Effexor XR® (venlafaxine extended release) FDA-APPROVED INDICATIONS Effexor XR is indicated for:
A. The treatment of Major Depressive Disorder (MDD). B. The treatment of Generalized Anxiety Disorder (GAD) as defined in DSM-IV. Anxiety or tension
associated with the stress of everyday life usually does not require treatment with an anxiolytic.
C. The treatment of Social Anxiety Disorder, also known as Social Phobia, as defined in DSM-IV
D. The treatment of panic disorder, with or without agoraphobia, as defined in DSM-IV.
COVERAGE POLICY Effexor XR is covered for members who meet the following criteria:
A. Have tried at least one SSRI, such as fluoxetine (Prozac*), paroxetine (Paxil*), citalopram
(Celexa*), sertraline (Zoloft*) or Lexapro (A trial of a generic SSRI is required before Lexapro is authorized for coverage).
DOSE Initial Treatment Major Depressive Disorder: For most patients, the recommended starting dose for Effexor XR is 75 mg/day, administered in a single dose. In the clinical trials establishing the efficacy of Effexor XR in moderately depressed outpatients, the initial dose of venlafaxine was 75 mg/day. For some patients, it may be desirable to start at 37.5 mg/day for 4 to 7 days, to allow new patients to adjust to the medication before increasing to 75 mg/day. Generalized Anxiety Disorder: For most patients, the recommended starting dose for Effexor XR is 75 mg/day, administered in a single dose. For some patients, it may be desirable to start at 37.5 mg/day for 4 to 7 days, to allow new patients to adjust to the medication before increasing to 75 mg/day. Certain patients not responding to the initial 75 mg/day dose may benefit from dose increases to a maximum of approximately 225 mg/day. Dose increases should be in increments of up to 75 mg/day, as needed, and should be made at intervals of not less than 4 days. Social anxiety disorder (social phobia): For most patients, the recommended starting dose for Effexor XR is 75 mg/day, administered in a single dose. In clinical trials establishing the efficacy of Effexor XR in outpatients with social anxiety disorder, the initial dose of Effexor XR was 75 mg/day and the maximum dose was 225 mg/day. For some patients, it may be desirable to start at 37.5 mg/day for 4 to 7 days to allow new patients to adjust to the medication before increasing to 75 mg/day. Certain patients not responding to the initial 75 mg/day dose may benefit from dose increases to a maximum of approximately 225 mg/day. Make dose increases in increments of up to 75 mg/day, as needed, and at intervals of no less than 4 days. Panic Disorder: It is recommended that initial single doses of 37.5 mg/day of Effexor XR be used for 7 days. In clinical trials establishing the efficacy of Effexor XR in outpatients with panic disorder, initial doses of 37.5 mg/day for 7 days were followed by doses of 75 mg/day and subsequent weekly dose increases of 75 mg/day to a maximum dose of 225 mg/day. Certain patients not responding to 75 mg/day may benefit from dose increases to a maximum of approximately 225 mg/day. Dose increases should be in increments of up to 75 mg/day, as needed, and should be made at intervals of not less than 7 days. *Generic Drug Available a-gamajor Page
Patients should be periodically reassessed to determine the need for maintenance treatment and the appropriate dose for such treatment. Maintenance Treatment There is no body of evidence available from controlled trials to indicate how long patients with major depressive disorder, Generalized Anxiety Disorder, Social Anxiety Disorder, or panic disorder, should be treated with Effexor XR. Quantity limit: 1 capsule/day for all strengths and generic equivalents. NON COVERAGE Effexor XR is NOT covered for members with the following criteria:
A. No trial of at least one SSRI. B. Patients taking concomitant MAOIs. C. Use in pediatrics.
REFERENCES
1. Effexor XR (venlafaxine extended-release) prescribing information. Wyeth Pharmaceuticals Inc.,
2007. http://www.wyeth.com/content/showlabeling.asp?id=100
*Generic Drug Available a-gamajor Page
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