine or itching, which may be signs of inflammation of the liver (hepatitis)
• Heart problems, such as fast or irregular heartbeat, increased blood pressure
• Eye problems such as blurred vision, dilated pupils
• Nerve problems, such as dizziness, feeling of pins and needles, movement disorder, seizures or fits.
Psychiatric problems such as hyperactivity and euphoria (feeling unusually overexcited)
• syndromes stopping treatment (see. Point "HOW TO TAKE EFECTIN  ER  ER, If you stop taking EFECTIN  ER  ER").

Do not worry if you see small white granules in your stools after taking EFECTIN  ER  ER Inside EFECTIN  ER  ER capsules are spheroids or small white balls that contain the venlafaxine active ingredient. These spheroids are released from the capsule into your gastrointestinal tract. As the spheroids travel the length of your gastrointestinal tract, venlafaxine is slowly released. "Shell" of the microspheres remains undissolved and is eliminated in your stools. So even though you may see spheroids in your stools, your dose of venlafaxine has been absorbed.

Complete list of side effects

Very common (influenced more than 1 user in 10)

• Headache; dry mouth; sweating (including night sweats)
• Nausea

Common (Affected 1 to 10 users in 100)
• Weight loss; decreased appetite; constipation; vomiting; high cholesterol
• Feeling separated (or detached) from yourself and reality; nervousness; confusion; abnormal dreams; insomnia
• Tremor; increased muscle tone
• needles and chills
• Increased blood pressure; redness; palpitation
• Increased frequency of urination; difficulty in passing urine
• Decreased libido; abnormal ejaculation / orgasm (males); lack of orgasm; erectile dysfunction (impotence)
• Irregularities such as increased bleeding or increased irregular bleeding
• weakness (asthenia); dizziness; sedation; chills
• Blurred vision
• Yawning

Uncommon (influenced by 1 to 10 users in 1000)

• Bruising; black tarry stools (faeces) or blood in stools, which can be a sign of internal bleeding
• Grinding of teeth; involuntary muscle movements
• Hallucinations
• Total swelling of the skin, especially the face, mouth, tongue, throat or hands stypalatai and / or itchy rash (tingling)
• Sensitivity to sunlight; pathological hair loss; rash
• Impaired coordination and balance; feeling dizzy (particularly when standing up too quickly); fainting, fast heartbeat
• Weight gain; diarrhea
• Altered taste sensations
• Loss of feeling or emotion; agitation
• Ringing in the ears (tinnitus)
• Inability to pass urine
• abnormal orgasm (females)

Rare (influenced by 1 to 10 users in 10,000)

• Feelings of restlessness or inability to sit or stand still; convulsions or seizures; sense of euphoria or hyperexcitability
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