• Chest pain or have a fast heart rate

• Experience severe headaches or confusion

• Have worsening mood or thoughts of self-harm (thoughts and ideation of suicide)

• Seizures

Do not drive, use heavy machinery, or do anything that requires you to be alert.

Do not take over-the-counter anti-inflammatory drugs, such as aspirin, Advil, Motrin, ibuprofen. Taking these drugs with Venlafaxine raises the risk of bleeding. Tell your doctor right away if you notice any abnormal bleeding or bruising. 

Do Not Stop the Medication Suddenly:

Even when you feel better.

ALWAYS talk to your doctor before stopping Venlafaxine. Missing doses or stopping can cause discontinuation syndrome and worsen anxiety or depression. Take it at the same time every day for the best results.

Report Any Heart-Related or Mood Changes Immediately:

Tell your doctor if you feel chest pain, fast heart rate, or light-headedness. With a heart history, early reporting is essential for safety.

Avoid Alcohol and Limit Sedating Medications:

Combining Venlafaxine, alcohol, and zopiclone may intensify side effects like severe drowsiness, increased fall risk, and worsened depression and confusion. Avoid alcohol to reduce the risk of CNS depression or falls.

Stay Hydrated and Eat Well:

• Take Venlafaxine with food.

• Drink plenty of water daily—aim for at least 1 to 2 liters. Watch for signs of dehydration, such as dry mouth, dizziness, or dark urine.

• Eat Fiber-Rich Foods, such as whole grains, fruits, vegetables, and legumes, to help reduce constipation. A gentle fiber supplement may also be needed.

• Watch for appetite changes and track any significant shifts in appetite or weight. Let your healthcare provider know if you eat much less or more than usual.

Tips for Success

• Set a daily reminder to take your dose, drink water, eat well, and avoid alcohol and smoking.

• Speak to (or get in touch) a health care provider and mental health or addiction counsellor, including Substance Use Support Services, to reduce alcohol consumption and smoking. Access online support forums and Mental Health Counselling Programs or speak to your healthcare provider for mental health support.

• Keep a mood journal to track changes and share with your healthcare provider.

• Stay in touch with your support system—you are not alone.

• Nausea or dry mouth

• Feeling tired or dizzy

• Blurry vision or vision changes

• Headache

• Increased heart rate

• Trouble sleeping

• Increased sweating

*These symptoms are mild and should go away within a few days to weeks.

More severe side effects include:

• Cardiac - high blood pressure

• Mental Health - mania, trouble sleeping, worsen anxiety and depression

• Increased suicide risk

• Serotonin syndrome

• Increased risk of bleeding when taken with over-the-counter Anti-inflammatory drugs

• Discontinuation Syndrome

• Lung Disease - interstitial lung disease

Additional risks and side effects are associated with Smoking and Alcohol use and Drug-Drug Interactions (See Table 1 for interaction summary).

Alcohol can increase sedation and worsen CNS side effects like drowsiness, confusion, or dizziness. It can also interfere with SNRIs, such as Venlafaxine effectiveness, and liver metabolism, increasing toxicity risk.

Cigarette smoke contains compounds that activate liver enzymes, that break down a drug. Smoking can alter the metabolism of Venlafaxine by speeding up its break down, making it less effective at the prescribed dose. Additionally, Venlafaxine can cause inflammation of the lungs, called interstitial lung disease. Smoking can increase the risk of lung disease and reduce respiratory function and rate. Overall, smoking increases the strain on the heart, nervous system, and respiratory function, which is especially concerning given a cardiac history and use of other CNS-active drugs.

Together, both smoking and alcohol should be avoided to reduce the worsening of side effects and to ensure the benefits of Venlafaxine, including zopiclone and bisoprolol. Avoiding smoking and alcohol will also ensure functional safety, cardiac balance, reduced risk of lung infection and respiratory strain.

See Table 1 for an outline of drug-drug interaction and added negative effects of both alcohol consumption and smoking.

• Venlafaxine can cause drowsiness, dizziness, and impaired coordination, especially when starting the medication.

• Zopiclone is a sedative-hypnotic, used to help with sleep, and it enhances GABA activity, further suppressing CNS function.

Close monitoring is required for sleep quality (excessive daytime sleepiness) and energy levels.

Do not drive, use heavy machinery, or do anything that requires you to be alert until you know you can function normally. 

• Venlafaxine may increase blood pressure and heart rate, especially at higher doses.

• Bisoprolol, a beta-blocker, works to lower heart rate and blood pressure.

  
  

This combination requires monitoring of blood pressure, heart rate, and any signs of palpitations or chest pain due to medication dosage and usage, alcohol use, and male gender.

Be consistent to the daily dose and monitor any abrupt changes to the heart.

Close monitoring is needed for mood changes, abrupt mental health symptoms, and suicidal thoughts and ideation.

• Nausea

• Dry mouth

• Loss of appetite

• Constipation

• Vomiting

These symptoms can discourage adherence if not managed.

Venlafaxine can slow bowel motility, especially when combined with other CNS depressants like zopiclone or a low-fiber diet.

Substances like, alcohol can dehydrate the body, disrupt gut flora, and disrupt electrolytes balance (low sodium levels). Combined with Venlafaxine-induced sweating, dry mouth, or nausea, this can raise the risk of dehydration, blood pressure changes, kidney stain, and drug clearance.

Ensure adequate fluid intake.

Take Venlafaxine with food.

• dizziness

• nausea

• irritability

• shaking

• confusion

• tiredness

• restlessness

• nausea

• vomiting

• diarrhea

Given a history of stress, anxiety, and PTSD, sudden withdrawal could worsen one's mental condition and symptoms.

Although rare, this condition can be serious and life-threatening.

Get immediate help if you experience the following symptoms:

• Sweating, fever, or flushing

• Confusion

• Feeling agitated or restless

• Seeing or hearing unusual things

• Dizziness

• Fast or racing heartbeat

• Nausea, vomiting, or diarrhea

• Muscle twitching, stiffness, or tremor

• Seizures

To reduce risk of increase serotonin levels, avoid the following herbs:

• Ginkgo

• St John's Wort

Continue to inform your health care provider of any supplements.