Desvenlafaxine (oral)

Desvenlafaxine works to increase the activity of serotonin and norepinephrine within the brain for the treatment of patients with depression.

Overview

Desvenlafaxine is used in the treatment of depression in patients. While it is not known exactly how this treatment works, it is believed it increases the activity of chemicals called serotonin and norepinephrine within the brain of the patient.

Desvenlafaxine is only available with a doctor's prescription and is administered as either Khedezla or Pristiq.

The treatment is taken in the form of an extended-release tablet.

Condition treated

  • Depression

Type Of Medicine

  • Serotonin and norepinephrine reuptake inhibitor (SNRI)

Side Effects

In addition to the required side effects from the use of Desvenlafaxine, other unwanted side effects may occur. These side effects may not all occur in the patient, but in some cases when they do the patient will need to seek medical attention.

You should check with your doctor immediately if you experience any of the following:

Occurring less commonly:

  • Chills when warm
  • Cold sweats
  • Confusion or disorientation
  • Faintness, or dizziness when rising quickly from lying or sitting down
  • Fast or pounding pulse
  • Headaches
  • Irregularity of pulse
  • Numbness in the arms or legs
  • Shakiness of the legs, arms, hands or feet
  • Tingling in the arms or legs
  • Trembling of the hands or feet
  • Trouble speaking
  • Trouble thinking
  • Trouble walking
  • Weakness

Frequency of incidence unknown:

  • Blistering or peeling of the skin
  • Blood appearing in the stool
  • Blood appearing in the urine
  • Convulsions or seizures
  • Coughing
  • Diarrhea
  • Dilated pupils
  • Enlarged pupils
  • Feeling of irritation
  • Feverishness
  • Hives
  • Hoarseness
  • Irritated eyes that may be red
  • Itching
  • Jerking of extremities
  • Joint pains, stiffness or swelling
  • Loosening of the skin
  • Loss of usual bladder control
  • Muscle pains
  • Muscle spasms
  • Nosebleeds
  • Rash
  • Red skin lesions that sometimes have a purple center
  • Reddening of the skin
  • Soreness of the throat
  • Sores or ulcers on the mouth
  • Sudden loss of consciousness
  • Swelling with the appearance of hives on the:
  • Tongue
  • Throat
  • Sexual organs
  • Lips
  • Legs
  • Hands
  • Feet
  • Face
  • Eyelids
  • Swollen eyelids, face, lips, hands or feet
  • Talking, feeling or acting with unusual excitement
  • Tightness across the chest
  • Troubled breathing
  • Troubled swallowing
  • Unusual bruising
  • Unusual tiredness
  • Unusual weakness
  • Vomiting of blood
  • White spots on the mouth or lips

Other side effects may also occur from the use of this treatment that may not require you to seek medical attention. These side effects will usually abate with use of the treatment as the body becomes used to the treatment and they are not usually signs of other medical conditions developing. The following side effects would not normally necessitate seeking medical attention, but you can consult your doctor if these side effects are ongoing or become bothersome:

Occurring more commonly:

  • Decreased hunger
  • Dilated pupils
  • Enlarged pupils
  • Inability to gain or maintain an erection
  • Inability to orgasm
  • Increased sensitivity of eyes to light
  • Loss of sexual ability and performance
  • Loss of sexual desire and drive
  • Sleeplessness
  • Unusual drowsiness
  • Unusual sleepiness

Occurring less commonly:

  • Changed taste
  • Continuous ringing or buzzing noise in the ears
  • Decrease in weight
  • Difficulty with urination
  • Fear or nervousness
  • Hearing loss
  • Increased sensitivity of eyes to light
  • Jitteriness
  • Lack of strength
  • Loss of strength
  • Loss of taste

Other side effects can also occur that may not have been listed here. You should check with your healthcare professional if other side effects occur and seek their advice. If you are concerned about your immediate health, however, then you should contact the emergency services.

Dosage

This medication should only ever be taken as directed by your doctor. Do not take more of it, use it more frequently than prescribed or take it for longer than prescribed.

This medication is usually supplied along with a medication guide that you should read and follow closely. If you have any questions following the reading of the guide, you should discuss these with your doctor.

You may need to take this treatment for a number of weeks before any change or effect is realized.

This medication should be taken at the same time each day and should be taken with food.

Extended release tablets should be swallowed whole and should not be crushed, broken or in any way damaged before taking them.

Part of the extended release tablet may be seen in your stools. This is normal and is not anything to be concerned about.

This dose will differ for each person and your doctor may make changes to your dose a number of times. You should not, however, make any changes to the dose yourself unless directed to by your doctor. The following information is a guideline only:

For the treatment of depression with extended release tablets in:

  • Adults ' 50mg taken once daily. Your doctor may adjust this dose as required.
  • Children 'Use and dose must be determined by the doctor in each case.

If a dose of this medication is missed then you should take it as soon as you are able to. If you are then close to your second dose, however, then you should skip the missed dose and return to your usual schedule of treatment. You should not take double doses of this medication under any circumstances.

For best effect with this treatment, the medication should be taken at the same time each day. This should form a part of your daily routine to help you avoid missing treatments.

Interactions

Desvenlafaxine can interact with a range of other medications in the body. For this reason, it is essential that you share information with your doctor about all treatments that you are taking before you begin the use of this medication. Some medications can have severe side effects when taken together while others may simply need adjustments to be made to the dose taken.

Desvenlafaxine is not recommended for use with the following treatments. Your doctor may need to prescribe an alternative medication:

  • Tranylcypromine
  • Selegiline
  • Safinamide
  • Rasagiline
  • Procarbazine
  • Phenelzine
  • Moclobemide
  • Metoclopramide
  • Methylene Blue
  • Linezolid
  • Isocarboxazid
  • Iproniazid
  • Furazolidone
  • Bromopride

Desvenlafaxine use is not normally recommended in conjunction with the following medications. Your doctor may still prescribe both, but may change the dose or frequency of use of one or more of these treatments:

  • Zolmitriptan
  • Ziprasidone
  • Xemilofiban
  • Warfarin
  • Vortioxetine
  • Vilazodone
  • Venlafaxine
  • Valdecoxib
  • Tryptophan
  • Trimipramine
  • Trazodone
  • Tramadol
  • Tolmetin
  • Tolfenamic Acid
  • Tirofiban
  • Ticlopidine
  • Tiaprofenic Acid
  • Tianeptine
  • Tenoxicam
  • Tapentadol
  • Sumatriptan
  • Sulodexide
  • Sulindac
  • Sulfinpyrazone
  • St John's Wort
  • Sodium Salicylate
  • Sibutramine
  • Sibrafiban
  • Sertraline
  • Salsalate
  • Salicylic Acid
  • Rofecoxib
  • Rizatriptan
  • Rivaroxaban
  • Protriptyline
  • Proquazone
  • Propyphenazone
  • Proglumetacin
  • Pranoprofen
  • Piroxicam
  • Piketoprofen
  • Phenylbutazone
  • Phenprocoumon
  • Phenindione
  • Pentosan Polysulfate Sodium
  • Pentazocine
  • Paroxetine
  • Parecoxib
  • Palonosetron
  • Oxyphenbutazone
  • Oxycodone
  • Oxaprozin
  • Opipramol
  • Nortriptyline
  • Nimesulide Beta Cyclodextrin
  • Nimesulide
  • Niflumic Acid
  • Nepafenac
  • Nefazodone
  • Naratriptan
  • Naproxen
  • Nabumetone
  • Morniflumate
  • Mirtazapine
  • Milnacipran
  • Methadone
  • Meperidine
  • Meloxicam
  • Melitracen
  • Mefenamic Acid
  • Meclofenamate
  • Lumiracoxib
  • Loxoprofen
  • Lornoxicam
  • Lorcaserin
  • Lofepramine
  • Lithium
  • Lexipafant
  • Levomilnacipran
  • Lamifiban
  • Ketorolac
  • Ketoprofen
  • Iobenguane I 123
  • Indomethacin
  • Imipramine
  • Iloprost
  • Ibuprofen
  • Hydroxytryptophan
  • Heparin
  • Granisetron
  • Frovatriptan
  • Fondaparinux
  • Fluvoxamine
  • Flurbiprofen
  • Fluoxetine
  • Flufenamic Acid
  • Floctafenine
  • Feprazone
  • Fepradinol
  • Fentanyl
  • Fenoprofen
  • Felbinac
  • Etoricoxib
  • Etofenamate
  • Etodolac
  • Escitalopram
  • Eptifibatide
  • Epoprostenol
  • Eletriptan
  • Edoxaban
  • Duloxetine
  • Droxicam
  • Doxepin
  • Donepezil
  • Dolasetron
  • Dipyrone
  • Dipyridamole
  • Diflunisal
  • Dicumarol
  • Diclofenac
  • Dibenzepin
  • Dextromethorphan
  • Dexketoprofen
  • Dexibuprofen
  • Desirudin
  • Desipramine
  • Dermatan Sulfate
  • Defibrotide
  • Danaparoid
  • Cyclobenzaprine
  • Cocaine
  • Clopidogrel
  • Clonixin
  • Clomipramine
  • Citalopram
  • Cilostazol
  • Choline Salicylate
  • Chlorpheniramine
  • Celecoxib
  • Carbamazepine
  • Buspirone
  • Bupropion
  • Buprenorphine
  • Bufexamac
  • Brompheniramine
  • Bromfenac
  • Bivalirudin
  • Aspirin
  • Apixaban
  • Antithrombin III Human
  • Anisindione
  • Ancrod
  • Anagrelide
  • Amtolmetin Guacil
  • Amoxapine
  • Amitriptylinoxide
  • Amitriptyline
  • Amineptine
  • Almotriptan
  • Acenocoumarol
  • Acemetacin
  • Aceclofenac
  • Abciximab

Interactions between Desvenlafaxine and other medications may also occur. You should ensure that your doctor is aware of every substance you take before you begin this treatment.

Certain medications can also interact with foods, drinks, tobacco, and alcohol and should not be taken in conjunction with these. You should discuss this with your doctor before use. In the case of Desvenlafaxine, this medication will interact with ethanol, making alcohol consumption less safe during use. You should discuss this with your doctor before use.

Medical problems from which you suffer can also affect the use of this treatment. In some cases, a medical condition may make a medication less effective or may be worsened by the treatment for another condition. You should inform your doctor of your full medical history before you begin treatment with Desvenlafaxine. This is especially important with the following conditions:

The following conditions may be worsened by Desvenlafaxine:

  • Bipolar disorder
  • Bleeding problems
  • Glaucoma
  • Heart disease
  • Blood vessel disease
  • Hyperlipidemia
  • Hyponatremia
  • History of intersititial lung disease
  • History of mania or hypermania
  • History of seizures
  • History of stroke
  • Tachycardia

The effects of Desvenlafaxine may be increased because of slower removal from the body in patients with the following conditions:

  • Kidney disease
  • Liver disease

Warnings

Before beginning treatment with Desvenlafaxine, it is important that you consider the risks of use in relation to the benefit. The risks may differ for different patients but it is important to consider all of the possible side effects. Make this decision with your doctor and ensure that you have taken the following factors into account:

Allergies ' If you have had an unusual reaction to any medications in the past then you must inform your doctor. Allergies to medications may prohibit the use of this treatment. You should also inform your doctor of any other allergies that you have including allergies to dyes, preservatives, foods, and animals.

Pediatric ' Safety and efficiency have not been established in children. You should discuss this with your doctor. More appropriate treatments may be available for use in children.

Geriatric ' Elderly patients have not demonstrated any specific problems with the use of Desvenlafaxine. They are, however, more likely to have other medical conditions including kidney problems, hyponatremia and low blood pressure that may require an adjustment in dose.

Pregnancy' There is a risk to the use of Desvenlafaxine in patients who are pregnant. In some cases, however, the benefits of the use of this treatment may outweigh the risk by keeping the mother healthy during pregnancy. If you are pregnant or may get pregnant then you should inform your doctor before use. You should inform your doctor immediately if you believe you have become pregnant during the use of this treatment.

Breastfeeding ' There are no studies determining the safety of use of Desvenlafaxine when breastfeeding. You should consider this with your doctor and weigh the benefits of use against the risks of use when nursing an infant.

Your doctor will need to see you regularly during the use of this treatment. This will allow for changes in dose to be made and will allow the doctor to check for unwanted side effects that may be being caused by the treatment. Your doctor may wish to check your blood pressure and take samples of your blood in order to check for any unwanted side effects of treatment.

Desvenlafaxine should not be taken in conjunction with any monoamine oxidase inhibitors (MAOs). You should not use this treatment for 2 weeks after having received an MAO treatment and you should wait for 1 week after ceasing use of Desvenlafaxine before receiving an MAO treatment. The use of these medications together can cause serious problems in the patient. Ensure that you always wait for the proper period before use.

You should not take any medications that contain venlafaxine with Desvenlafaxine.

Desvenlafaxine can cause teenagers and young adults to have abnormal behaviors and may cause some people to have abnormal thoughts. If you notice a change in behavior when taking this treatment you should contact your doctor immediately. Any big increases in energy or reckless behavior should be reported, especially if these behaviors are worsening.

You should inform your doctor before use if anyone in your family has ever attempted to commit suicide or has suffered from manic-depressive disorder.

You should never stop this treatment without discussing it with your doctor. This treatment will cause a level of dependency in your body and ceasing it suddenly will give you withdrawal symptoms that may make your condition worse. Patients will need to have their dose gradually reduced to prevent this from occurring. Side effects of rapid cessation of treatment will include:

  • Agitation
  • Changed vision
  • Difficulty breathing
  • Dizziness
  • Headache
  • Increased heartbeat
  • Lightheadedness
  • Muscle pains
  • Nausea
  • Profuse sweating
  • Shaking
  • Unusual tiredness
  • Unusual weakness
  • Vomiting

Desvenlafaxine may cause a condition called serotonin syndrome if you use it in conjunction with other treatments. This can include use of St. John's Wort and other herbal remedies. You should consult your doctor before taking any other medication whether it is prescribed or purchased.

Desvenlafaxine lung problems can occur from the use of this treatment. You should inform your doctor immediately that you experience any symptoms of lung problems such as:

  • Chest pains
  • Cough
  • Troubled breathing

This treatment can increase the risk of the development of bleeding problems. Any other treatments that may thin the blood should be avoided and reported to your doctor before use. Inform any other prescribing doctor that you are taking Desvenlafaxine before receiving any other treatment.

This medication can cause hyponatraemia and this is especially common in elderly patients, patients receiving diuretic treatments and those who are also suffering vomiting or diarrhea. The symptoms of this condition include:

  • Confusion or disorientation
  • Headache
  • Problems with memory
  • Trouble in concentrating
  • Weakness
  • Unsteadiness on feet

Desvenlafaxine can make you dizzy or drowsy. Driving or operating machinery in this state is dangerous and should not be done. Ensure that you are fully alert and competent to operate before use.

Alcohol should not be consumed when taking this treatment. If this is a problem for you then you should inform your doctor before treatment.

You should inform all medical professionals that you are taking this treatment before having any tests carried out. Desvenlafaxine can affect the results of certain tests and may lead to misdiagnosis.

You should not take any other medication with this treatment without first discussing it with your doctor. Over the counter treatments such as ibuprofen and herbal remedies such as St. John's Wort can put a patient in significant danger if taken with Desvenlafaxine. Ensure that you check before taking any other medication for any other condition.

Storage

This medication can be stored at room temperature but should be kept away from heat, moisture and direct light. This medication should not be allowed to freeze.

Always store well out of the reach of children.

Dispose of unwanted or outdated medication safely as directed to by your pharmacist or doctor.

Summary

Desvenlafaxine is a treatment used in patients who are suffering from depression. The exact means by which this treatment works is unknown, but it is believed to work by increasing the activity of chemicals called serotonin and norepinephrine within the brain of the patient. This treatment is part of the grouping of medications known as Serotonin and norepinephrine reuptake inhibitors (SNRIs).

Desvenlafaxine needs to be taken on a regular daily schedule in order to be effective. It should be worked into the normal routine of the patient and taken with a meal at the same time each day. Doing so will keep treatment regular and will help the patient to form a habit and ensure that they remember to take it.

Desvenlafaxine is administered as an extended release tablet that should be taken whole and unbroken. The medication will then release into the body slowly through the day. The casings of these capsules may appear in your stools. This is normal and is nothing to be worried about.

Desvenlafaxine should not be taken with alcohol. Patients being treated with this medication should avoid alcohol at all times and you should inform your doctor if this is going to be problematic for you.

Desvenlafaxine may cause a wide range of side effects and can cause serious health conditions to develop in the patient. You should understand the potential risks of use and weigh them against the benefits of use before you begin treatment with Desvenlafaxine.

Teenagers and young adults using this treatment may experience behavioral changes and may have thoughts of suicide before use. Any changes to mental state or behavior must be reported to the doctor immediately.