| Major Depressive Disorder
Effexor XR vs Fetzima
Side-by-side clinical, coverage, and cost comparison for major depressive disorder.Deep comparison between: Effexor vs Fetzima with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsFetzima has a higher rate of injection site reactions vs Effexor based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Fetzima but not Effexor, including UnitedHealthcare
Sign up to reveal the full AI analysis
Category
Effexor
Fetzima
At A Glance
Oral
Daily
SNRI
Oral
Once daily
SNRI
Indications
- Major Depressive Disorder
- Generalized Anxiety Disorder
- Phobia, Social
- Panic Disorder
- Major Depressive Disorder
Dosing
Major Depressive Disorder Starting dose 37.5-75 mg/day; target 75 mg/day; max 225 mg/day; administered once daily with food.
Generalized Anxiety Disorder Starting dose 37.5-75 mg/day; target 75 mg/day; max 225 mg/day; administered once daily with food.
Phobia, Social Recommended dose 75 mg/day; administered once daily with food; no evidence that higher doses confer additional benefit.
Panic Disorder Starting dose 37.5 mg/day for 7 days, then 75 mg/day; max 225 mg/day; administered once daily with food.
Major Depressive Disorder Initiate at 20 mg once daily for 2 days, then increase to 40 mg once daily; may increase in 40 mg increments at intervals of 2 or more days; max 120 mg once daily, oral, with or without food.
Renal Impairment Severe (CrCl 15-29 mL/min): max 40 mg once daily; moderate (CrCl 30-59 mL/min): max 80 mg once daily; ESRD: not recommended.
Contraindications
- Known hypersensitivity to venlafaxine hydrochloride, desvenlafaxine succinate, or any excipients in the formulation
- Concomitant use with MAOIs (including linezolid and intravenous methylene blue), or within 14 days of stopping an MAOI antidepressant, due to risk of serotonin syndrome
- Hypersensitivity to levomilnacipran, milnacipran HCl, or any excipient in the formulation
- Concomitant use with MAOIs intended to treat psychiatric disorders, or within 7 days of stopping FETZIMA
- Use of FETZIMA within 14 days of stopping an MAOI intended to treat psychiatric disorders
- Concomitant use with linezolid or intravenous methylene blue
Adverse Reactions
Most common (>=5%) Nausea, somnolence, dry mouth, sweating, abnormal ejaculation, anorexia, constipation, impotence, decreased libido
Serious Serotonin syndrome, elevated blood pressure, increased risk of bleeding, angle-closure glaucoma, activation of mania/hypomania, discontinuation syndrome, seizure, hyponatremia, interstitial lung disease, eosinophilic pneumonia
Postmarketing Anaphylaxis, angioedema, QT prolongation, ventricular fibrillation, ventricular tachycardia (including torsade de pointes), takotsubo cardiomyopathy, Stevens-Johnson syndrome, toxic epidermal necrolysis, erythema multiforme, neuroleptic malignant syndrome, rhabdomyolysis, hyponatremia, SIADH
Most common (>=5%) Nausea, constipation, hyperhidrosis, heart rate increased, erectile dysfunction, ejaculation disorder, tachycardia, vomiting, palpitations
Serious Suicidal thoughts and behaviors, serotonin syndrome, elevated blood pressure, elevated heart rate, increased risk of bleeding, angle closure glaucoma, urinary hesitation or retention, activation of mania/hypomania, seizure, discontinuation syndrome, hyponatremia, sexual dysfunction
Postmarketing Takotsubo cardiomyopathy, anosmia, hyposmia
Pharmacology
Venlafaxine is an SNRI whose antidepressant and anxiolytic effects are thought to be related to potentiation of serotonin and norepinephrine in the CNS through inhibition of their reuptake; it also weakly inhibits dopamine reuptake and has no significant affinity for muscarinic, H1-histaminergic, or alpha1-adrenergic receptors.
Levomilnacipran is a potent and selective serotonin and norepinephrine reuptake inhibitor (SNRI) that potentiates serotonin and norepinephrine neurotransmission in the central nervous system through inhibition of reuptake at their respective transporters, with no significant affinity for other receptors, ion channels, or transporters.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Effexor
- Covered on 5 commercial plans
- PA (0/12) · Step Therapy (0/12) · Qty limit (12/12)
Fetzima
- Covered on 5 commercial plans
- PA (3/12) · Step Therapy (11/12) · Qty limit (12/12)
UnitedHealthcare
Effexor
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Fetzima
- Covered on 4 commercial plans
- PA (1/8) · Step Therapy (8/8) · Qty limit (6/8)
Humana
Effexor
- Covered on 0 commercial plans
- PA (0/3) · Step Therapy (0/3) · Qty limit (2/3)
Fetzima
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (2/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Effexor.
No savings programs available for Fetzima.
Compare Other Drugs
Let us handle your prior authsJust enter your patient's info and we'll:
- Verify eligibility with the payer.
- Pull the right PA forms directly from the payer.
- Submit, track & send live updates to your dashboard.
Free to start · HIPAA compliant
Next Steps for Your Patient
EffexorView full Effexor profile
FetzimaView full Fetzima profile
Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.