Comprehensive medication guide to Venlafaxine XR including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$0–$30 copay for generic Venlafaxine XR; Tier 1–2 on most commercial and Medicare Part D plans. Brand Effexor XR is typically Tier 3–4 and may require step therapy or prior authorization.
Estimated Cash Pricing
$10–$45 retail for generic Venlafaxine XR (30-day supply); as low as $4–$10 with GoodRx or SingleCare coupons at Walmart, Costco, or Kroger. Brand Effexor XR costs $300–$500/month without a savings program.
Medfinder Findability Score
65/100
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Venlafaxine XR (brand name: Effexor XR) is an extended-release antidepressant belonging to the serotonin-norepinephrine reuptake inhibitor (SNRI) class. It is FDA-approved for adults to treat major depressive disorder (MDD), generalized anxiety disorder (GAD), social anxiety disorder (SAD), and panic disorder. It is taken once daily with food.
Originally marketed as Effexor by Wyeth (now Viatris), the extended-release formulation was introduced to allow once-daily dosing and improve tolerability compared to the immediate-release tablet. Generic Venlafaxine XR has been widely available since approximately 2010 and is made by multiple manufacturers including Teva, Aurobindo, Zydus, and Sun Pharma.
Venlafaxine XR is available in extended-release capsules (37.5 mg, 75 mg, 150 mg) and extended-release tablets (37.5 mg, 75 mg, 112.5 mg, 150 mg, 225 mg). Typical dosing starts at 37.5–75 mg/day and can be increased to a maximum of 225 mg/day. Venlafaxine is also sometimes used off-label for hot flashes, PTSD, and neuropathic pain.
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Venlafaxine XR works by blocking the reuptake (reabsorption) of two key neurotransmitters in the brain: serotonin and norepinephrine. By preventing neurons from reabsorbing these chemicals, more serotonin and norepinephrine remain available in the synaptic gap between neurons, helping to improve mood, reduce anxiety, and restore emotional balance.
One of Venlafaxine XR's unique features is its dose-dependent mechanism. At lower doses (~75 mg/day), it primarily acts on serotonin reuptake, similar to SSRIs. At higher doses (150–225 mg/day), its norepinephrine reuptake inhibition becomes clinically significant — providing a dual mechanism that may help patients who haven't fully responded to SSRIs alone.
When your body metabolizes Venlafaxine, it converts a portion to its active metabolite: desvenlafaxine (sold separately as Pristiq). Both the parent drug and its metabolite contribute to the therapeutic effect. Steady-state blood levels are typically reached within 3 days, though the full antidepressant benefit takes 4–8 weeks to develop.
37.5 mg — extended-release capsule
Starting/tapering dose; take once daily with food
75 mg — extended-release capsule
Standard starting/maintenance dose; most widely stocked
150 mg — extended-release capsule
Common maintenance dose; widely available
37.5 mg — extended-release tablet
Tablet formulation; bioequivalent to capsule
75 mg — extended-release tablet
Tablet formulation; bioequivalent to capsule
112.5 mg — extended-release tablet
Available only as tablet, not capsule
150 mg — extended-release tablet
Tablet formulation; bioequivalent to capsule
225 mg — extended-release tablet
Maximum dose; lower availability; may require special ordering
Venlafaxine XR is generally available at most pharmacies, but specific strengths — particularly the 37.5 mg and 225 mg capsules — experience intermittent localized supply disruptions. As of early 2026, Venlafaxine XR is not on the FDA's national shortage list; however, patients in some areas may still encounter difficulty finding specific doses due to manufacturer-level supply issues.
The 75 mg and 150 mg capsules are most consistently available at chain pharmacies. Problems arise most often with 37.5 mg (used for starting and tapering) and 225 mg (maximum dose). Multiple generic manufacturers — including Teva, Zydus, Aurobindo, and Sun Pharma — produce Venlafaxine XR, which helps maintain overall supply but means availability can vary by pharmacy depending on which manufacturer's version they stock.
If your pharmacy is out of stock, medfinder can call pharmacies near you to find which ones have your specific strength in stock — saving you the time and frustration of calling around yourself.
Venlafaxine XR is not a controlled substance and is not scheduled by the DEA. This means any licensed prescriber with the authority to write prescription medications can prescribe it without special DEA registration. There are no quantity restrictions, and prescriptions can be sent electronically or called in to any pharmacy.
Providers who commonly prescribe Venlafaxine XR include:
Psychiatrists — most specialized for complex psychiatric conditions or treatment-resistant cases
Primary care physicians (PCPs) — the most common prescribers for antidepressants in the U.S.
Nurse practitioners (NPs) and physician assistants (PAs) — have full prescribing authority in most states
Neurologists — may prescribe for off-label uses including neuropathic pain
OB-GYNs — sometimes prescribe for menopausal hot flashes (off-label) or perinatal depression
Since Venlafaxine XR is not a controlled substance, it can be prescribed via telehealth without requiring an in-person visit. Platforms like Talkiatry, Brightside Health, Teladoc, and MDLive can evaluate patients and send Venlafaxine XR prescriptions directly to a pharmacy — often with same-day or next-day appointment availability.
No. Venlafaxine XR is not a controlled substance and is not scheduled by the DEA. This means it can be prescribed by any licensed healthcare provider — including primary care physicians, nurse practitioners, physician assistants, and telehealth providers — without any special DEA registration requirements.
Because it is not a controlled substance, Venlafaxine XR prescriptions can be called in, sent electronically, or written without the quantity and refill restrictions that apply to scheduled medications. Patients can also obtain 90-day supplies and use mail-order pharmacy services without the limitations that apply to controlled substances. Telehealth providers can prescribe Venlafaxine XR without requiring an in-person visit.
The most common side effects of Venlafaxine XR typically occur in the first few weeks of treatment and often improve as your body adjusts:
Nausea (most common; take with food to minimize)
Headache
Insomnia or drowsiness
Dizziness
Dry mouth
Sweating (diaphoresis)
Sexual dysfunction (decreased libido, delayed orgasm)
Constipation
Decreased appetite
BLACK BOX WARNING: Increased suicidal thoughts in patients under 24; monitor closely
Serotonin syndrome (with other serotonergic drugs) — seek emergency care immediately
Elevated blood pressure — monitor at higher doses
Hyponatremia (low sodium) — especially in elderly
Abnormal bleeding — especially with NSAIDs or anticoagulants
Discontinuation syndrome (brain zaps, dizziness, nausea) — taper slowly, never stop abruptly
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Duloxetine (Cymbalta)
Most commonly prescribed SNRI alternative; also approved for chronic pain conditions; more balanced serotonin/norepinephrine activity; generic available at $4–$15/month
Desvenlafaxine (Pristiq)
Active metabolite of Venlafaxine; pharmacologically closest alternative; simpler pharmacokinetics; fixed 50 mg dose; not approved for anxiety disorders
Levomilnacipran (Fetzima)
SNRI with stronger norepinephrine effect; once daily; FDA-approved for MDD; useful for patients needing more noradrenergic support
Sertraline (Zoloft)
SSRI; widely available and affordable; first-line for depression, anxiety, and panic; gentler side effect profile than SNRIs
Escitalopram (Lexapro)
SSRI; approved for MDD and GAD; well-tolerated; very low drug interaction profile
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MAOIs (phenelzine, tranylcypromine, linezolid)
majorAbsolutely contraindicated. 14-day washout required after stopping MAOI before starting Venlafaxine XR. Risk of fatal serotonin syndrome.
SSRIs and other SNRIs
majorAdditive serotonergic effects; serotonin syndrome risk. Do not combine without close physician supervision.
Triptans (sumatriptan, rizatriptan)
majorSerotonin syndrome risk, especially at higher doses. Use with caution; monitor closely.
Warfarin and anticoagulants
majorVenlafaxine impairs platelet function; combined use significantly increases bleeding risk. Monitor INR closely.
NSAIDs and aspirin
moderateAdditive bleeding risk due to antiplatelet effects. Increased GI bleeding risk. Use acetaminophen if possible.
St. John's Wort
majorSerotonin syndrome risk. Do not combine with any SNRI or SSRI.
CYP2D6 inhibitors (paroxetine, fluoxetine, bupropion)
moderateRaise Venlafaxine blood levels; may increase side effects and toxicity risk.
Lithium
moderateAdditive serotonergic and QT effects. Monitor closely if combined.
Tramadol
majorSerotonin syndrome risk and lowered seizure threshold when combined with Venlafaxine.
Alcohol
moderatePotentiates CNS depression. Avoid alcohol during treatment.
Venlafaxine XR (Effexor XR) is a well-established, effective SNRI antidepressant with a broad range of FDA-approved indications — depression, generalized anxiety disorder, social anxiety disorder, and panic disorder. Its dual mechanism of action targeting both serotonin and norepinephrine makes it particularly useful for patients who haven't fully responded to SSRIs.
The most important practical considerations for patients on Venlafaxine XR are its significant discontinuation syndrome and the need for proactive supply management. Because missing doses can quickly cause uncomfortable withdrawal symptoms, it's essential to refill early, keep your prescriber informed of any supply problems, and never stop abruptly. Generic Venlafaxine XR is one of the most affordable antidepressants available — typically $4–$10/month with discount coupons.
If you're having difficulty finding Venlafaxine XR at your pharmacy, medfinder can call pharmacies in your area to identify which ones have your specific strength in stock — taking the search burden off your shoulders so you can focus on your health.
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Our medication guides are researched and written to help patients make informed decisions. All content is reviewed for accuracy and updated regularly. Learn more about our standards
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