Two medicines, side by side
Duloxetine vs venlafaxine
Duloxetine and venlafaxine are both labeled for depression and anxiety. Drugs@FDA records approvals of duloxetine since 2004 and of venlafaxine since 1993. Pharmacies paid $0.102 per duloxetine HCl DR 30 mg capsule and $0.0799 per venlafaxine HCl ER 75 mg capsule (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. How each works, in its label's words: Duloxetine, “Although the exact mechanisms of the antidepressant, central pain inhibitory and anxiolytic actions of duloxetine in humans are unknown, these actions are believed to be related to its potentiation …”; Venlafaxine, “The mechanism of action of venlafaxine in the treatment of MDD, GAD, SAD, and PD is unclear, but is thought to be related to the potentiation of serotonin and norepinephrine in the central nervous …”
Check it at the source: the duloxetine FDA label on DailyMed (effective May 14, 2024); the venlafaxine FDA label on DailyMed (effective August 15, 2023).
Highlights of the duloxetine record
Duloxetine (Cymbalta) · label of May 14, 2024
SUICIDAL THOUGHTS AND BEHAVIORS Antidepressants increased the risk of suicidal thoughts and behavior in pediatric and young adult patients in short-term studies. Closely monitor all antidepressant-treated patients for clinical worsening, and for emergence of suicidal thoughts and behaviors [see Warnings and Precautions (5.1)]. WARNING: SUICIDAL THOUGHTS AND BEHAVIORS See full prescribing information for complete boxed warning.
Used for
From the label: indicationsDRIZALMA SPRINKLE is indicated for the treatment of: • Major Depressive Disorder in adults • Generalized Anxiety Disorder in adults and pediatric patients 7 years of age and older • Diabetic Peripheral Neuropathy in adults • Fibromyalgia in adults • Chronic Musculoskeletal Pain in adults Additional pediatric use information is approved for Eli Lilly and Company, Inc.’s CYMBALTA (duloxetine delayed-release capsules). […]
On the market
- Earliest approval on file
- August 3, 2004
- Generic labelers
- 45 labelers
- Pharmacy cost
- $0.102 per capsule
Supply and safety
- Shortage
- No current entry
- Recalls
- 56
Highlights of the venlafaxine record
Venlafaxine (Effexor) · label of August 15, 2023
SUICIDAL THOUGHTS AND BEHAVIORS Antidepressants increased the risk of suicidal thoughts and behavior in pediatric and young adult patients in short-term studies. Closely monitor all antidepressant-treated patients for clinical worsening, and emergence of suicidal thoughts and behaviors [see Warnings and Precautions (5.1) ]. Effexor XR is not approved for use in pediatric patients [see Use in Specific Populations (8.4) ].
Used for
From the label: indicationsEffexor XR is indicated in adults for the treatment of: • Major Depressive Disorder (MDD) [see Clinical Studies (14.1) ] • Generalized Anxiety Disorder (GAD) [see Clinical Studies (14.2) ] • Social Anxiety Disorder (SAD) [see Clinical Studies (14.3) ] • Panic Disorder (PD) [see Clinical Studies (14.4) ] Effexor XR is a serotonin and norepinephrine reuptake inhibitor (SNRI) indicated for the treatment of adults with: • Major Depressive Disorder (MDD) ( 1 ) • Generalized Anxiety Disorder (GAD) ( 1 ) • Social Anxiety Disorder (SAD) ( 1 ) • Panic Disorder (PD) […]
On the market
- Earliest approval on file
- December 28, 1993
- Generic labelers
- 61 labelers
- Pharmacy cost
- $0.0799 per capsule
Supply and safety
- Shortage
- No current entry
- Recalls
- 21
Source: FDA drug labels via openFDA (Duloxetine label of May 14, 2024, Venlafaxine label of August 15, 2023); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do duloxetine and venlafaxine differ on the record?
How each works, in its label's words: Duloxetine, “Although the exact mechanisms of the antidepressant, central pain inhibitory and anxiolytic actions of duloxetine in humans are unknown, these actions are believed to be related to its potentiation …”; Venlafaxine, “The mechanism of action of venlafaxine in the treatment of MDD, GAD, SAD, and PD is unclear, but is thought to be related to the potentiation of serotonin and norepinephrine in the central nervous …”
Both are in FDA's class serotonin and norepinephrine reuptake inhibitors.
Half-life, in each label's words: Duloxetine, “Mean terminal half-life was 12.4 hours (range 7.8 to 22.2 hour) in subjects receiving a single dose DRIZALMA SPRINKLE.”; Venlafaxine, “The apparent elimination half-life is 5 ± 2 hours for venlafaxine and 11 ± 2 hours for ODV.”
Both labels carry a boxed warning; the records quote them.
Generics: duloxetine since 2013; venlafaxine since 2006 (Drugs@FDA).
| Duloxetine | Venlafaxine | |
|---|---|---|
| Labeled for | Depression, Anxiety, Nerve pain and fibromyalgia, Pain | Depression, Anxiety |
| Pharmacologic class | Serotonin and Norepinephrine Reuptake Inhibitor | Serotonin and Norepinephrine Reuptake Inhibitor |
| How it works (label) | Although the exact mechanisms of the antidepressant, central pain inhibitory and anxiolytic actions of duloxetine in humans are unknown, these actions are believed to be related to its potentiation of serotonergic and noradrenergic … | The mechanism of action of venlafaxine in the treatment of MDD, GAD, SAD, and PD is unclear, but is thought to be related to the potentiation of serotonin and norepinephrine in the central nervous system, through inhibition of their … |
| Half-life (label) | Mean terminal half-life was 12.4 hours (range 7.8 to 22.2 hour) in subjects receiving a single dose DRIZALMA SPRINKLE. | The apparent elimination half-life is 5 ± 2 hours for venlafaxine and 11 ± 2 hours for ODV. |
| Earliest approval on file (Drugs@FDA) | August 3, 2004 | December 28, 1993 |
| First generic approved | December 11, 2013 | August 3, 2006 |
| Generic labelers (NDC) | 45 labelers | 61 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.102 per capsule (Duloxetine HCl DR 30 mg capsule) | $0.0799 per capsule (Venlafaxine HCl ER 75 mg capsule) |
| 12-month price change | +31% | -13% |
| Boxed warning | Yes | Yes |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 56 | 21 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 69,298 | 131,560 |
| DEA schedule | none | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
What do the labels say about using others of their kind?
Duloxetine label, drug interactionsExamples Selegiline, tranylcypromine, isocarboxazid, phenelzine, linezolid, intravenous methylene blue Other Serotonergic Drugs Clinical Impact Concomitant use of duloxetine with other serotonergic drugs increases the risk of serotonin syndrome.
Venlafaxine label, drug interactionsOther Serotonergic Drugs Clinical Impact Concomitant use of Effexor XR with other serotonergic drugs (including other SNRIs, SSRIs, triptans, tricyclic antidepressants, opioids, lithium, buspirone, amphetamines, tryptophan, and St. John's Wort) increases the risk of serotonin syndrome.
Source: FDA drug labels via openFDA
What next?
- Alternatives to duloxetine
- every medicine labeled for the same conditions