desvenlafaxine PRISTIQ

Class: SNRI
FDA Indications: MDD
Off-Label Use: Fibromyalgia, PMDD, GAD, PTSD, Social Anxiety, Panic Disorder, Vasomotor Symptoms
Prescribing
Forms: 25, 50, 100mg extended-release tablet
Dose Range: 50-100 mg/day
Starting: 50 mg is both a starting dose and therapeutic dose.
Stopping: A gradual reduction in the dose rather than abrupt cessation is recommended whenever possible

NAMI drug fact sheet

Precautions
Contraindications: Concomitant use of MAOIs
Serious Side Effects: Serotonin syndrome; ↑ risk of SI in children and young adults; may impair platelet aggregation; SIADH; HTN
Side Effects: sedation/somnolence, dizziness, constipation, hyperhidrosis, nausea, insomnia, decreased appetite, sexual dysfunction, anxiety
Pharmacodynamics
1° MOA: Serotonin norepinephrine reuptake inhibitor
Target: SERT, NET
Pharmacokinetics
t½: 10 (9-13)° TMAX: 7.5°
Substrate of: 3A4 (minimal)
Inhibits: ∅ ; Induces:
Active Metabolites:
DDIs
  • - DO NOT CO-PRESCRIBE WITH MAOIs (need a 14-day washout period)
  • - few known DDIs
Misc
  • - desvenlafaxine is venlafaxine's primary active metabolite
  • - from most to least noradrenergic: levomilnacipran (1:2, 5HT:NE ratio) >> duloxetine (10:1) > desvenlafaxine (12:1) > venlafaxine (30:1)
Special Populations

Category C—No controlled studies in humans; not generally recommended for use during pregnancy

RID 7.8%


↑ incidence of orthostatic hypotension


Maximum dose 25 mg per day or 50 mg qod


Max dose 100 mg qd in moderate to severe hepatic impairment

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Last updated December 05 2018 19:19:12. Disclaimer: This website does not provide medical advice, nor is it a substitute for clinical judgment.