Monograph Details
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Central Nervous System
> Mood disorders
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PRISTIQ |
| Manufacturer |
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Wyeth Pharmaceuticals |
| Legal Classification |
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Rx
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| Pharmacological Class |
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Serotonin and norepinephrine reuptake inhibitor. |
| Generic Name |
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Desvenlafaxine (as succinate) 50mg, 100mg; ext-rel tabs. |
| Indications |
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Major depressive disorder. |
| Children |
Not recommended.
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| Adults |
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Swallow whole. 50mg once daily. Severe renal impairment (CrCl <30mL/min), ESRD: 50mg every other day. Do not give supplemental dose after dialysis. Moderate renal impairment: max 50mg/day. Hepatic impairment: max 100mg/day. Withdraw gradually. |
| Contraindications |
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MAOIs: see Interactions. |
| Precautions |
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Monitor BP; reduce dose or discontinue if elevated BP persists. Cardio- or cerebrovascular disease. Hypercholesterolemia. Increased intraocular pressure. Mania/hypomania. Severe renal dysfunction. Seizure disorder. Reevaluate periodically. Suicidal ideation. Write Rx for smallest practical amount. Elderly. Labor & delivery. Pregnancy (Cat.C; avoid in 3rd trimester; taper). Nursing mothers: not recommended. |
| Interactions |
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Allow ≥14 days after MAOI discontinuance before starting desvenlafaxine; allow ≥7 days after desvenlafaxine discontinuance before starting an MAOI. Avoid alcohol, concomitant venlafaxine, other forms of desvenlafaxine. Concomitant serotonin precursors (eg, tryptophan): not recommended. May potentiate anticoagulants. Monitor for serotonin syndrome with SSRIs, SNRIs, triptans. May be potentiated by potent CYP3A4 inhibitors. May antagonize CYP3A4 substrates. Caution with serotonergics, other CNS-active drugs. |
| Adverse Reactions |
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GI upset, dizziness, insomnia, hyperhidrosis, constipation, somnolence, decreased appetite, anxiety, sexual dysfunction; rare: hyponatremia/SIADH (esp in elderly), interstitial lung disease, eosinophilic pneumonia, serotonin syndrome, mydriasis. |
| How Supplied |
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Tabs—14, 30, 90 |
| Additional Resources |
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• Related Prescribing Note |
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