Generic Name and Formulations:
Desvenlafaxine (as succinate) 25mg, 50mg, 100mg; ext-rel tabs.
Indications for PRISTIQ:
Major depressive disorder.
Swallow whole. 50mg once daily. Moderate renal impairment (CrCl 30–50mL/min): max 50mg/day. Severe renal impairment (CrCl <30mL/min), ESRD: max 25mg daily or 50mg every other day. Do not give supplemental dose after dialysis. Moderate-to-severe hepatic impairment: max 100mg/day. Withdraw gradually.
During or within 14 days of MAOIs; do not start an MAOI during or within 7 days of desvenlafaxine. Concomitant linezolid or IV methylene blue.
Increased risk of suicidal thinking or behavior; monitor for clinical worsening or unusual changes. Screen for bipolar disorder. Monitor for serotonin syndrome; discontinue if occurs. Monitor BP; reduce dose or discontinue if elevated BP persists. Cardio- or cerebrovascular disease. Angle-closure glaucoma. History of mania/hypomania. Seizure disorder. Volume depleted. Renal or hepatic impairment. Avoid abrupt cessation. Reevaluate periodically. Write ℞ for smallest practical amount. Elderly. Labor & delivery. Pregnancy (Cat.C; avoid in 3rd trimester; taper). Nursing mothers: not recommended.
See Contraindications. Avoid alcohol, concomitant venlafaxine, other forms of desvenlafaxine. Increased risk of serotonin syndrome with other serotonergic drugs (eg, triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, tryptophan, buspirone, amphetamines, St. John's Wort) or with drugs that impair serotonin metabolism (eg, MAOIs, linezolid, IV methylene blue). Increased risk of bleeding with concomitant NSAIDs, aspirin, warfarin, or other drugs that affect coagulation; monitor. May affect CYP2D6 substrates (eg, desipramine, atomoxetine, dextromethorphan, metoprolol, nebivolol, perphenazine, tolterodine); reduce dose by up to ½ if concomitant with desvenlafaxine 400mg dose. May cause false (+) urine immunoassay screening tests for PCP and amphetamine.
Nausea, dizziness, insomnia, hyperhidrosis, constipation, somnolence, decreased appetite, anxiety, specific male sexual dysfunction; hyponatremia (esp. in elderly); rare: interstitial lung disease or eosinophilic pneumonia (consider discontinuing if occurs).
Tabs 25mg—30; 50mg, 100mg—14, 30, 90