Can You Cut Venlafaxine ER Tablets?

In our latest question and answer, the pharmacist answers whether or not you can safely cut venlafaxine ER tablets.

Apr 21, 2018

BTT asked

I want to taper off of Venlafaxine XR. I plan to taper very slowly over months if necessary. I use 150MG a day. Can I cut an XR pill? Or do I need to get a prescription for smaller doses? The pills are not capsules. They are solid pills.

Answer

No, the venlafaxine ER (extended release) tablet should not be cut, split, crushed or chewed. Doing so with compromise the extended release mechanism of the tablet, causing the entire dose to be released at one time, as opposed to slowly over time. This can significantly increase the risk of side effects.

Venlafaxine ER tablets use what is known as a "OROS" (Osmotic Release Oral System) delivery mechanism. The tablet core contains the active ingredient (venlafaxine) and osmotically active components which will expand when they come into contact with liquid. Once the tablet is swallowed and enters the GI tract, water enters through a membrane in the tablet, causing the drug to dissolve and osmotic comment in the tablet to expand. The expansion pushes the venlafaxine out of a laser drilled hold in the side of the tablet at a controlled rate.

Therefore, if you cut, split, crush or chew venlafaxine ER tablets, the OROS release mechanism will no longer work.

If you are tapering venlafaxine ER and need to decrease your dose, be sure to speak to your doctor as you will need a lower dose venlafaxine ER tablet prescribed to you. Venlafaxine ER tablets come in the following strengths:

  • Venlafaxine 37.5mg extended release
  • Venlafaxine 75mg extended release
  • Venlafaxine 150mg extended release
  • Venlafaxine 225mg extended release

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