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.
Ketoconazole (Nizoral, Extina, Xolegel, Kuric) may reduce the breakdown of desvenlafaxine, therefore increasing concentrations of desvenlafaxine in the body and the risk of adverse effects. Desvenlafaxine may reduce the concentration of midazolam (Versed).
PREGNANCY: There are no adequate studies of desvenlafaxine in pregnant women.
NURSING MOTHERS: Desvenlafaxine is secreted in breast milk. Mothers who are taking desvenlafaxine should discuss with their doctor whether to not breastfeed or to discontinue desvenlafaxine.
SIDE EFFECTS: Desvenlafaxine can cause nausea, headaches, anxiety, insomnia, drowsiness, constipation, weakness, dry mouth, sweating, diarrhea, and loss of appetite. Increased blood pressure can occur and should be monitored. Seizures have been reported. Sexual dysfunction (decreased sex drive and delayed orgasm and ejaculation) has been associated with desvenlafaxine. Desvenlafaxine and other SNRIs may increase the risk of gastrointestinal bleeding.
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