Venlafaxine
Dosing in kidney impairment
Patients with Renal Impairment In patients with renal impairment (GFR = 10 to 70 mL/min), the clearances of venlafaxine and its active metabolites were decreased, thus prolonging the elimination half-lives of these substances [ see Clinical Pharmacology ]. It is recommended that the total daily dose be reduced by 25% to 50% in patients with renal impairment.
Because there was much individual variability in clearance between patients with renal impairment, individualization of dosage may be desirable in some patients. In patients undergoing hemodialysis, it is recommended that the total daily dose be reduced by 50% [s ee Dosage and Administration ]. Venlafaxine extended-release tablets, like all drugs effective in the treatment of major depressive disorder, should be used with caution in such patients.
Dosing in liver impairment
Patients with Hepatic Impairment In patients with cirrhosis of the liver, the clearances of venlafaxine and its active metabolite (ODV) were decreased, thus prolonging the elimination half-lives of these substances. A large degree of intersubject variability was noted [ see Clinical Pharmacology ]. A lower dose and individualization of dosing may be necessary [ see Dosage and Administration ].
Venlafaxine extended-release tablets, like all drugs effective in the treatment of major depressive disorder, should be used with caution in such patients.