FREQUENTLY ASKED QUESTIONS

EFFEXOR XR and other antidepressant medicines may cause serious side effects, including:

1. Suicidal thoughts or actions:
   • EFFEXOR XR and other antidepressant medicines may increase suicidal thoughts or actions in some children, teenagers, or young adults within the first few months of treatment or when the dose is changed
   • Depression or other serious mental illnesses are the most important causes of suicidal thoughts or actions
   • Watch for these changes and call your healthcare provider right away if you notice:
     • New or sudden changes in mood, behavior, actions, thoughts, or feelings, especially if severe
     • Pay particular attention to such changes when EFFEXOR XR is started or when the dose is changed

   Keep all follow-up visits with your healthcare provider and call between visits if you are worried about symptoms.

   Call your healthcare provider right away if you have any of the following symptoms, or call 911 if an emergency, especially if they are new, worse, or worry you:

   • attempts to commit suicide
   • acting on dangerous impulses
   • acting aggressive or violent
   • thoughts about suicide or dying
   • new or worse depression
   • new or worse anxiety or panic attacks
   • feeling agitated, restless, angry or irritable
   • trouble sleeping
   • an increase in activity or talking more than what is normal for you
   • other unusual changes in behavior or mood
   • visual problems
     • eye pain
     • changes in vision
     • swelling or redness in or around the eye

   Only some people are at risk for these problems. You may want to undergo an eye examination to see if you are at risk and receive preventative treatment if you are.

   Call your healthcare provider right away if you have any of the following symptoms, or call 911 if an emergency. EFFEXOR XR may be associated with these serious side effects:

2. Serotonin Syndrome

   This condition can be life-threatening and may include:

   • agitation, hallucinations, coma or other changes in mental status
   • coordination problems or muscle twitching (overactive reflexes)
   • racing heartbeat, high or low blood pressure
   • sweating or fever
   • nausea, vomiting, or diarrhea
   • muscle rigidity

3. Changes in blood pressure. EFFEXOR XR may:

   • increase your blood pressure. Control high blood pressure before starting treatment and monitor blood pressure regularly
4. Enlarged pupils (mydriasis).
5. Anxiety and insomnia.
6. Changes in appetite or weight.
7. Manic/hypomanic episodes:
   • greatly increased energy
   • severe trouble sleeping
   • racing thoughts
   • reckless behavior
   • unusually grand ideas
   • excessive happiness or irritability
   • talking more or faster than usual
8. Low salt (sodium) levels in the blood. Elderly people may be at greater risk for this. Symptoms may include:
   • headache
   • weakness or feeling unsteady
   • confusion, problems concentrating or thinking or memory problems
9. Seizures or convulsions.
10. Abnormal bleeding: EFFEXOR XR and other antidepressant medicines may increase your risk of bleeding or bruising, especially if you take the blood thinner warfarin (Coumadin^®, Jantoven^®), a non-steroidal anti-inflammatory drug (NSAIDs, like ibuprofen or naproxen), or aspirin.
11. Elevated cholesterol.
12. Lung disease and pneumonia: EFFEXOR XR may cause rare lung problems. Symptoms include:
    • worsening shortness of breath
    • cough
    • chest discomfort
13. Severe allergic reactions:
    • trouble breathing
    • swelling of the face, tongue, eyes or mouth
    • rash, itchy welts (hives) or blisters, alone or with fever or joint pain
14. Sexual Problems (dysfunction). Taking serotonin and norepinephrine reuptake inhibitors (SNRIs), including EFFEXOR XR, may cause sexual problems.

    Symptoms in males may include:

    • delayed ejaculation or inability to have an ejaculation
    • decreased sex drive
    • problems getting or keeping an erection

    Symptoms in females may include:

    • decreased sex drive
    • delayed orgasm or inability to have an orgasm

    Talk to your healthcare provider if you develop any changes in your sexual function or if you have any questions or concerns about sexual problems during treatment with EFFEXOR XR. There may be treatments your healthcare provider can suggest.

    Do not stop EFFEXOR XR without first talking to your healthcare provider. Stopping EFFEXOR XR too quickly or changing from another antidepressant too quickly may cause serious symptoms including (in some patients these symptoms can be severe and last for a long time):

    • anxiety, irritability, aggressiveness, violent behavior
    • feeling tired, restless or problems sleeping
    • headache, sweating, dizziness
    • electric shock-like sensations, shaking, confusion, nightmares
    • vomiting, nausea, diarrhea
    • problems with eyesight such as blurred vision or trouble focusing
    • increased blood pressure

Here are 3 suggested tips to help make sure you receive brand-name EFFEXOR XR and not a generic:

1. At your doctor’s office: Ask your doctor to prescribe brand-name EFFEXOR XR and to indicate “DAW” (Dispense As Written)—or the language used in your state—on all of your EFFEXOR XR prescriptions.
2. At your pharmacy’s drop-off: Tell the pharmacist that you want brand-name EFFEXOR XR—and be sure to use the EFFEXOR XR Savings Card. The EFFEXOR XR Savings Card can only be used with brand-name EFFEXOR XR.
3. At your pharmacy’s pick-up: Check your pills to be sure they’re brand-name EFFEXOR XR—not the generic—and also check that you’ve saved on your prescription.

Talk to your doctor and/or your pharmacist to ask if you should be getting brand-name EFFEXOR XR. For tips on having that conversation, download the Pharmacy Tip Sheet.

Check your pills for the distinctive shape and markings of brand-name EFFEXOR XR.

The EFFEXOR XR Savings Card allows eligible patients to pay as little as $4 every time they get a 30-day fill of brand-name EFFEXOR XR—and could save up to $1,800 a year. If you have a prescription for brand-name EFFEXOR XR, you can use the card for every fill through December 31, 2023.*

*Terms and conditions apply.

There are 2 ways to use the card immediately. Once you’ve activated your Savings Card, you can either:

• Bring a printed copy of it to the pharmacy
• Show it to your pharmacist on your phone

You can keep this card with you and continue to save on each fill for EFFEXOR XR through December 31, 2023.

To be eligible to use an EFFEXOR XR Savings Card, you must:

• Be 18 years of age or older
• Not be covered by Medicare, Medicaid, or any other federal or state healthcare programs

To learn the full details of who is eligible, please see the full Terms and Conditions.

To get a Savings Card, register here and then download your card or have it sent to you via mail, email, or text.

You can activate your Savings Card here.

Yes. We’ll reimburse you for the cost of your prescription over and above your eligible cost. Simply pay for your EFFEXOR XR prescription and mail a copy of your original pharmacy receipt (cash register receipt NOT valid) with product name, date, and amount circled to:

EFFEXOR XR Savings Offer
2250 Perimeter Park Drive, Suite 300
Morrisville, NC 27560

Please be sure to include a copy of the front of your EFFEXOR XR Savings Card, your name, and your mailing address. All rebate submissions will be processed within 10 to 14 business days of the date we receive your information.

EFFEXOR XR should be taken exactly as prescribed. Your doctor may need to adjust your dosage of EFFEXOR XR until the right dose is established for you; do not change your dose without consulting your physician.

• Take a single dose of EFFEXOR XR with food at about the same time every day, in the morning or in the evening
• The capsule should be swallowed whole; it should not be divided, crushed, chewed, or placed in water
• It can also be administered by carefully opening the capsule and sprinkling its contents onto a spoonful of applesauce. This mixture should be swallowed immediately, without chewing, and followed by a glass of water

If you have questions about taking your medication, adjusting your daily dose, or discontinuing treatment with EFFEXOR XR, speak with your doctor.

It is important to take EFFEXOR XR every day according to your doctor's instructions. If you miss a dose or abruptly decrease your dosage without your doctor's approval, there is a chance that you may experience “discontinuation symptoms.” This term describes the symptoms that may occur when a person suddenly stops or quickly lowers his or her daily dose of an antidepressant.

In some patients these symptoms can be severe and last for a long time. Symptoms my include:

• anxiety, irritability, aggressiveness, violent behavior
• feeling tired, restless or problems sleeping
• headache, sweating, dizziness
• electric shock-like sensations, shaking, confusion, nightmares
• vomiting, nausea, diarrhea
• problems with eyesight such as blurred vision or trouble focusing
• increased blood pressure

Do not stop EFFEXOR XR without first talking to your healthcare provider. When people suddenly stop using or quickly lower their daily dose of EFFEXOR XR, serious discontinuation symptoms may occur and in some patients these symptoms can be severe and last for a long time.

If you and your doctor have made the decision to discontinue treatment, gradually reducing the dose is recommended rather than abruptly stopping your medication. To successfully taper you off treatment with EFFEXOR XR and avoid discontinuation symptoms, your physician should slowly decrease your daily dose and carefully monitor you for symptoms.

You should take EFFEXOR XR at about the same time every day. However, if you miss a dose, take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and take your next dose at the regularly scheduled time. Do not take 2 doses of EFFEXOR XR at the same time.

If you take too much EFFEXOR XR, call your doctor or poison control center or seek emergency treatment immediately.

It is important to be aware of the possible side effects when taking any medication. Be sure to tell your doctor if you experience any side effects. Please see additional warnings and Important Safety Information at right.

In clinical studies, the most common side effects with EFFEXOR XR were:

• Unusual dreams
• Sexual problems
• Loss of appetite, constipation, diarrhea, nausea or vomiting, or dry mouth
• Feeling tired, fatigued, or overly sleepy
• Change in sleep habits, problems sleeping
• Yawning
• Tremor or shaking
• Dizziness, blurred vision
• Sweating
• Feeling anxious, nervous, or jittery
• Headache
• Increase in heart rate

• See "What is the most important information I should know about EFFEXOR XR?" in the Medication Guide
• Increased cholesterol–have your cholesterol checked regularly
• Newborns whose mothers take EFFEXOR XR in the third trimester may have problems right after birth including:
  • problems feeding and breathing
  • seizures
  • shaking, jitteriness or constant crying
• Angle-closure glaucoma