This section gives an overview of the commonly used drugs (excluding opioids) to manage symptoms in patients with terminal illnesses. The information includes basic dosage information as well as indications for use and potential side effects. Please note that non-opioid drugs commonly used in palliative care in Singapore are shown here but the list is NOT exhaustive and neither are the side effects nor indications. Doses are for adults only. Please check with pharmacy colleagues for dose adjustments (if any) in renal or liver impairment. Unless otherwise indicated, use water for injection for dilution in continuous subcutaneous infusions.
*For information on opioids, please search and refer to the drugs with their given context.
Venlafaxine
Route, Dosage and Frequency
ROUTE
|
DOSAGE AND FREQUENCY
|
| PO |
37.5-75 mg b.d. (max dose 375mg/day) |
Other Information
Indications
Refractory depression, Refractory anxiety, Hot flushes.
Side-Effects
Dizziness, Nausea, Insomnia, Somnolence, Dry mouth, Constipation, Sweating, Sexual dysfunction, Serotonin syndrome (risk if combined with another serotonergic drug).
Remarks
Serotonin and noradrenaline reuptake inhibitor (SNRI). May increase suicidal risk in those <25 years of age (suicide risk higher than SSRIs and TCAs). May take 4-6 weeks to take effect. Avoid abrupt withdrawal after prolonged use.
Reference
- Watson M. Oxford Handbook of Palliative Care. Oxford, NY: Oxford University Press; 2009.