Medications and Drugs
Pharmacy Author: Omudhome Ogbru, PharmD
Medical and Pharmacy Editor: Jay W. Marks, MD
GENERIC NAME: desvenlafaxine
BRAND NAME: Pristiq
DRUG CLASS AND MECHANISM: Desvenlafaxine is an oral drug that is used
for treating depression. It is in a class of drugs called selective serotonin
and norepinephrine reuptake inhibitors (SNRI); a class that also contains
venlafaxine (Effexor) and duloxetine (Cymbalta). (Desvenlafaxine is an active
metabolite of venlafaxine, that is, it is a product of venlafaxine that is
manufactured by the body from venlafaxine.) Desvenlafaxine affects
neurotransmitters, the chemicals that nerves within the brain make and release
in order to communicate with each other. Neurotransmitters either travel across
the space between nerves and attach to receptors on the surface of nearby nerves
or they attach to receptors on the surface of the nerves that produced them, to
be taken up by the nerve and released again (a process referred to as
re-uptake).
Many experts believe that an imbalance among neurotransmitters is the cause
of depression. Serotonin and norepinephrine are two neurotransmitters released
by nerves in the brain. Desvenlafaxine works by preventing the reuptake of
serotonin and epinephrine by nerves after they have been released. Since uptake
is an important mechanism for removing released neurotransmitters and
terminating their actions on adjacent nerves, the reduced uptake caused by
desvenlafaxine increases the effect of serotonin and norepinephrine in the
brain. The FDA approved desvenlafaxine in February 2008.
PRESCRIPTION: Yes
GENERIC AVAILABLE: No
PREPARATIONS: Tablets (extended release): 50, and 100 mg
STORAGE: Tablets should be kept at room temperature, 68-77 F
(20-25 C).
PRESCRIBED FOR: Desvenlafaxine is used for the treatment of major
depression.
DOSING: The recommended dose of desvenlafaxine is 50 mg daily, with or
without food. Doses greater than 50 mg are not more effective but cause more
side effects.
DRUG INTERACTIONS: All SNRIs, including desvenlafaxine, should not be
taken with any of the monoamine oxidase inhibitor (MAOI) class of
antidepressants, for example, isocarboxazid (Marplan), phenelzine (Nardil),
tranylcypromine (Parnate), selegiline (Eldepryl), and
procarbazine (Matulane) or
other drugs that inhibit monoamine oxidase [for example,
linezolid (Zyvox)]. Such combinations may
lead to confusion, high blood pressure, tremor, hyperactivity,
coma, and death.
Desvenlafaxine should not be administered within 14 days after stopping MAOIs
and MAOIs should not be administered within 7 days of stopping desvenlafaxine.
Similar reactions may occur if desvenlafaxine is combined with other SNRIs,
selective serotonin reuptake inhibitors [for example, fluoxetine (Prozac) or paroxetine
(Paxil)] or other drugs that increase serotonin in the brain, for example, tryptophan,
St. John's wort,
meperidine (Demerol) or tramadol (Ultram).
SNRIs may increase the effect of warfarin
(Coumadin), leading to excessive bleeding.
Warfarin therapy should be monitored more frequently in patients who are also
taking desvenlafaxine. Combining SNRIs with
aspirin,
nonsteroidal
antiinflammatory drugs (NSAIDs) or other drugs that affect bleeding may increase the
likelihood of upper gastrointestinal bleeding.
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
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