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|
|
 desvenlafaxine |
| Pristiq |
Pharmaceutical
company:
Wyeth
www.wyeth.com |
Pharmacologic classification: selective serotonin and norepinephrine reuptake inhibitor (SSNRI)
Therapeutic classification: antidepressant
Pregnancy risk category: C
AVAILABLE FORMS
Tablets: 50 mg, 100 mg
INDICATIONS AND DOSAGES
Major depressive disorder--
Adults: 50 mg P.O. daily, with or without food. Dose range 50 to 400 mg/day.
ADJUST-A-DOSE:
In patients with moderate renal dysfunction, give 50 mg P.O. daily. In patients with severe renal dysfunction and end-stage renal disease, give 50 mg P.O. every other day. In patients with hepatic dysfunction, don’t give more than 100 mg daily.
CONTRAINDICATIONS AND CAUTIONS
Contraindicated in patients hypersensitive to any component of desvenlafaxine or venlafaxine
Contraindicated in those who use an monoamine oxidase (MAO) inhibitor, or within 14 days of stopping an MAO inhibitor.
Use cautiously in patients with hypertension, glaucoma, abnormal bleeding (or who use drugs that alter coagulation), vascular disease, lipid disorders, renal impairment, or lung disease.
Use cautiously in pregnant or breast-feeding patients.
INTERACTIONS
Drug-drug.
CYP3A4 inhibitors (ketoconazole): May increase desvenlafaxine levels. Use cautiously together.
Drugs that affect coagulation (nonsteroidal anti-inflammatory drugs, aspirin, warfarin): May increase the risk of bleeding. Monitor patient closely and adjust dosage as needed.
MAO inhibitors: May increase risk of serious adverse reactions. Wait 14 days after stopping MAO inhibitor before beginning desvenlafaxine. Allow 7 days after stopping desvenlafaxine before beginning MAO inhibitor.
Other CNS active drugs: May increase the risk of impaired mental ability. Monitor patient closely.
Selective serotonin reuptake inhibitors, SSNRIs, triptans: May increase the risk of serotonin syndrome. Avoid using together if possible. If use together is unavoidable, monitor patient closely, especially during initial treatment and dose increases.
Venlafaxine: May increase the risk of toxicity. Avoid using together.
Drug-herb.
St. John’s wort: May increase risk of serotonin syndrome. Avoid using together.
Drug-lifestyle.
Alcohol use: May increase impairment of mental ability. Discourage use together.
ADVERSE REACTIONS
CNS: asthenia, anxiety, depersonalization, dizziness, extrapyramidal disorder, fatigue, headache, hypomania, insomnia, somnolence, tremor, paresthesia, nervousness, irritability, abnormal dreams, seizures, suicidal ideation, syncope, activation of bipolar symptoms.
CV: hot flushes, palpitations, increased blood pressure, orthostatic hypotension, tachycardia.
EENT: blurred vision, dysguesia, epistaxis, tinnitus, mydriasis.
GI: nausea, dry mouth, diarrhea, constipation, vomiting, decreased appetite.
GU: sexual dysfunction, urinary hesitation.
Metabolic: increased cholesterol and triglyceride levels, weight decrease.
Respiratory: interstitial lung disease, eosinophilic pneumonia.
Skin: hyperhidrosis, rash.
Other: chills, hypersensitivity reaction, yawning.
Reactions may be common, uncommon, life-threatening,
or COMMON AND LIFE-THREATENING.
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