Desvenlafaxine

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Generic Name: Desvenlafaxine Brand Name(s): Desvenlafaxine.

Uses

What is Desvenlafaxine used for?

Desvenlafaxine is commonly used to treat depression. It may improve your mood, feelings of well-being, and energy level. Desvenlafaxine is known as a serotonin-norepinephrine reuptake inhibitor (SNRI). It works by helping to restore the balance of certain natural substances (serotonin and norepinephrine) in the brain.

How should I take Desvenlafaxine?

Take this medication by mouth with or without food as directed by your doctor, usually once daily. The dosage is based on your medical condition and response to treatment.

Do not crush, chew, or dissolve this medication in water. Doing so can release all of the drug at once, increasing the risk of side effects. Also, do not split the tablets unless they have a score line and your doctor or pharmacist tells you to do so. Swallow the whole or split tablet without crushing or chewing.

To reduce your risk of side effects, your doctor may direct you to start this medication at a low dose and gradually increase your dose. Follow your doctor’s instructions carefully. Do not increase your dose or use this drug more often or for longer than prescribed. Your condition will not improve any faster, and your risk of side effects will increase. Use this medication regularly to get the most benefit from it. To help you remember, use it at the same time each day.

It is important to continue taking this medication even if you feel well. Do not stop taking this medication without consulting your doctor. Some conditions may become worse when this drug is suddenly stopped. Also, you may experience symptoms such as mood swings, headache, tiredness, sleep changes, and brief feelings similar to electric shock. To prevent these symptoms while you are stopping treatment with this drug, your doctor may reduce your dose gradually. Consult your doctor or pharmacist for more details. Report any new or worsening symptoms right away.

If you are switching from another antidepressant to desvenlafaxine, your doctor should slowly reduce the dose of your old antidepressant to prevent withdrawal reactions from the other antidepressant. Ask your doctor or pharmacist for more details.

It may take several weeks before you get the full benefit of this medication. Tell your doctor if your condition does not improve or if it worsens.

How do I store Desvenlafaxine?

Desvenlafaxine is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store Desvenlafaxine in the bathroom or the freezer. There may be different brands of Desvenlafaxine that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush Desvenlafaxine down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using Desvenlafaxine?

Before using this medication, tell your doctor or pharmacist your medical history, especially of: personal or family history of psychiatric disorders (such as bipolar/manic-depressive disorder), personal or family history of suicide attempts, bleeding problems, personal or family history of glaucoma (angle-closure type), high blood pressure, heart problems (such as chest pain, heart failure, heart attack), history of stroke, high cholesterol, kidney disease, liver disease, seizure disorder, low sodium in the blood (hyponatremia).

This drug may make you dizzy or drowsy or cause blurred vision. Do not drive, use machinery, or do any activity that requires alertness or clear vision until you are sure you can perform such activities safely. Avoid alcoholic beverages.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Older adults may be more sensitive to the side effects of this drug, especially dizziness when standing and bleeding. Older adults are also more likely to develop a type of mineral imbalance (hyponatremia), especially if they are also taking “water pills” (diuretics) with this medication. Dizziness and mineral imbalance can increase the risk of falling.

Based on information for a similar drug (venlafaxine), children may be more sensitive to the side effects of this drug, especially loss of appetite and weight loss. Monitor height and weight in children who are taking this drug. Consult your doctor or pharmacist for more details.

During pregnancy, this medication should be used only when clearly needed. It may harm an unborn baby. Also, babies born to mothers who have used this drug during the last 3 months of pregnancy may rarely develop withdrawal symptoms such as feeding/breathing difficulties, seizures, muscle stiffness, or constant crying. If you notice any of these symptoms in your newborn, tell the doctor promptly.

Since untreated mental/mood problems (such as depression, anxiety, and panic attacks) can be a serious condition, do not stop taking this medication unless directed by your doctor. If you are planning pregnancy, become pregnant, or think you may be pregnant, immediately discuss with your doctor the benefits and risks of using this medication during pregnancy.

This drug passes into breast milk and may have undesirable effects on a nursing infant. Consult your doctor before breast-feeding.

Is it safe during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using this Desvenlafaxine during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking this Desvenlafaxine. This Desvenlafaxine is pregnancy risk category C according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk,
  • B=No risk in some studies,
  • C=There may be some risk,
  • D=Positive evidence of risk,
  • X=Contraindicated,
  • N=Unknown

Side effects

What side effects can occur from Desvenlafaxine?

Drowsiness, dizziness, nausea, dry mouth, constipation, loss of appetite, weight loss, blurred vision, nervousness, trouble sleeping, or excessive sweating may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

This medication may raise your blood pressure. Check your blood pressure regularly and tell your doctor if the results are high.

An empty tablet shell may appear in your stool. This effect is harmless because your body has already absorbed the medication.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: severe/pounding headache, shakiness (tremor), decreased interest in sex, changes in sexual ability, easy bruising/bleeding.

Get medical help right away if you have any very serious side effects, including: cough that doesn’t go away, shortness of breath, chest pain, black stools, vomit that looks like coffee grounds, eye pain/swelling/redness, widened pupils, vision changes (such as seeing rainbows around lights at night), seizures.

This medication may increase serotonin and rarely cause a very serious condition called serotonin syndrome/toxicity. The risk increases if you are also taking other drugs that increase serotonin, so tell your doctor or pharmacist of all the drugs you take. Get medical help right away if you develop some of the following symptoms: fast heartbeat, hallucinations, loss of coordination, severe dizziness, severe nausea/vomiting/diarrhea, twitching muscles, unexplained fever, unusual agitation/restlessness.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Desvenlafaxine?

Some products that may interact with this drug include: other drugs that can cause bleeding/bruising (including antiplatelet drugs such as clopidogrel, NSAIDs such as ibuprofen/naproxen, “blood thinners” such as dabigatran/warfarin).

Aspirin can increase the risk of bleeding when used with this medication. However, if your doctor has directed you to take low-dose aspirin for heart attack or stroke prevention (usually at dosages of 81-325 milligrams a day), you should continue taking it unless your doctor instructs you otherwise. Ask your doctor or pharmacist for more details.

Taking MAO inhibitors with this medication may cause a serious (possibly fatal) drug interaction. Avoid taking MAO inhibitors (isocarboxazid, linezolid, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, tranylcypromine) during treatment with this medication. Most MAO inhibitors should also not be taken for two weeks before and at least 7 days after treatment with this medication. Ask your doctor when to start or stop taking this medication.

The risk of serotonin syndrome/toxicity increases if you are also taking other drugs that increase serotonin. Examples include street drugs such as MDMA/”ecstasy,” St. John’s wort, certain antidepressants (including other SNRIs such as duloxetine/milnacipran, SSRIs such as fluoxetine/paroxetine), tryptophan, among others. The risk of serotonin syndrome/toxicity may be more likely when you start or increase the dose of these drugs.

Tell your doctor or pharmacist if you are taking other products that cause drowsiness such as opioid pain or cough relievers (such as codeine, hydrocodone), alcohol, marijuana, drugs for sleep or anxiety (such as alprazolam, lorazepam, zolpidem), muscle relaxants (such as carisoprodol, cyclobenzaprine), or antihistamines (such as cetirizine, diphenhydramine).

Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.

Desvenlafaxine is very similar to venlafaxine. Do not use medications containing venlafaxine while using desvenlafaxine.

This medication may interfere with certain lab tests (including urine tests for amphetamines), possibly causing false test results. Make sure lab personnel and all your doctors know you use this drug.

Desvenlafaxine may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Does food or alcohol interact with Desvenlafaxine?

Desvenlafaxine may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Desvenlafaxine?

Desvenlafaxine may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this Desvenlafaxine.

What is the dose of Desvenlafaxine for an adult?

Usual Adult Dose for Depression

50 mg orally once a day, with or without food

-Maximum dose: 400 mg/day

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)

Renal Dose Adjustments

Mild renal dysfunction (CrCl greater than 50 mL/min): No adjustment recommended.

Moderate renal dysfunction (CrCl 30 to 50 mL/min): 50 mg orally once a day

Severe renal dysfunction (CrCl less than 30 mL/min) OR end-stage renal disease (CrCl less than 15 mL/min): 25 mg orally once a day OR 50 mg orally every other day

Liver Dose Adjustments

Mild liver dysfunction (Child-Pugh Class A): No adjustment recommended.

Moderate to severe liver dysfunction (Child-Pugh Class B to C): 50 mg per day

-Doses above 100 mg per day are not recommended.

Dose Adjustments

-A reduction in dose OR discontinuation should be considered in patients who develop a sustained increase in blood pressure.

-Prior to discontinuing treatment, gradual dose reduction to 25 mg/day is recommended to minimize discontinuation symptoms.

Switching patients to/from MAOIs:

-Starting treatment with this drug: At least 14 days should elapse between discontinuing MAOI therapy and starting treatment.

-Stopping treatment with this drug: At least 7 days should elapse between stopping treatment and starting an MAOI.

Patients who require urgent treatment with linezolid/IV methylene blue during treatment:

-The potential benefits must outweigh the risks of serotonin syndrome.

-This drug should be stopped promptly before administering linezolid/IV methylene blue.

-Patients should be monitored for serotonin syndrome for 7 days OR 24 hours after the last dose of linezolid/IV methylene blue, whichever comes first.

-Treatment may resume 24 hours after the last dose of linezolid/IV methylene blue.

Dialysis

Supplemental doses should not be administered after dialysis.

Other Comments

Administration advice:

-Tablets should be taken at approximately the same time each day.

-Tablets should be swallowed whole with fluid and not divided, crushed, chewed, or dissolved.

General:

-Acute episodes usually require at least several months of sustained treatment.

-Patients should be periodically reassessed to determine the need for continued treatment.

-A gradual dose reduction is recommended whenever possible.

-If intolerable symptoms develop following a decrease in the dose or upon discontinuation, resumption of the previously prescribed dose should be considered.

-Discontinuation symptoms have been reported when switching from other antidepressants, including venlafaxine, to this drug.

Monitoring:

-Cardiovascular: Regular blood pressure monitoring

-Neurologic: Signs/symptoms of serotonin syndrome

-Psychiatric: Discontinuation symptoms, worsening and emergence of suicidal thoughts

Patient advice:

-Patients should be advised to avoid alcohol.

-Patients may notice an inert matrix tablet passing in the stool or via colostomy.

-Inform patients that this drug may impair judgement, motor skills, and/or thinking, and they should avoid driving or operating machinery if these side effects occur.

-Advise patients to speak to their healthcare provider if they become pregnant, intend to become pregnant, or are breastfeeding.

What is the dose of Desvenlafaxine for a child?

The dosage has not been established in pediatric patients. It may be unsafe for your child. It is always important to fully understand the safety of the drug before using. Please consult with your doctor or pharmacist for more information.

How is Desvenlafaxine available?

Desvenlafaxine is available in the following dosage forms and strengths:

  • Tablet,Extended Release

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Desvenlafaxine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: January 19, 2018 | Last Modified: January 19, 2018

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