desvenlafaxine PRISTIQ

Class: SNRI
FDA Indications: MDD
Off-Label Use: GAD, Vasomotor Symptoms, Fibromyalgia, PTSD, Social Anxiety, Panic Disorder, PMDD
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: nausea, dizziness, insomnia, sedation/somnolence, hyperhidrosis, constipation, 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

References
Desvenlafaxine Package Insert
Desvenlafaxine. Indian Journal Of Psychiatry.

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Last updated August 16 2023 14:43:53. Disclaimer: This website does not provide medical advice, nor is it a substitute for clinical judgment.