Desvenlafaxine


Concise Prescribing Info
Indications/Uses
Depression.
Dosage/Direction for Use
Adult : PO 50 mg once daily; doses up to 400 mg once daily have been studied but no additional benefit was observed w/ doses >50 mg once daily.
Dosage Details
Oral
Depression
Adult: 50 mg once daily. Doses up to 400 mg once daily have been studied and shown to be effective, but no additional benefit was observed w/ doses >50 mg once daily.
Renal Impairment
CrCl (mL/min) Dosage
<30 or ESRD 25 mg daily or 50 mg every other day. Supplemental doses should not be given after dialysis.
30-50 Max: 50 mg once daily.
Hepatic Impairment
Moderate to severe: 50 mg daily. Max: 100 mg once daily.
Administration
Extended-Release: May be taken with or without food. Take at the same time each day. Swallow whole, do not divide/crush/chew/dissolve tab.
Contraindications
Concurrent use or w/in 14 days of discontinuing MAOIs (e.g. linezolid, IV methylene blue). Initiation of MAOI at least 7 days after discontinuing desvenlafaxine.
Special Precautions
Patient w/ pre-existing HTN or other conditions that may be compromised by increased BP, raised intraocular pressure, personal or family history of mania or hypomania; CV, cerebrovascular or lipid metabolism disorders; seizure disorder. Avoid abrupt withdrawal. Renal and moderate to severe hepatic impairment. Pregnancy and lactation.
Adverse Reactions
Suicidal thinking/behaviour, HTN, mydriasis, seizure, hyponatraemia, interstitial lung disease and eosinophilic pneumonia; nausea, dizziness, insomnia, hyperhidrosis, constipation, somnolence, decreased appetite, anxiety, sexual function disorders in males (e.g. anorgasmia, decreased libido, abnormal orgasm, delayed ejaculation, erectile dysfunction, ejaculation disorder, ejaculation failure, sexual dysfunction).
Potentially Fatal: Serotonin syndrome or neuroleptic malignant syndrome-like reactions; haemorrhage.
Patient Counseling Information
May impair ability to drive or operate machinery.
MonitoringParameters
Monitor renal function, BP, lipid panel (e.g. total cholesterol, LDL, triglycerides); signs/symptoms of serotonin syndrome; mental status for depression, suicidal ideation (esp at the beginning of therapy or when doses are increased or decreased); intraocular pressure (in patients w/ baseline elevations or history of glaucoma).
Drug Interactions
Increased risk of bleeding w/ aspirin or other NSAIDs, warfarin and other anticoagulants.
Potentially Fatal: Increased risk of serotonin syndrome w/ MAOIs (e.g. linezolid, IV methylene blue).
Food Interaction
Avoid alcohol. May increase risk of serotonin syndrome w/ St John's wort.
Lab Interference
May cause false positive urine immunoassay screening tests for phencyclidine and amphetamine.
Action
Description: Desvenlafaxine is the principal active metabolite of venlafaxine. The exact mechanism is unknown, but is thought to be related to the potentiation of serotonin and norepinephrine in the CNS, through inhibition of their reuptake.
Pharmacokinetics:
Absorption: Well absorbed. Bioavailability: 80%. Time to peak plasma concentration: Approx 7.5 hr.
Distribution: Volume of distribution: 3.4 L/kg. Plasma protein binding: Approx 30%.
Metabolism: Hepatic, via conjugation (major pathway), and oxidation by CYP3A4 (minor pathway).
Excretion: Via urine, as unchanged drug (45%) and as metabolites (approx 24%). Elimination half-life: Approx 10-11 hr.
Chemical Structure

Chemical Structure Image

Source: National Center for Biotechnology Information. PubChem Database. Desvenlafaxine, CID=125017, https://pubchem.ncbi.nlm.nih.gov/compound/Desvenlafaxine (accessed on Jan. 20, 2020)

Storage
Store between 20-25°C.
MIMS Class
ATC Classification
N06AX23 - desvenlafaxine ; Belongs to the class of other antidepressants.
References
Anon. Desvenlafaxine. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 06/11/2015.

Buckingham R (ed). Desvenlafaxine Succinate. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com . Accessed 06/11/2015.

McEvoy GK, Snow EK, Miller J et al (eds). Desvenlafaxine Succinate. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 06/11/2015.

Pristiq Extended-Release Tablet (Wyeth Pharmaceuticals Inc., a subsidiary of Pfizer Inc). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 06/11/2015.

Disclaimer: This information is independently developed by MIMS based on Desvenlafaxine from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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