Why come off slowly
Stopping venlafaxine is usually harder than starting it. The relationship between the dose you take and its effect on the brain isn't a straight line — at lower doses, even a small reduction in milligrams can be a large change in effect. This is why prescribers increasingly recommend hyperbolic tapering: smaller and smaller reductions as the dose gets lower, rather than fixed steps.
In practice that means the standard strengths — designed for the treatment range, not for coming off — often can't give you the small doses the end of a taper needs. That's where a method like the one below, so you can measure a precise fraction, comes in.
Combining capsule strengths, step by step
- Check which capsule strengths your pharmacy can dispense or compound.
- Use the calculator below to find a combination of whole capsules that reaches your target dose.
- Take the combination together as a single daily dose.
- Re-check the combination with your prescriber at each reduction step.
Your step-by-step taper schedule
This is the Venlafaxine schedule from the RELEASE Toolkit, reproduced with permission. It's a starting point to discuss with your prescriber — you can pause, slow down or speed up depending on how you feel. Aim to reduce roughly every 2–4 weeks.
| Step | Daily dose | Daily capsules |
|---|---|---|
| 1 | 150mg | 1 × 150mg capsule |
| 2 | 75mg | 2 × 37.5mg capsules |
| 3 | 57.5mg | 1 × 37.5mg & 2 × 10mg capsules |
| 4 | 37.5mg | 1 × 37.5mg capsule |
| 5 | 25mg | 2 × 10mg & 1 × 5mg capsules |
| 6 | 20mg | 2 × 10mg capsules |
| 7 | 15mg | 1 × 10mg & 1 × 5mg capsules |
| 8 | 12mg | 1 × 10mg & 2 × 1mg capsules |
| 9 | 10.5mg | 1 × 10mg & 1 × 0.5mg capsules |
| 10 | 8mg | 1 × 5mg & 3 × 1mg capsules |
| 11 | 6.5mg | 1 × 5mg & 3 × 0.5mg capsules |
| 12 | 5mg | 1 × 5mg capsule |
| 13 | 4mg | 4 × 1mg capsules |
| 14 | 3mg | 3 × 1mg capsules |
| 15 | 2.5mg | 2 × 1mg & 1 × 0.5mg capsules |
| 16 | 2mg | 2 × 1mg capsules |
| 17 | 1.5mg | 1 × 1mg & 1 × 0.5mg capsules |
| 18 | 1mg | 1 × 1mg capsule |
| 19 | 0.75mg | 3 × 0.25mg capsules |
| 20 | 0.5mg | 1 × 0.5mg capsule |
| 21 | 0.25mg | 1 × 0.25mg capsule |
| 22 | Stop | You've completed the taper 🎉 |
Highlighted steps are the most important — do not skip them.
| Step | Daily dose | Daily capsules |
|---|---|---|
| 1 | 300mg | 2 × 150mg capsules |
| 2 | 150mg | 1 × 150mg capsule |
| 3 | 75mg | 2 × 37.5mg capsules |
| 4 | 57.5mg | 1 × 37.5mg & 2 × 10mg |
| 5 | 47.5mg | 1 × 37.5mg & 1 × 10mg |
| 6 | 37.5mg | 1 × 37.5mg |
| 7 | 30mg | 3 × 10mg |
| 8 | 25mg | 2 × 10mg & 1 × 5mg |
| 9 | 22.5mg | 2 × 10mg & 1 × 2.5mg |
| 10 | 20mg | 2 × 10mg |
| 11 | 17.5mg | 1 × 10mg & 3 × 2.5mg |
| 12 | 15.4mg | 1 × 10mg & 1 × 5mg & 1 × 0.4mg |
| 13 | 14mg | 1 × 10mg & 2 × 2mg |
| 14 | 12.5mg | 1 × 10mg & 1 × 2.5mg |
| 15 | 11.5mg | 1 × 10mg & 1 × 1.5mg |
| 16 | 10.4mg | 1 × 10mg & 1 × 0.4mg |
| 17 | 9.4mg | 3 × 3mg & 1 × 0.4mg |
| 18 | 8.5mg | 2 × 3mg & 1 × 2.5mg |
| 19 | 7.8mg | 3 × 2.5mg & 1 × 0.3mg |
| 20 | 7.5mg | 1 × 5mg & 1 × 2.5mg |
| 21 | 6.5mg | 1 × 5mg & 1 × 1.5mg |
| 22 | 6mg | 2 × 3mg |
| 23 | 5.5mg | 1 × 5mg & 1 × 0.5mg |
| 24 | 5mg | 1 × 5mg capsule |
| 25 | 4.6mg | 2 × 2mg & 2 × 0.3mg |
| 26 | 4.2mg | 1 × 3mg & 3 × 0.4mg |
| 27 | 3.8mg | 1 × 3mg & 2 × 0.4mg |
| 28 | 3.5mg | 1 × 3mg & 1 × 0.5mg |
| 29 | 3.2mg | 1 × 3mg & 1 × 0.2mg |
| 30 | 3mg | 1 × 3mg |
| 31 | 2.6mg | 1 × 2mg & 2 × 0.3mg |
| 32 | 2.3mg | 1 × 2mg & 1 × 0.3mg |
| 33 | 2mg | 1 × 2mg |
| 34 | 1.9mg | 1 × 1mg & 3 × 0.3mg |
| 35 | 1.6mg | 1 × 1mg & 2 × 0.3mg |
| 36 | 1.4mg | 1 × 1mg & 1 × 0.4mg |
| 37 | 1.2mg | 1 × 1mg & 1 × 0.2mg |
| 38 | 1mg | 1 × 1mg |
| 39 | 0.9mg | 3 × 0.3mg |
| 40 | 0.73mg | 2 × 0.3mg & 1 × 0.13mg |
| 41 | 0.56mg | 1 × 0.3mg & 2 × 0.13mg |
| 42 | 0.39mg | 3 × 0.13mg |
| 43 | 0.26mg | 2 × 0.13mg |
| 44 | 0.13mg | 1 × 0.13mg |
| 45 | Stop | You've completed the taper 🎉 |
Highlighted steps are the most important — do not skip them.
- Do not skip the final small-dose steps — they're the most important for preventing withdrawal.
- Don't skip days, alternate days, or suddenly stop.
- If withdrawal symptoms appear, you can return to your previous dose; when ready, reduce more slowly.
Schedule © The University of Queensland (RELEASE Toolkit), reproduced with permission. Dosing guidance: Dr Mark Horowitz.
Measuring smaller doses accurately
Use the right tool for your method — an oral syringe for liquids (your pharmacist can supply 1 mL, 5 mL and 10 mL sizes), or a milligram scale for weighing. Choose the smallest measuring tool that fits your dose: it's far more accurate for tiny amounts.
- Measure slowly and double-check before you take your dose.
- Read at eye level, against the syringe plunger's flat edge.
- Keep the concentration or method the same each day so doses stay consistent.
What withdrawal can feel like
Withdrawal effects vary a lot between people. They often come in waves — harder days followed by windows of feeling more like yourself. Common, usually-manageable effects include dizziness, "brain zaps", nausea, vivid dreams, irritability and low mood. They tend to ease if you hold at your current dose for a while before reducing again.
Questions for your appointment
- How quickly is it safe for me to reduce, and by how much each step?
- How long should I hold at each dose before the next reduction?
- What should I do on a bad day — hold, slow down, or pause?
- Which symptoms mean I should contact you sooner?
- Would a compounded oral liquid be more accurate for my lowest doses?