Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.pleurisy rootMinor (1)pleurisy root decreases effects of venlafaxine by unspecified interaction mechanism. Minor/Significance Unknown. Theoretical interaction.posaconazoleContraindicated (1)posaconazole will increase the level or effect of venlafaxine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.Monitor Closely (1)posaconazole and venlafaxine both increase QTc interval. Use Caution/Monitor.pregabalinMonitor Closely (1)pregabalin, venlafaxine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.primaquineMonitor Closely (1)primaquine and venlafaxine both decrease QTc interval. Use Caution/Monitor.procainamideSerious - Use Alternative (1)procainamide and venlafaxine both increase QTc interval. Avoid or Use Alternate Drug.procarbazineContraindicated (1)procarbazine and venlafaxine both increase serotonin levels. Contraindicated. Combination is contraindicated within 2 weeks of MAOI use.prochlorperazineMonitor Closely (2)prochlorperazine and venlafaxine both increase QTc interval. Use Caution/Monitor. venlafaxine will increase the level or effect of prochlorperazine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.promazineMonitor Closely (1)promazine and venlafaxine both increase QTc interval. Modify Therapy/Monitor Closely.Minor (1)venlafaxine will increase the level or effect of promazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.promethazineMonitor Closely (1)promethazine and venlafaxine both increase QTc interval. Use Caution/Monitor.Serious - Use Alternative (1)venlafaxine will increase the level or effect of promethazine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.propafenoneMonitor Closely (1)venlafaxine will increase the level or effect of propafenone by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.propranololMonitor Closely (1)venlafaxine will increase the level or effect of propranolol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.protriptylineMonitor Closely (1)protriptyline and venlafaxine both increase QTc interval. Modify Therapy/Monitor Closely.Serious - Use Alternative (1)venlafaxine and protriptyline both increase serotonin levels. Avoid or Use Alternate Drug.pseudoephedrineSerious - Use Alternative (1)venlafaxine increases effects of pseudoephedrine by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug.quetiapineMonitor Closely (1)venlafaxine, quetiapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).quinidineSerious - Use Alternative (1)quinidine and venlafaxine both increase QTc interval. Avoid or Use Alternate Drug.ranolazineMonitor Closely (1)ranolazine and venlafaxine both increase QTc interval. Use Caution/Monitor.rasagilineSerious - Use Alternative (1)rasagiline and venlafaxine both increase serotonin levels. Avoid or Use Alternate Drug. Severe CNS toxicity associated with hyperpyrexia has been reported with the combined treatment of an antidepressant and rasagiline. Avoid combination within 14 days of MAOI use.remifentanilSerious - Use Alternative (1)venlafaxine and remifentanil both decrease serotonin levels. Avoid or Use Alternate Drug. May cause serotonin syndromeremimazolamMonitor Closely (1)remimazolam, venlafaxine. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely. Coadministration may result in profound sedation, respiratory depression, coma, and/or death. Continuously monitor vital signs during sedation and recovery period if coadministered. Carefully titrate remimazolam dose if administered with opioid analgesics and/or sedative/hypnotics.ribociclibSerious - Use Alternative (1)ribociclib will increase the level or effect of venlafaxine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.risperidoneMonitor Closely (3)venlafaxine, risperidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction). venlafaxine will increase the level or effect of risperidone by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. risperidone and venlafaxine both increase QTc interval. Use Caution/Monitor.ritonavirMonitor Closely (1)ritonavir increases levels of venlafaxine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Potential for increased toxicity. .rizatriptanMonitor Closely (1)rizatriptan and venlafaxine both increase serotonin levels. Modify Therapy/Monitor Closely.Minor (1)venlafaxine, rizatriptan. Mechanism: unknown. Minor/Significance Unknown. Risk of weakness, dyspnea, chest pain.rolapitantMonitor Closely (1)rolapitant will increase the level or effect of venlafaxine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Rolapitant may increase plasma concentrations of CYP2D6 substrates for at least 28 days following rolapitant administration.romidepsinMonitor Closely (1)romidepsin and venlafaxine both increase QTc interval. Use Caution/Monitor.rucaparibMonitor Closely (1)rucaparib will increase the level or effect of venlafaxine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Adjust dosage of CYP3A4 substrates, if clinically indicated.safinamideContraindicated (1)venlafaxine, safinamide. Either increases toxicity of the other by serotonin levels. Contraindicated. Concomitant use could result in life-threatening serotonin syndrome.salicylates (non-asa)Monitor Closely (1)venlafaxine, salicylates (non-asa). Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.salsalateMonitor Closely (1)venlafaxine, salsalate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.SAMeMonitor Closely (1)venlafaxine and SAMe both increase serotonin levels. Modify Therapy/Monitor Closely.saquinavirSerious - Use Alternative (1)saquinavir, venlafaxine. Either increases toxicity of the other by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. May increase risk for QT prolongation.selegilineContraindicated (1)selegiline and venlafaxine both increase serotonin levels. Contraindicated. At least 14 days should elapse between discontinuation of selegiline and initiation of treatment with a serotonergic drug.selegiline transdermalSerious - Use Alternative (1)selegiline transdermal and venlafaxine both increase serotonin levels. Avoid or Use Alternate Drug.serdexmethylphenidate/dexmethylphenidateMinor (1)serdexmethylphenidate/dexmethylphenidate increases effects of venlafaxine by decreasing metabolism. Minor/Significance Unknown.sertralineSerious - Use Alternative (2)sertraline and venlafaxine both increase serotonin levels. Avoid or Use Alternate Drug. sertraline and venlafaxine both decrease QTc interval. Avoid or Use Alternate Drug.sevofluraneSerious - Use Alternative (1)sevoflurane and venlafaxine both decrease QTc interval. Avoid or Use Alternate Drug.siponimodSerious - Use Alternative (1)siponimod and venlafaxine both decrease QTc interval. Avoid or Use Alternate Drug.sodium sulfate/potassium chloride/magnesium sulfate/polyethylene glycolMonitor Closely (1)venlafaxine, sodium sulfate/potassium chloride/magnesium sulfate/polyethylene glycol. Other (see comment). Use Caution/Monitor. Comment: Caution when bowel preps are used with drugs that cause SIADH or NSAIDs; increased risk for water retention or electrolyte imbalance.solifenacinMonitor Closely (1)solifenacin and venlafaxine both decrease QTc interval. Use Caution/Monitor.sotalolSerious - Use Alternative (1)sotalol and venlafaxine both increase QTc interval. Avoid or Use Alternate Drug.St John's WortSerious - Use Alternative (1)venlafaxine and St John's Wort both increase serotonin levels. Avoid or Use Alternate Drug.stiripentolMonitor Closely (1)stiripentol, venlafaxine. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Stiripentol is a CYP3A4 inhibitor and inducer. Monitor CYP3A4 substrates coadministered with stiripentol for increased or decreased effects. CYP3A4 substrates may require dosage adjustment.sufentanilSerious - Use Alternative (1)venlafaxine and sufentanil both decrease serotonin levels. Avoid or Use Alternate Drug. May cause serotonin syndromesufentanil SLMonitor Closely (1)sufentanil SL, venlafaxine. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment.sulfamethoxazoleMonitor Closely (1)sulfamethoxazole and venlafaxine both increase QTc interval. Use Caution/Monitor.sulfasalazineMonitor Closely (1)venlafaxine, sulfasalazine. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.sulindacMonitor Closely (1)venlafaxine, sulindac. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.sumatriptanMonitor Closely (1)sumatriptan and venlafaxine both increase serotonin levels. Modify Therapy/Monitor Closely.Minor (1)venlafaxine, sumatriptan. Mechanism: unknown. Minor/Significance Unknown. Risk of weakness, dyspnea, chest pain.sumatriptan intranasalMonitor Closely (1)sumatriptan intranasal and venlafaxine both increase serotonin levels. Modify Therapy/Monitor Closely.Minor (1)venlafaxine, sumatriptan intranasal. Mechanism: unknown. Minor/Significance Unknown. Risk of weakness, dyspnea, chest pain.sunitinibMonitor Closely (1)sunitinib and venlafaxine both decrease QTc interval. Use Caution/Monitor.tacrolimusMonitor Closely (1)tacrolimus and venlafaxine both decrease QTc interval. Use Caution/Monitor.tamoxifenMonitor Closely (1)venlafaxine decreases effects of tamoxifen by decreasing metabolism. Use Caution/Monitor. Inhibition of CYP2D6 metabolism to tamoxifen's active metabolite, endoxifen.tapentadolMonitor Closely (1)venlafaxine and tapentadol both increase serotonin levels. Modify Therapy/Monitor Closely.tazemetostatMonitor Closely (1)tazemetostat will decrease the level or effect of venlafaxine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.tecovirimatMonitor Closely (1)tecovirimat will decrease the level or effect of venlafaxine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Tecovirimat is a weak CYP3A4 inducer. Monitor sensitive CYP3A4 substrates for effectiveness if coadministered.tedizolidSerious - Use Alternative (1)tedizolid, venlafaxine. Either increases effects of the other by Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. both increase serotonin levels; increased risk of serotonin syndrome.telavancinMonitor Closely (1)telavancin and venlafaxine both increase QTc interval. Use Caution/Monitor.terbinafineMonitor Closely (1)terbinafine will increase the level or effect of venlafaxine by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Assess need to reduce dose of CYP2D6-metabolized drug.tetrabenazineSerious - Use Alternative (1)tetrabenazine and venlafaxine both decrease QTc interval. Avoid or Use Alternate Drug.thioridazineSerious - Use Alternative (2)thioridazine and venlafaxine both increase QTc interval. Avoid or Use Alternate Drug. venlafaxine will increase the level or effect of thioridazine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.thiothixeneMonitor Closely (1)venlafaxine, thiothixene. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).timololMonitor Closely (1)venlafaxine will increase the level or effect of timolol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.tipranavirMonitor Closely (2)tipranavir, venlafaxine. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. tipranavir will increase the level or effect of venlafaxine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.tolfenamic acidMonitor Closely (1)venlafaxine, tolfenamic acid. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.tolmetinMonitor Closely (1)venlafaxine, tolmetin. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.tolterodineMinor (1)venlafaxine will increase the level or effect of tolterodine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.toremifeneSerious - Use Alternative (1)venlafaxine and toremifene both increase QTc interval. Avoid or Use Alternate Drug. Concurrent use of toremifene with agents causing QT prolongation should be avoided. If concomitant use is required it's recommended that toremifene be interrupted. If interruption not possible, patients requiring therapy with a drug that prolongs QT should be closely monitored. ECGs should be obtained for high risk patients.torsemideMinor (1)torsemide, venlafaxine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Possible additive hyponatremia.tramadolMonitor Closely (1)venlafaxine and tramadol both increase serotonin levels. Modify Therapy/Monitor Closely.tranylcypromineContraindicated (1)tranylcypromine and venlafaxine both increase serotonin levels. Contraindicated.trazodoneMonitor Closely (1)trazodone and venlafaxine both increase QTc interval. Modify Therapy/Monitor Closely.Serious - Use Alternative (1)trazodone and venlafaxine both increase serotonin levels. Avoid or Use Alternate Drug.trifluoperazineMonitor Closely (3)venlafaxine, trifluoperazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction). trifluoperazine and venlafaxine both increase QTc interval. Modify Therapy/Monitor Closely. venlafaxine will increase the level or effect of trifluoperazine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.trimethoprimMonitor Closely (1)trimethoprim and venlafaxine both increase QTc interval. Use Caution/Monitor.trimipramineMonitor Closely (1)trimipramine and venlafaxine both increase QTc interval. Modify Therapy/Monitor Closely.Serious - Use Alternative (1)venlafaxine and trimipramine both increase serotonin levels. Avoid or Use Alternate Drug.tropisetronMonitor Closely (1)tropisetron and venlafaxine both increase QTc interval. Use Caution/Monitor.Minor (1)venlafaxine will increase the level or effect of tropisetron by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.tucatinibSerious - Use Alternative (1)tucatinib will increase the level or effect of venlafaxine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid concomitant use of tucatinib with CYP3A substrates, where minimal concentration changes may lead to serious or life-threatening toxicities. If unavoidable, reduce CYP3A substrate dose according to product labeling.valbenazineMonitor Closely (1)valbenazine and venlafaxine both decrease QTc interval. Use Caution/Monitor.valerianMonitor Closely (1)valerian and venlafaxine both increase sedation. Use Caution/Monitor.vilazodoneSerious - Use Alternative (1)venlafaxine, vilazodone. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. .vorapaxarMonitor Closely (1)venlafaxine, vorapaxar. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive antiplatelet effect may occur; SSRIs and SNRIs may cause platelet serotonin depletion .voriconazoleMonitor Closely