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Licensed to fill prescriptions for patients in RI, MA, CT, NJ, NH, FL, ME and PA. New York patients are served on a limited basis while nonresident registration is pending.
Prepared to a prescriber's order for one patient. Not FDA-approved.
Venlafaxine is a serotonin and norepinephrine reuptake inhibitor (SNRI) antidepressant that compounding pharmacies prepare as oral capsules and liquids in individualized strengths.
Venlafaxine is an SNRI. It raises serotonin and norepinephrine in the brain by blocking their reuptake, acting mostly on serotonin at lower doses and on both at higher doses. Its major active metabolite is O-desmethylvenlafaxine. Manufactured products include Effexor XR extended-release capsules (Viatris) and generic immediate-release tablets, extended-release capsules and extended-release tablets. Effexor XR is FDA-approved for adults with major depressive disorder, generalized anxiety disorder, social anxiety disorder and panic disorder; it is not approved for children. Prescribers may order venlafaxine compounded when a patient needs a strength below or between manufactured ones for a slow taper, an oral liquid, or a capsule free of a specific dye or filler. Compounded preparations are not FDA-approved and require a prescription.
Venlafaxine carries the FDA boxed warning "Suicidal Thoughts and Behaviors": antidepressants increased the risk of suicidal thoughts and behavior in children, adolescents and young adults, so watch for worsening mood or thoughts of self-harm, especially early in treatment and after dose changes. Do not take it with an MAOI, linezolid or intravenous methylene blue, or within 14 days of stopping an MAOI, and wait at least 7 days after stopping venlafaxine before starting an MAOI. Venlafaxine can raise blood pressure and heart rate, and the label also warns of serotonin syndrome, bleeding, angle-closure glaucoma, mania, seizures, low sodium, lung inflammation and sexual dysfunction. Stopping abruptly can cause dizziness, nausea and electric-shock sensations, so doses are tapered. Third-trimester use can cause temporary newborn adaptation problems, and later-pregnancy exposure has been linked to preeclampsia and postpartum hemorrhage. Venlafaxine and its metabolite pass into breast milk; serious infant effects are rare, but watch newborns for sedation. If side effects are severe or persist, talk to your prescriber or pharmacist.
Venlafaxine inhibits neuronal serotonin and norepinephrine reuptake, with serotonergic effects predominant at lower doses and noradrenergic effects added at higher doses; the label states the mechanism in MDD, GAD, SAD and PD is unclear but thought to relate to potentiation of both monoamines in the CNS. Absorption is about 92 percent with bioavailability near 45 percent; protein binding is low at 27 to 30 percent; CYP2D6 forms the active metabolite O-desmethylvenlafaxine, CYP3A inhibitors raise levels of both, and venlafaxine itself raises exposure to CYP2D6 substrates; immediate-release half-life is about 5 hours for venlafaxine and about 11 hours for O-desmethylvenlafaxine, steady state is reached within 3 days, and the label calls for dose reduction in renal and hepatic impairment. Labeled indications (Effexor XR, Viatris, revised 8/2023): MDD, GAD, SAD and panic disorder in adults. Prescribers have ordered venlafaxine off-label for vasomotor hot flashes, diabetic neuropathy and other pain syndromes, migraine prophylaxis, PTSD, OCD and PMDD (StatPearls; MedlinePlus lists hot flashes); compounded low-strength capsules and liquids let them individualize titration and tapers. Dosing per prescriber. Monitoring: blood pressure and heart rate, suicidality and mood, sodium, bleeding risk, and depression scales such as PHQ-9 or MADRS. Venlafaxine is not a controlled substance (label section 9.1).
Shake the bottle if your label says to. Measure each dose with the oral syringe or dosing cup the pharmacy gave you, never a kitchen spoon. Give the liquid slowly into the mouth. Rinse the syringe with water after each use. Call the pharmacy if you are unsure how to measure.
Storage depends on the vehicle. Water-based liquids with a preservative usually carry a USP <795> beyond-use date of up to 35 days; without a preservative they are kept refrigerated for up to 14 days. Oil-based (nonaqueous) oral liquids may carry up to 90 days. Your label states whether to refrigerate and the beyond-use date. Keep out of reach of children and discard after that date.
This formulation is compounded by Bayview Pharmacy on a prescriber's order for an individual patient. It is not an FDA-approved drug product, and the FDA has not evaluated it for safety, effectiveness, or manufacturing quality.
A valid prescription is required. Availability depends on Bayview's licensure in your state. This page is general information, not medical advice. Discuss your situation with a licensed healthcare provider.
Search by NCPDP 4106882, or by name and ZIP: Bayview Pharmacy, Warwick, RI 02886. Select it as the destination pharmacy and save it as a favorite. Click any value to copy it.
Compounded preparations have no NDC, so this formula will not appear in your EHR's drug search. Use your system's compound, non-formulary, or free-text prescription entry and name the preparation exactly as written in step 3. If your EHR forces you to pick a listed drug, pick the closest entry for the active ingredient and put the full formula in the prescription body (the Sig or directions field), not in Notes to Pharmacy.
Compounded preparations have no NDC and will not appear in your drug search. For EPCS to validate, select a drug entry your EHR recognizes as controlled, usually the bulk powder entry for the active ingredient (for example Ketamine (bulk) powder, not a branded product), then put the full formula from step 3 in the prescription body. A free-text entry that does not validate as controlled will be rejected by your EPCS module.
Quantity and directions are starting points for this dose form, not treatment recommendations. Dosing remains the prescriber's responsibility.
Transmit from your EHR. For this non-controlled preparation we also accept fax to (401) 284-4506 and phoned orders at (401) 284-4505. Order forms are on the formulation pages and in the prescriber portal.
Transmit with two-factor authentication through your EPCS-enabled EHR. No order form is offered for this preparation; e-prescribing guides for our controlled preparations are on the formulation pages.
Licensed to dispense in RI, MA, CT, NJ, NH, FL, ME, and PA; New York is served on a limited basis while nonresident registration is pending. Compounded preparations are not FDA-approved. A valid prescription is required. Full guide, including steps by EHR: How to e-prescribe to Bayview. Questions about this formula: call (401) 284-4505.
Take orally
