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VANDRAL RETARD 225 mg PROLONGED-RELEASE HARD CAPSULE

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About the medicine

How to use VANDRAL RETARD 225 mg PROLONGED-RELEASE HARD CAPSULE

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This page provides general information and does not replace a doctor’s consultation. Always consult a doctor before taking any medication. Seek urgent medical care if symptoms are severe.

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Introduction

Package Leaflet: Information for the User

Vandral Retard 75 mg prolonged-release hard capsules

Vandral Retard 150 mg prolonged-release hard capsules

Vandral Retard 225 mg prolonged-release hard capsules

venlafaxine

Doctor consultation

Not sure if this medicine is right for you?

Discuss your symptoms and treatment with a doctor online.

Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.

  • Keep this leaflet, you may need to read it again.
  • If you have any further questions, ask your doctor or pharmacist.
  • This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.
  • If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.

Contents of the pack and other information

  1. What is Vandral Retard and what is it used for
  2. What you need to know before you take Vandral Retard
  3. How to take Vandral Retard
  4. Possible side effects
  5. Storing Vandral Retard
  6. Pack contents and further information
Medicine questions

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1. What is Vandral Retard and what is it used for

Vandral Retard contains the active substance venlafaxine.

Vandral Retard is an antidepressant that belongs to a group of medicines called serotonin and norepinephrine reuptake inhibitors (SNRIs). This group of medicines is used to treat depression and other conditions such as anxiety disorders. It is not fully understood how antidepressants work, but they may help to increase the levels of serotonin and norepinephrine in the brain.

Vandral Retard is a treatment for adults with depression. It is also a treatment for adults with the following anxiety disorders: generalized anxiety disorder, social anxiety disorder (fear or avoidance of social situations), panic disorder (panic attacks). Treating depression and anxiety disorders properly is important to help you feel better. If left untreated, your condition may not improve or may get worse and become more difficult to treat.

2. What you need to know before you take Vandral Retard

Do not take Vandral Retard

  • If you are allergic to venlafaxine or any of the other ingredients of this medicine (listed in section 6).
  • If you are also taking, or have taken within the last 14 days, any medicines known as irreversible monoamine oxidase inhibitors (MAOIs) used to treat depression or Parkinson’s disease. Taking an irreversible MAOI with Vandral Retard can cause serious or even life-threatening side effects. Also, you must wait at least 7 days after stopping Vandral Retard before taking any MAOI (see also the section “Taking Vandral Retard with other medicines” and the information in that section about “Serotonin Syndrome”).

Warnings and precautions

Consult your doctor or pharmacist beforestarting treatment with Vandral Retard:

  • If you are taking other medicines that, when taken with Vandral Retard, could increase the risk of developing serotonin syndrome (see the section “Taking Vandral Retard with other medicines”).
  • If you have eye problems, such as certain types of glaucoma (increased pressure in the eye).
  • If you have a history of high blood pressure.
  • If you have a history of heart problems.
  • If you have been told you have an irregular heartbeat.
  • If you have a history of seizures (fits).
  • If you have a history of low sodium levels in your blood (hyponatremia).
  • If you have a history of bleeding disorders (tendency to develop bruises or tend to bleed easily), or if you are using other medicines that may increase the risk of bleeding, e.g. warfarin (used to prevent blood clots), or if you are pregnant (see section Pregnancy, breastfeeding and fertility).
  • If you have a history of, or if someone in your family has had, mania or bipolar disorder (feeling overexcited or elated).
  • If you have a history of aggressive behavior.

Vandral Retard may cause a feeling of restlessness or difficulty sitting or standing still during the first few weeks of treatment. You should consult your doctor if this happens to you.

Do not drink alcohol while being treated with Vandral Retard, as it may cause extreme drowsiness and unconsciousness. Taking Vandral Retard with certain medicines or alcohol may worsen the symptoms of depression and other conditions, such as anxiety disorders.

Thoughts of suicide and worsening of your depression or anxiety disorder

If you are depressed and/or have an anxiety disorder, you may sometimes have thoughts of harming or killing yourself. These thoughts may be more frequent when you first start taking antidepressants, as all these medicines take time to work, usually about 2 weeks, but sometimes longer. These thoughts may also occur when your dose is reduced or when you stop taking Vandral Retard.

This is more likely to happen:

  • If you have previously had thoughts of suicide or harming yourself.
  • If you are a young adult. Information from clinical trials has shown an increased risk of suicidal behavior in adults aged less than 25 years with psychiatric conditions who were treated with an antidepressant.

If you have thoughts of harming or killing yourself at any time, contact your doctor or go to a hospital straight away.

You may find it helpful to tell a relative or close friend that you are depressed or have an anxiety disorder and ask them to read this leaflet. You might ask them to tell you if they think your depression or anxiety is getting worse, or if they are worried about changes in your behavior.

Dry mouth

Dry mouth has been reported in 10% of patients treated with venlafaxine. This may increase the risk of tooth decay (caries). Therefore, you should be careful with your dental hygiene.

Diabetes

Your blood glucose levels may be altered by Vandral Retard. Therefore, the doses of your diabetes medicines may need to be adjusted.

Sexual problems

Some medicines of the same group as Vandral Retard (called SNRIs) may cause symptoms of sexual dysfunction (see section 4). In some cases, these symptoms have persisted after stopping treatment.

Children and adolescents

Vandral Retard should not normally be used in the treatment of children and adolescents under 18 years of age. Also, you should know that in patients under 18 years of age, there is an increased risk of side effects such as suicide attempt, suicidal thoughts, and hostility (predominantly aggression, confrontation, and irritability) when they take this class of medicines. Despite this, your doctor may prescribe this medicine to patients under 18 years of age when he decides that it is the best option for the patient. If your doctor has prescribed this medicine to a patient under 18 years of age and you want to discuss this, please go back to your doctor. You should inform your doctor if any of the above symptoms occur or worsen when these patients under 18 years of age are taking Vandral Retard.

Furthermore, long-term safety data on growth, maturation, and cognitive and behavioral development in children and adolescents treated with SNRIs are not available.

Taking Vandral Retard with other medicines

Tell your doctor or pharmacist if you are taking or have recently taken or might take any other medicines.

Your doctor will decide whether you can take Vandral Retard with other medicines.

Do not start or stop taking any medicines, including those bought without a prescription, herbal or plant-based remedies, before checking with your doctor or pharmacist.

  • Irreversible monoamine oxidase inhibitors used to treat depression or Parkinson’s disease must not be taken with Vandral Retard. Tell your doctor if you have taken any of these medicines in the last 14 days. (MAOI: see section “What you need to know before you take Vandral Retard”).
  • Serotonin Syndrome:

A potentially life-threatening condition, or reactions similar to Neuroleptic Malignant Syndrome (NMS) (see section “Possible side effects”) may occur with venlafaxine treatment, particularly when taken with other medicines.

Examples of these medicines include:

  • Triptans (used for migraine)
  • Other medicines for treating depression, for example, SNRIs, SSRIs, tricyclic antidepressants, or medicines containing lithium
  • Medicines containing amphetamines (used to treat attention deficit hyperactivity disorder (ADHD), narcolepsy, and obesity)
  • Medicines containing the antibiotic linezolid (used to treat infections)
  • Medicines containing moclobemide, an MAOI (used to treat depression)
  • Medicines containing sibutramine (used for weight loss)
  • Medicines containing opioids (e.g. buprenorphine, tramadol, fentanyl, tapentadol, pethidine, or pentazocine) used to treat severe pain
  • Medicines containing dextromethorphan (used to treat cough)
  • Medicines containing methadone (used for opioid addiction treatment or for severe pain treatment)
  • Medicines containing methylene blue (used to treat high levels of methemoglobin in the blood)
  • Products containing St. John’s Wort (also known as Hypericum perforatum, a herbal or plant-based remedy used to treat mild depression)
  • Products containing tryptophan (used for problems such as sleep and depression)
  • Antipsychotics (used to treat a disease with symptoms such as hearing, seeing, or feeling things that do not exist, mistaken beliefs, unusual suspicion, unclear reasoning, and a tendency to withdraw)

The signs and symptoms of serotonin syndrome may include a combination of the following:

restlessness, hallucinations, loss of coordination, rapid heartbeat, increased body temperature, rapid changes in blood pressure, overactive reflexes, diarrhea, coma, nausea, vomiting.

In its most severe form, serotonin syndrome can resemble Neuroleptic Malignant Syndrome (NMS). The signs and symptoms of NMS may include a combination of fever, rapid heartbeat, sweating, severe muscle stiffness, confusion, increased muscle enzymes (determined by a blood test).

Tell your doctor immediately or go to the casualty department of the nearest hospital if you think you are experiencing serotonin syndrome.

Tell your doctor if you are taking medicines that may affect your heart rhythm.

Some examples of these medicines include:

  • Anti-arrhythmics such as quinidine, amiodarone, sotalol, or dofetilide (used to treat irregular heartbeat)
  • Antipsychotics such as thioridazine (see also serotonin syndrome above)
  • Antibiotics such as erythromycin or moxifloxacino (used to treat bacterial infections)
  • Antihistamines (used to treat allergies)

The following medicines may also interact with Vandral Retard and should be used with caution. It is especially important to mention to your doctor or pharmacist if you are taking medicines containing:

  • Ketoconazole (an antifungal medicine).
  • Haloperidol or risperidone (for treating psychiatric conditions).
  • Metoprolol (a beta-blocker for treating high blood pressure and heart problems).

Taking Vandral Retard with food, drinks, and alcohol

Vandral Retard should be taken with food (see section 3 “How to take Vandral Retard”).

Do not drink alcohol during treatment with Vandral Retard. Drinking alcohol while taking Vandral Retard may cause extreme drowsiness and unconsciousness, and may worsen the symptoms of depression and other conditions, such as anxiety disorders.

Pregnancy, breastfeeding, and fertility

If you are pregnant or breastfeeding, think you may be pregnant, or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine. You should only take Vandral Retard after discussing the potential benefits and risks with your doctor.

Make sure your midwife and/or doctor knows you are taking Vandral Retard. When similar medicines (SSRIs) are taken during pregnancy, they may increase the risk of a serious condition in babies, called persistent pulmonary hypertension of the newborn (PPHN), which makes the baby breathe faster and turn blue. These symptoms usually start during the first 24 hours after the baby is born. If this happens to your baby, you must contact your midwife and/or doctor immediately.

If you take Vandral Retard during the late stage of pregnancy, there may be an increased risk of heavy vaginal bleeding shortly after delivery, especially if you have a history of bleeding disorders. Your doctor or midwife should know that you are taking Vandral Retard so they can advise you.

If you are taking this medicine during pregnancy, in addition to breathing problems, another symptom your baby may have when born is feeding problems. If your baby has these symptoms when born and you are concerned, contact your doctor and/or midwife who can advise you.

Vandral Retard passes into breast milk. There is a risk of an effect on the baby. Therefore, you should discuss this with your doctor and he will decide whether you should stop breastfeeding or stop treatment with this medicine.

Driving and using machines

Do not drive or use tools or machines until you know how this medicine affects you.

Vandral Retard contains sodium

Vandral Retard 150 mg and 225 mg capsules contain less than 23 mg of sodium (1mmol) per capsule; this is, essentially, “sodium-free”.

3. How to take Vandral Retard

Follow exactly the administration instructions given by your doctor. If you are unsure, ask your doctor or pharmacist.

The usual recommended starting dose for the treatment of depression, generalized anxiety disorder, and social anxiety disorder is 75 mg once daily. Your doctor may gradually increase the dose and, if necessary, up to a maximum of 375 mg per day for depression. If you are being treated for panic disorder, your doctor will start you on a lower dose (37.5 mg) and then gradually increase the dose. The maximum dose for generalized anxiety disorder, social anxiety disorder, and panic disorder is 225 mg/day.

Take Vandral Retard at approximately the same time each day, either in the morning or in the evening. The capsules should be swallowed whole with fluid and should not be opened, crushed, chewed, or dissolved.

Vandral Retard should be taken with food.

If you have liver or kidney problems, talk to your doctor, as you may need a different dose of this medicine.

Do not stop taking this medicine without talking to your doctor (see the section “If you stop taking Vandral Retard”).

If you take more Vandral Retard than you should

In case of overdose or accidental ingestion, contact your doctor, pharmacist, or call the Toxicology Information Service, telephone 91 562 04 20, indicating the medicine and the amount taken.

Overdose can put your life in danger, especially when taken with certain medicines and/or alcohol (see Taking Vandral Retard with other medicines).

The symptoms of a possible overdose may include palpitations, changes in the level of consciousness (ranging from drowsiness to coma), blurred vision, seizures or fits, and vomiting.

If you forget to take Vandral Retard

If you miss a dose, take it as soon as you remember. However, if it is already the time for your next dose, skip the missed dose and take only a single dose as usual. Do not take a double dose to make up for forgotten doses. Do not take more than the daily dose of Vandral Retard that has been prescribed for you in one day.

If you stop taking Vandral Retard

Do not stop taking your treatment or reduce the dose without the advice of your doctor, even if you feel better. If your doctor thinks you no longer need Vandral Retard, he may ask you to reduce the dose gradually before stopping treatment completely. It is known that side effects occur when people stop using this medicine, especially when it is stopped abruptly or the dose is reduced too quickly. Some patients may experience symptoms such as suicidal thoughts, aggression, tiredness, dizziness, unsteadiness, headache, insomnia, nightmares, dry mouth, loss of appetite, nausea, diarrhea, nervousness, agitation, confusion, ringing in the ears, tingling, or, in rare cases, sensations of electric shock, weakness, sweating, seizures, or symptoms similar to flu, vision problems, and increased blood pressure (which may cause headache, dizziness, ringing in the ears, sweating, etc.).

Your doctor will advise you how to gradually stop taking Vandral Retard. This may take several weeks or months. In some patients, the withdrawal may need to be very gradual over several months or more. If you experience any of these or other symptoms that are troublesome for you, consult your doctor for advice.

If you have any further questions on the use of this medicine, ask your doctor or pharmacist.

4. Possible Adverse Effects

Like all medicines, this medicine can cause adverse effects, although not all people suffer from them.

If any of the following effects occur, do not take more Vandral Retard. Tell your doctor immediately, or go to the emergency room of the nearest hospital:

Uncommon (may affect up to 1 in 100 people)

  • Swelling of the face, mouth, tongue, throat, hands, or feet, and/or swollen rash with itching, difficulty swallowing or breathing.

Rare (may affect up to 1 in 1,000 people)

  • Chest oppression, breathing noise, difficulty swallowing or breathing.
  • Severe skin rash, itching, or hives (elevated areas of reddened or pale skin that often itch).
  • Signs and symptoms of serotonin syndrome that may include agitation, hallucinations, loss of coordination, rapid heartbeat, increased body temperature, rapid changes in blood pressure, hyperactive reflexes, diarrhea, coma, nausea, vomiting.

In its most severe form, serotonin syndrome can resemble neuroleptic malignant syndrome (NMS). The signs and symptoms of NMS may include a combination of fever, rapid heartbeat, sweating, severe muscle stiffness, confusion, increased muscle enzymes (determined by a blood test).

  • Signs of infection, such as increased temperature, chills, shivering, headache, sweating, or flu-like symptoms. This may be due to a blood disorder that can lead to an increased risk of infection.
  • Severe rash, which can lead to the formation of severe blisters and skin peeling.
  • Unexplained muscle pain, discomfort, or weakness. This may be a sign of rhabdomyolysis.

Frequency not known (cannot be estimated from the available data)

  • Signs and symptoms of a condition called "stress cardiomyopathy" that may include chest pain, difficulty breathing, dizziness, fainting, irregular heartbeats.

Other adverse effects that you should inform your doctor aboutare (the frequency of these adverse effects is included in the list below "other adverse effects that may occur"):

  • Cough, breathing noise, and difficulty breathing that may be accompanied by a high temperature.
  • Stools (deposits) with tar or blood in stools.
  • Itching, yellow eyes or skin, dark urine, which are symptoms of liver inflammation (hepatitis).
  • Heart problems, such as rapid or irregular heartbeat, increased blood pressure.
  • Eye problems, such as blurred vision, dilated pupils.
  • Nerve problems, such as dizziness, tingling, movement disorder (muscle spasms and stiffness), convulsions, or seizures.
  • Psychiatric problems, such as hyperactivity (unusual feeling of overexcitement).
  • Withdrawal effects (see section "How to take Vandral Retard, if you interrupt treatment with Vandral Retard").
  • Prolonged bleeding, if you cut or injure yourself, it may take a little longer than usual for the bleeding to stop.

Do not worry if you notice small white balls or granules in your stools after taking this medicine. Inside the Vandral Retard capsules, there are spheroids (small white balls) that contain the active ingredient (venlafaxine). These spheroids are released from the capsule in the stomach. As they circulate through the stomach and intestines, venlafaxine is slowly released. The "shell" of the spheroid does not dissolve and is eliminated in the stools. Therefore, even if you see spheroids in the stools, the dose of the medicine has been absorbed.

Other Adverse Effects that May Occur

Very Common (may affect more than 1 in 10 people)

  • Dizziness, headache, drowsiness.
  • Insomnia.
  • Nausea, dry mouth, constipation.
  • Excessive sweating (including night sweats).

Common (may affect up to 1 in 10 people)

  • Decreased appetite.
  • Confusion, feeling strange, lack of orgasm, decreased libido, agitation, nervousness, abnormal dreams.
  • Tremors, a feeling of restlessness or inability to remain seated or still, tingling, altered taste perception, increased muscle tone.
  • Visual disturbances including blurred vision, dilated pupils, inability of the eye to automatically change focus from distant to near objects.
  • Ringing in the ears (tinnitus).
  • Rapid heartbeat, palpitations.
  • Increased blood pressure, hot flashes.
  • Difficulty breathing, yawning.
  • Vomiting, diarrhea.
  • Mild skin rash, itching.
  • Increased urination frequency, inability to urinate, difficulty urinating.
  • Menstrual irregularities, such as increased bleeding or irregular bleeding, abnormal ejaculation/orgasm (males), erectile dysfunction (impotence).
  • Weakness (asthenia), fatigue, chills.
  • Weight gain or loss.
  • Increased cholesterol.

Uncommon (may affect up to 1 in 100 people)

  • Hyperactivity, accelerated thoughts, and decreased need for sleep (mania).
  • Hallucinations, feeling detached from reality, abnormal orgasm, lack of feelings or emotions, feeling overexcited, teeth grinding.
  • Fainting, involuntary muscle movements, altered coordination and balance.
  • Feeling dizzy (especially when getting up too quickly), decreased blood pressure.
  • Vomiting blood, black stools, or blood in stools, which may be a sign of internal bleeding.
  • Sensitivity to sunlight, bruising, abnormal hair loss.
  • Inability to control urination.
  • Stiffness, spasms, and involuntary muscle movements.
  • Mild changes in blood levels of liver enzymes.

Rare (may affect up to 1 in 1,000 people)

  • Seizures or fits.
  • Cough, breathing noise, and shortness of breath that may be accompanied by a high temperature.
  • Disorientation and confusion often accompanied by hallucinations (delirium).
  • Excessive water intake (known as SIADH).
  • Decreased sodium levels in the blood.
  • Severe eye pain and reduced or blurred vision.
  • Abnormal heartbeat, rapid or irregular, which can lead to fainting.
  • Severe abdominal or back pain (which may indicate a serious problem in the intestine, liver, or pancreas).
  • Itching, yellow eyes or skin, dark urine, flu-like symptoms, which are symptoms of liver inflammation (hepatitis).

Very Rare (may affect up to 1 in 10,000 people)

  • Prolonged bleeding, which may be due to a reduced number of platelets in the blood that leads to an increased risk of bruising or bleeding.
  • Abnormal milk production.
  • Unexpected bleeding, for example, bleeding from the gums, blood in urine or vomit, or the appearance of unexpected bruises or broken blood vessels (broken veins).

Frequency not known (cannot be estimated from the available data)

  • Suicidal thoughts and behavior, cases of suicidal thoughts and behavior have been reported during treatment with venlafaxine or shortly after stopping treatment (see section 2. "What you need to know before taking Vandral Retard").
  • Aggression.
  • Dizziness.
  • Excessive vaginal bleeding shortly after childbirth (postpartum hemorrhage), see "Pregnancy, breastfeeding, and fertility" in section 2 for more information.

Vandral Retard sometimes produces unwanted effects that you may not be aware of, such as increased blood pressure or an abnormal heartbeat; changes in blood levels of liver enzymes, sodium, or cholesterol. Less frequently, Vandral Retard may reduce the function of blood platelets, leading to an increased risk of bruising or bleeding. Therefore, your doctor may want to perform occasional blood tests, especially if you have been taking Vandral Retard for a long time.

Reporting of Adverse Effects

If you experience any type of adverse effect, consult your doctor, pharmacist, or nurse, even if it is a possible adverse effect that is not listed in this leaflet. You can also report them directly through the Spanish Pharmacovigilance System for Human Use Medicines: http://www.notificaram.es. By reporting adverse effects, you can contribute to providing more information on the safety of this medicine.

5. Storage of Vandral Retard

Keep this medicine out of the sight and reach of children.

Do not use this medicine after the expiration date that appears on the packaging. The expiration date is the last day of the month indicated.

Do not store above 30°C.

Medicines should not be thrown away through wastewater or household waste. Deposit the packaging and medicines you no longer need in the SIGRE collection point at the pharmacy. In case of doubt, ask your pharmacist how to dispose of the packaging and medicines you no longer need. This will help protect the environment.

6. Package Contents and Additional Information

Composition of Vandral Retard

The active ingredient is venlafaxine.

Vandral Retard 75 mg:

Each prolonged-release capsule contains 84.85 mg of venlafaxine hydrochloride, equivalent to 75 mg of venlafaxine base.

The other ingredients are:

Capsule content:microcrystalline cellulose, ethylcellulose, hypromellose, talc.

Capsule shell:gelatin, iron oxide red and yellow (E172), titanium dioxide (E171).

Capsule printing ink:shellac, iron oxide red (E172), ammonium hydroxide, simethicone, propylene glycol.

Vandral Retard 150 mg:

Each prolonged-release capsule contains 169.7 mg of venlafaxine hydrochloride, equivalent to 150 mg of venlafaxine base.

The other ingredients are:

Capsule content:microcrystalline cellulose, ethylcellulose, hypromellose, talc.

Capsule shell:gelatin, iron oxide red and yellow (E172), titanium dioxide (E171).

Capsule printing ink:shellac, sodium hydroxide (see section 2), povidone, titanium dioxide (E171), propylene glycol.

Vandral Retard 225 mg:

Each prolonged-release capsule contains 254.52 mg of venlafaxine hydrochloride, equivalent to 225 mg of venlafaxine base.

The other ingredients are:

Capsule content:microcrystalline cellulose, ethylcellulose, hypromellose, talc.

Capsule shell:gelatin, iron oxide black, red, and yellow (E172), titanium dioxide (E171).

Capsule printing ink:shellac, sodium hydroxide (see section 2), povidone, titanium dioxide (E171), propylene glycol.

Product Appearance and Package Contents

Vandral Retard 75 mg is a hard (gelatin) prolonged-release capsule, opaque, and peach-colored, 19.4 mm x 6.91 mm, with a 'W' and the dose '75' printed in red.

Vandral Retard 75 mg is available in:

Packages with blisters of 7, 10, 14, 15, 20, 28, 30, 50, 56, 60, 98, 100 hard capsules and clinical packages of 500 (10x50) and 1,000 (10x100) hard capsules or in HDPE plastic bottles of 14, 20, 50, 100 hard capsules and clinical packages of 500 and 1,000 hard capsules.

Unit-dose blister packages of 14, 28, 84, and 100 hard capsules.

Vandral Retard 150 mg is a hard (gelatin) prolonged-release capsule, opaque, and orange-colored, 23.5 mm x 7.65 mm, with a 'W' and the dose '150' printed in white.

Vandral Retard 150 mg is available in:

Packages with blisters of 7, 10, 14, 15, 20, 28, 30, 50, 56, 60, 98, 100 hard capsules and clinical packages of 500 (10x50) and 1,000 (10x100) hard capsules or in HDPE plastic bottles of 14, 20, 50, 100 hard capsules and clinical packages of 500 and 1,000 hard capsules.

Unit-dose blister packages of 14, 28, 84, and 100 hard capsules.

Vandral Retard 225 mg is an opaque capsule with a light gray shell and dark orange body, with "W" and "225" in white print

Vandral Retard 225 mg is available in:

Packages with blisters of 7, 10, 14, 15, 20, 28, 30, 50, 56, 60, 98, 100 and clinical packages of 500 (10x50) and 1,000 (10x100).

Unit-dose blister packages of 14, 28, 84, and 100 hard capsules.

Not all package sizes may be marketed.

Marketing Authorization Holder, Manufacturer, and Local Representative

Marketing Authorization Holder

Viatris Healthcare Limited

Damastown Industrial Park

Mulhuddart, Dublin 15

Dublin

Ireland

Manufacturer

Pfizer Manufacturing Deutschland GmbH

Mooswaldallee 1

79108 Freiburg Im Breisgau

Germany

or

Pfizer Ireland Pharmaceuticals

Little Connell

Newbridge

County Kildare

Ireland

You can request more information about this medicine by contacting the local representative of the marketing authorization holder:

Viatris Pharmaceuticals, S.L.U.

Calle General Aranaz, 86

28027 Madrid

Spain

This medicine is authorized in the Member States of the European Economic Area and in the United Kingdom (Northern Ireland) with the following names*:

Austria

Efectin ER 37.5 mg capsules

Efectin ER 75 mg capsules

Efectin ER 150 mg capsules

Belgium, Luxembourg

Efexor-Exel 37.5

Efexor-Exel 75

Efexor-Exel 150

Efexor-Exel 225

Bulgaria

Efectin ER 75 mg

Efectin ER 150 mg

Czech Republic

Efectin ER 37.5 mg

Efectin ER 75 mg

Efectin ER 150 mg

Cyprus, Greece, Estonia, Lithuania, Portugal

Efexor XR

Latvia

Efexor XR

Efexor XR 75

Efexor XR 150

Denmark, Finland, Iceland, Norway, Sweden

Efexor Depot

France

Effexor L.P.

Germany

Trevilor retard 37.5 mg

Trevilor retard 75 mg

Trevilor retard 150 mg

Ireland, Malta, United Kingdom (Northern Ireland)

Efexor XL

Netherlands

Efexor XR 37.5

Efexor XR 75

Efexor XR 150

Italy

Efexor

Faxine

Poland

Efectin ER 37.5

Efectin ER 75

Efectin ER 150

Romania

Efectin EP 37.5 mg

Efectin EP 75 mg

Efectin EP 150 mg

Slovenia

Efectin ER 37.5 mg prolonged-release capsules

Efectin ER 75 mg prolonged-release capsules

Efectin ER 150 mg prolonged-release capsules

Spain

Vandral Retard 75 mg prolonged-release hard capsules

Vandral Retard 150 mg prolonged-release hard capsules

Vandral Retard 225 mg prolonged-release hard capsules

*[Please note that not all products and concentrations listed may be marketed].

Date of the last revision of this leaflet: July 2023

Detailed and updated information on this medicine is available on the website of the Spanish Agency for Medicines and Health Products (AEMPS) http://www.aemps.gob.es

Online doctors for VANDRAL RETARD 225 mg PROLONGED-RELEASE HARD CAPSULE

Discuss questions about VANDRAL RETARD 225 mg PROLONGED-RELEASE HARD CAPSULE, including use, safety considerations and prescription review, subject to medical assessment and local regulations.

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Anastasiia Hladkykh

Psychiatry 15 years exp.

Dr Anastasiia Hladkykh is a physician-psychotherapist and psychologist with over 14 years of experience working with individuals struggling with various types of addictions and their families. She provides online consultations for adults, combining medical knowledge with deep psychological support and practical tools.

Key areas of expertise:

  • Addiction treatment: alcohol and drug dependence, gambling addiction, compulsive behaviours, codependent relationships.
  • Support for families of addicted individuals, behavioural correction within the family system, guidance for maintaining remission.
  • Mental health: depression, bipolar disorder, obsessive-compulsive disorder (OCD), anxiety disorders, phobias, PTSD, generalised anxiety, emotional trauma, and the psychological impact of loss or emigration.
  • Psychoeducation: explaining complex mental health concepts in simple language, helping patients and their families understand diagnoses and treatment steps.
Therapeutic approach:
  • Client-centred, straightforward, and empathetic – focused on practical outcomes and emotional stabilisation.
  • Prescribes medications when needed, but always aims to minimise unnecessary pharmaceutical use.
  • Certified in multiple evidence-based methods: CBT, NLP (Master Practitioner), Ericksonian hypnosis, symbol drama, art therapy, and systemic therapy.
  • Each consultation results in a clear, structured plan – patients leave knowing exactly what to do next.
Experience and background:
  • Member of the German association Gesundheitpraktikerin and the NGO “Mit dem Sonne in jedem Herzen.”
  • More than 18 publications in international peer-reviewed journals, translated into several languages.
  • Volunteer work with Ukrainian refugees and military personnel at the University Clinic of Regensburg.
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Doctor

Daria Portnova

Psychiatry 31 years exp.

Dr Daria Portnova is a psychiatrist and psychotherapist with over 30 years of clinical experience. She works with adults and adolescents aged 14 and over, providing online psychiatric and psychotherapeutic consultations.

In her practice, Dr Portnova supports patients facing the onset of mental health conditions, chronic psychiatric disorders, psychotic symptoms, trauma-related states, and complex emotional crises. Her work is structured and safety-focused, with an emphasis on stabilisation, accurate diagnosis, and long-term improvement in quality of life.

Patients consult Dr Daria Portnova for the following concerns:

  • existential crises and complex life situations;
  • loss, grief, and emotional exhaustion;
  • relationship difficulties, separation, and divorce;
  • psychological and psychiatric trauma, including complex PTSD (cPTSD);
  • anxiety disorders: generalised anxiety disorder and panic disorder;
  • social anxiety and social phobia;
  • obsessive-compulsive disorder (OCD);
  • sleep disorders;
  • depressive disorders;
  • bipolar affective disorder;
  • schizoaffective disorder;
  • schizophrenia;
  • personality disorders.
Dr Portnova combines psychiatric assessment with a psychotherapeutic approach. She works with evidence-based methods, including cognitive behavioural therapy (CBT) and third-wave approaches such as ACT, FACT, and CFT. Consultations are focused on clear clinical understanding, practical recommendations, and ongoing support over time.
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€110
5.0 (77)
Doctor

Sergey Ilyasov

Psychiatry 7 years exp.

Dr Sergey Ilyasov is an experienced neurologist and qualified psychiatrist who provides online consultations for adults and adolescents. Combining deep neurological expertise with a modern psychiatric approach, he ensures comprehensive diagnostics and effective treatment for a wide range of conditions affecting both physical and mental health.

Dr. Ilyasov helps patients in the following cases:

  • Chronic headaches (migraine, tension-type headache), back pain, neuropathic pain, dizziness, numbness in limbs, coordination disorders.
  • Anxiety disorders (panic attacks, generalized anxiety disorder), depression (including atypical and treatment-resistant forms), sleep disturbances (insomnia, hypersomnia, nightmares), stress, burnout.
  • Chronic pain syndromes and psychosomatic symptoms (e.g., irritable bowel syndrome related to stress, vegetative-vascular dystonia).
  • Behavioral disorders and concentration difficulties in adolescents (including ADHD, autism spectrum disorders), nervous tics.
  • Memory impairments, phobias, obsessive-compulsive disorder (OCD), emotional swings, and support for post-traumatic stress disorder (PTSD).

Thanks to his dual specialization in neurology and psychiatry, Dr Sergey Ilyasov offers integrated and evidence-based care for complex conditions requiring a multidisciplinary approach. His consultations focus on accurate diagnosis, development of an individualized treatment plan (including pharmacotherapy and psychotherapeutic methods), and long-term support adapted to each patient's unique needs.

Book an online consultation with Dr. Sergey Ilyasov to receive qualified assistance and improve your well-being today.

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€89
5.0 (137)
Doctor

Taisiia Proida

Psychiatry 7 years exp.

Dr. Taisiia Proida is a psychiatrist and cognitive behavioural therapist (CBT), and a member of the European Psychiatric Association. She offers online consultations for adults aged 18 and over, combining evidence-based medicine with an individualised approach to mental health care.

She specialises in consultations and ongoing support for a wide range of mental health concerns, including:

  • Mood disorders: depression, bipolar disorder, postpartum depression.
  • Anxiety disorders: generalised anxiety, OCD, panic attacks, phobias.
  • Post-traumatic stress disorder (PTSD) and complex PTSD.
  • Attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Assessment is provided only after an initial psychiatric evaluation and during a follow-up appointment.
  • Personality disorders and emotional instability.
  • Cyclothymia and mood fluctuations.
  • Schizophrenia spectrum and related conditions.

Dr. Proida combines clinical expertise with an empathetic approach, offering structured support based on evidence-based practices. Her work integrates CBT techniques with medical management, with a focus on anxiety and depressive disorders.

She works with clients from different countries and cultural backgrounds, adapting her communication style and recommendations to individual needs. With experience in international clinical trials (Pfizer, Merck), she values clarity, trust, and collaborative partnership in patient care.

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€120

Frequently Asked Questions

Is a prescription required for VANDRAL RETARD 225 mg PROLONGED-RELEASE HARD CAPSULE?
VANDRAL RETARD 225 mg PROLONGED-RELEASE HARD CAPSULE requires a prescription in Spain. You can check with a doctor online whether this medicine may be appropriate for your situation.
What is the active substance in VANDRAL RETARD 225 mg PROLONGED-RELEASE HARD CAPSULE?
The active ingredient in VANDRAL RETARD 225 mg PROLONGED-RELEASE HARD CAPSULE is venlafaxine. This information helps identify medicines with the same composition but different brand names.
How much does VANDRAL RETARD 225 mg PROLONGED-RELEASE HARD CAPSULE cost in pharmacies?
The average pharmacy price for VANDRAL RETARD 225 mg PROLONGED-RELEASE HARD CAPSULE is around 28.74 EUR. Prices may vary depending on the manufacturer and dosage form.
Who manufactures VANDRAL RETARD 225 mg PROLONGED-RELEASE HARD CAPSULE?
VANDRAL RETARD 225 mg PROLONGED-RELEASE HARD CAPSULE is manufactured by Viatris Healthcare Limited. Pharmacy brands and packaging may differ depending on the distributor.
Which doctors can assess the use of VANDRAL RETARD 225 mg PROLONGED-RELEASE HARD CAPSULE online?
Doctors such as Family doctors, Psychiatrists, Dermatologists, Cardiologists, Endocrinologists, Gastroenterologists, Pulmonologists, Nephrologists, Rheumatologists, Hematologists, Infectious disease physicians, Allergists, Geriatricians, Paediatricians, Oncologists may assess whether VANDRAL RETARD 225 mg PROLONGED-RELEASE HARD CAPSULE is appropriate, depending on your situation and local regulations. You can book an online consultation to discuss your symptoms and possible next steps.
What are the alternatives to VANDRAL RETARD 225 mg PROLONGED-RELEASE HARD CAPSULE?
Other medicines with the same active substance (venlafaxine) include DISLAVEN RETARD 150 mg PROLONGED-RELEASE CAPSULES, DISLAVEN RETARD 75 mg PROLONGED-RELEASE CAPSULES, DOBUPAL 37.5 mg TABLETS. These may have different brand names or formulations but contain the same therapeutic ingredient. Always consult a doctor before switching or starting a new medicine.
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