Generic name: desvenlafaxine (des VEN la FAX een)
Brand name: Khedezla, Pristiq
Dosage forms: oral tablet, extended release ((as base) 100 mg; (as base) 50 mg; 100 mg; 25 mg; 50 mg)
Drug class: Serotonin-norepinephrine reuptake inhibitors
Desvenlafaxine is a selective serotonin and norepinephrine reuptake inhibitor (SNRI) antidepressant.
Desvenlafaxine is used to treat major depressive disorder.
Desvenlafaxine may also be used for purposes not listed in this medication guide.
Warnings
Do not use desvenlafaxine within 7 days before or 14 days after you have used an MAO inhibitor, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine.
Some young people have thoughts about suicide when first taking an antidepressant. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor.
Do not stop using desvenlafaxine without first talking to your doctor.
Before taking this medicine
You should not use desvenlafaxine if you are allergic to desvenlafaxine or venlafaxine (Effexor).
Do not use desvenlafaxine within 7 days before or 14 days after you have used an MAO inhibitor, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine. A dangerous drug interaction could occur.
Tell your doctor if you have ever had:
- heart disease, high blood pressure, high cholesterol, or a stroke;
- bipolar disorder (manic depression);
- depression, suicidal thoughts;
- liver or kidney disease;
- glaucoma;
- seizures or epilepsy;
- lung or breathing problems;
- a bleeding or blood clotting disorder; or
- low levels of sodium in your blood.
Be sure your doctor knows if you also take stimulant medicine, opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. These medicines may interact with desvenlafaxine and cause a serious condition called serotonin syndrome.
Some young people have thoughts about suicide when first taking an antidepressant. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.
Ask your doctor about taking this medicine if you are pregnant. Taking desvenlafaxine during late pregnancy could increase your risk of excessive bleeding after you give birth, and may cause serious medical complications in the baby. However, you may have a relapse of depression if you stop taking your antidepressant. Tell your doctor right away if you become pregnant. Do not start or stop taking this medicine without your doctor's advice.
If you are pregnant, your name may be listed on a pregnancy registry to track the effects of desvenlafaxine on the baby.
It may not be safe to breastfeed while using this medicine. Ask your doctor about any risk.
Desvenlafaxine is not approved for use by anyone younger than 18 years old.
How should I take desvenlafaxine?
Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.
Take desvenlafaxine with water at the same time each day, with or without food.
Swallow the tablet whole and do not crush, chew, or break it.
Your blood pressure will need to be checked often.
It may take several weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve.
Do not stop using desvenlafaxine suddenly, or you could have unpleasant symptoms (such as dizziness, vomiting, agitation, sweating, confusion, numbness, tingling, or electric shock feelings). Ask your doctor how to safely stop using this medicine.
Some tablets are made with a shell that is not absorbed or melted in the body. Part of this shell may appear in your stool. This is normal and will not make the medicine less effective.
Store at room temperature away from moisture and heat.
What happens if I miss a dose?
Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
What should I avoid while taking desvenlafaxine?
Avoid drinking alcohol.
Ask your doctor before taking a nonsteroidal anti-inflammatory drug (NSAID) such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib (Celebrex), diclofenac, indomethacin, meloxicam, and others. Using an NSAID with desvenlafaxine may cause you to bruise or bleed easily.
Avoid driving or hazardous activity until you know how desvenlafaxine will affect you. Your reactions could be impaired.
Desvenlafaxine side effects
Get emergency medical help if you have signs of an allergic reaction: skin rash or hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.
Call your doctor at once if you have:
- a seizure (convulsions);
- easy bruising or bleeding (nosebleeds, bleeding gums), blood in your urine or stools, coughing up blood;
- blurred vision, eye pain or swelling, or seeing halos around lights;
- cough, chest discomfort, trouble breathing; or
- low levels of sodium in the body--headache, confusion, severe weakness, memory problems, feeling unsteady, hallucinations.
Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.
Common side effects may include:
- dizziness, drowsiness, anxiety;
- increased sweating;
- nausea, decreased appetite, constipation;
- sleep problems (insomnia); or
- decreased sex drive, impotence, or difficulty having an orgasm.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Desvenlafaxine dosing information
Usual Adult Dose for Depression:
50 mg orally once a day, with or without food
Comments:
-Doses of 10 to 400 mg/day were studied in clinical trials.
-There is no evidence that doses greater than 50 mg per day provide additional benefit.
-Side effects and discontinuations were more common at higher doses.
-Efficacy in patients with major depressive disorder was established in 4 short-term and 2 maintenance studies.
Use: Treatment of major depressive disorder (MDD)
What other drugs will affect desvenlafaxine?
Using desvenlafaxine with other drugs that make you drowsy can worsen this effect. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety or seizures.
Tell your doctor about all your other medicines, especially a blood thinner (warfarin, Coumadin, Jantoven) or other medicine used to prevents blood clots.
Other drugs may affect desvenlafaxine, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.