Desvenlafaxine | Side Effects, Dosage, Uses & More
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Generic Name:

desvenlafaxine, Oral tablet

Generic Name:

All Brands

  • Khedezla
  • Pristiq
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Highlights for desvenlafaxine

Oral tablet
1

Desvenlafaxine is used to treat major depression.

2

Desvenlafaxine comes in the form of an extended-release tablet you take by mouth. Extended-release drugs are slowly released into the body over time.

3

Desvenlafaxine is available as the brand-name drugs Pristiq and Khedezla. It’s also available as a generic drug.

4

The more common side effects include nausea, dry mouth, constipation, vomiting, or tiredness.

5

Desvenlafaxine can worsen depression and cause suicidal thoughts or actions. This risk is increased during the first four weeks of treatment. If you have thoughts of harming yourself, talk with your doctor right away.

IMPORTANT INFORMATION

FDA warning

This drug has a black box warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients about drug effects that may be dangerous.

Increased risk of suicidal thinking and behavior. This drug can worsen depression and cause suicidal thoughts or actions. This risk is increased during the first four weeks of treatment. The risk may be greatest in patients 24 years of age and younger. If you have thoughts of harming yourself, talk with your doctor right away.

Use in children. This drug has not been shown to be safe or effective in children (younger than 18 years). If it’s used in children, the risks should be weighed against the potential benefits.

Serotonin syndrome

This drug can cause a serious condition called serotonin syndrome. With this condition, levels of serotonin (a natural brain chemical) are raised to dangerously high levels. This is most likely to occur when you take this medication with other drugs that work in a similar way. Serotonin syndrome causes symptoms such as agitation, hallucinations (seeing or hearing things that aren’t real), seizures, or nausea. If you have these symptoms, call your doctor right away.

Increased blood pressure

This drug may increase your blood pressure. Call your doctor if you notice changes in your blood pressure after you begin taking this drug.

Withdrawal symptoms

You may have symptoms of withdrawal if you suddenly stop taking this drug. These symptoms can include dizziness, headache, sweating, stomach upset, or feeling irritable. Do not stop taking this drug without speaking to your doctor first. If you have these symptoms after stopping this drug, call your doctor.

Drug features

Desvenlafaxine is a prescription drug. It comes in the form of an extended-release tablet you take by mouth. Extended-release drugs are slowly released into the body over time.

Desvenlafaxine is available as the brand-name drugs Pristiq and Khedezla. It’s also available as a generic drug. Generic drugs usually cost less. In some cases, they may not be available in every strength or form as the brand-name version. Talk to your doctor to see if the generic version will work for you. 

This drug may be used as part of a combination therapy. This means you may need to take it with other medications.

Why it's used

Desvenlafaxine is used to treat major depression. Symptoms can include feelings of sadness, loss of interest in daily activities, decreased energy level, or trouble sleeping. These symptoms last for two weeks or longer.

How it works

This drug belongs to a class of drugs called antidepressants. The specific type of drug is called a serotonin-norepinephrine reuptake inhibitor.

More Details

How it works

This drug belongs to a class of drugs called antidepressants. The specific type of drug is called a serotonin-norepinephrine reuptake inhibitor. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.   

Serotonin and norepinephrine are natural chemicals in the brain that help maintain mental balance. Desvenlafaxine may work by stopping the breakdown of these chemicals by a process called reuptake. This increases the amount of these chemicals in your brain, and may help to improve symptoms of depression.

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desvenlafaxine Side Effects

Oral tablet

More Common Side Effects

The more common side effects of desvenlafaxine can include:

  • nausea

  • dry mouth

  • constipation

  • vomiting

  • tiredness

  • feeling jittery

  • decreased appetite

  • dizziness

  • trouble sleeping

  • blurry vision

  • decreased sex drive

  • problems with sexual function

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious Side Effects

Call your doctor right away if you have serious side effects. Call 9-1-1 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Serotonin syndrome. Symptoms can include:

    • agitation
    • hallucinations (seeing or hearing things that aren’t real)
    • seizures
    • nausea
  • Low salt levels. Symptoms can include:

    • headache
    • confusion
    • weakness
    • seizures
Pharmacist's Advice
Healthline Pharmacist Editorial Team

This drug may cause drowsiness. During the first few hours after you take it, it can also cause dizziness, drowsiness, dry mouth, or stomach upset.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
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desvenlafaxine May Interact with Other Medications

Oral tablet

Desvenlafaxine can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well. 

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Alcohol interaction

Avoid drinking alcohol while taking this drug. If you drink alcohol, talk with your doctor about whether this drug is safe for you.

Medications that might interact with this drug

Drugs you should not use with desvenlafaxine

Do not take these drugs with desvenlafaxine. Doing so can cause dangerous effects in the body. Examples of these drugs include: 

  • Monoamine oxidase inhibitors (MAOIs), a type of antidepressant, such as phenelzine, tranylcypromine, selegiline, or isocarboxazid.
    • Using these drugs with desvenlafaxine raises your risk of a condition called serotonin syndrome. If you’re starting treatment with desvenlafaxine, stop taking any MAOIs at least 7 days before. If you need to start treatment with an MAOI, stop taking desvenlafaxine at least 7 days before. 

Interactions that increase your risk of side effects

Taking desvenlafaxine with certain medications raises your risk of side effects from these drugs. These drugs include:

  • Antidepressants including SSRIs (such as citalopram, fluoxetine, or paroxetine), TCAs (such as amitriptyline or imipramine), and other serotonergic drugs including triptans (such as almotriptan, sumatriptan, or zolmitriptan).
    • Increased side effects can include raised serotonin levels, which can cause serotonin syndrome. Symptoms can include agitation, hallucinations (seeing or hearing things that aren’t real), seizures, or nausea. If you have these symptoms, call your doctor right away.
  • Drugs such as desipramine, atomoxetine, dextromethorphan, metoprolol, nebivolol, perphenazine, or tolterodine. 
    • Increased side effects vary depending on the drug. Your doctor may lower your dosage of these drugs if your desvenlafaxine dosage is 400 mg daily.
  • Diuretics (water pills), such as hydrochlorothiazide or furosemide.
    • Increased side effects can include low salt levels. If your salt levels get too low, your doctor may slowly take you off of desvenlafaxine and switch you to another antidepressant.
  • Non-steroidal anti-inflammatory drugs, such as aspirin, warfarin, dabigatran, edoxaban, apixaban, or rivaroxaban.
    • Using these drugs with desvenlafaxine raises your risk of bleeding.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

People with high blood pressure

This medication can increase your blood pressure. If you already have high blood pressure, talk with your doctor. You may need blood pressure treatment or regular monitoring of your blood pressure while you take this drug.

People with glaucoma

This drug may dilate your pupils (widen the dark centers of your eyes). This can trigger a glaucoma attack. Before taking this drug, talk with your doctor about whether this drug is safe for you.

People with seizure disorders

This medication may cause seizures. If you’ve ever had a seizure, tell your doctor before taking this drug.

People with low salt levels

This drug can cause low salt levels. The risk is higher for people whose salt levels are already low. This may include seniors (aged 65 years of older), people who take water pills, or people who are dehydrated. Talk with your doctor about whether this drug is safe for you.

People with kidney problems

This drug is cleared from your body by your kidneys. If your kidneys don’t work well, your body may clear this drug more slowly. This can increase the amount of the drug in your body and cause more side effects. To prevent this, your doctor may give you a lower dose of this drug.

People with liver problems

This drug is processed in your body by your liver. If your liver doesn’t work well, your body may process this drug more slowly. This may cause more side effects. To prevent this, your doctor may give you a lower dose of this drug.

Pregnant women

This drug is a category C pregnancy drug. That means two things:

  1. Research in animals has shown adverse effects to the fetus when the mother takes the drug.
  2. There haven’t been enough studies done in humans to be certain how the drug might affect the fetus.

Talk to your doctor if you’re pregnant or planning to become pregnant. This drug should only be used if the potential benefit justifies the potential risk to the fetus. 

Women who are breast-feeding

This drug may pass into breast milk and cause side effects in a child who is breast-fed.

Talk to your doctor if you breast-feed your child. You may need to decide whether to stop breast-feeding or stop taking this medication.

For seniors

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects.

If you are over the age of 65 years, you may be at higher risk of developing side effects while taking this drug. Therefore, your doctor may give you a lower dosage.

For children

This drug has not been studied in children. It should not be used in people younger than 18 years.

When to call the doctor

Call your doctor if you become pregnant while taking this drug.

Allergies

This drug can cause a severe allergic reaction. Symptoms can include:

  • trouble breathing
  • swelling of the throat or tongue 

If you have an allergic reaction, call your doctor or local poison control center right away. If your symptoms are severe, call 9-1-1 or go to the nearest emergency room. 

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

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How to Take desvenlafaxine (Dosage)

Oral tablet

All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What are you taking this medication for?

Major depressive disorder

Generic: desvenlafaxine

Form: Oral extended-release tablet
Strengths: 50 mg, 100 mg

Brand: Pristiq

Form: Oral extended-release tablet
Strengths: 25 mg, 50 mg, 100 mg

Brand: Khedezla

Form: Oral extended-release tablet
Strengths: 50 mg, 100 mg
Adult dosage (ages 18–64 years)
  • Typical starting dosage: 50 mg once per day.
  • Typical daily dosage: 50 mg once per day.
  • Dosage increases: Your doctor may increase your dosage to a maximum of 400 mg once per day.
Child dosage (ages 0–17 years)

Desvenlafaxine has not been studied in children. It should not be used in people younger than 18 years.

Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects.

Your doctor may start you on a lower dose or a different dosing schedule. This can help keep levels of this drug from building up too much in your body.

Special considerations

Kidney disease: Your dosage depends on the stage of your kidney disease. Your doctor may prescribe you 50 mg once per day, 25 mg once per day, or 50 mg once every other day.

Liver disease: Your dosage depends on the stage of your liver disease. Your doctor may prescribe you 50 mg once per day. In most cases, the maximum dosage would be 100 mg once per day.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Healthline Pharmacist Editorial Team

This drug comes with serious risks if you don’t take it as prescribed. 

If you stop taking the drug suddenly or don’t take it at all

If you suddenly stop taking this drug, you may have symptoms of withdrawal. These symptoms may include dizziness, headache, sweating, stomach upset, or feeling irritable. Do not stop taking this drug without talking to your doctor first. If you have these symptoms after stopping this drug, call your doctor right away.

If you don’t take this drug at all, your depression symptoms may not be controlled. These can include feelings of sadness, loss of interest in daily activities, decreased energy level, or trouble sleeping.

If you miss doses or don’t take the drug on schedule

Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times. 

If you take too much

You could have dangerous levels of the drug in your body. Symptoms of an overdose of this drug can include: 

  • agitation
  • hallucinations (seeing or hearing things that aren’t real)
  • seizures
  • nausea

If you think you’ve taken too much of this drug, call your doctor or local poison control center. If your symptoms are severe, call 9-1-1 or go to the nearest emergency room right away. 

What to do if you miss a dose

Take your dose as soon as you remember. But if you remember just a few hours before your next scheduled dose, take only one dose. Never try to catch up by taking two doses at once. This could result in dangerous side effects. 

How to tell if the drug is working

Your symptoms of depression should be less severe or happen less often. However, you may not notice any difference in your condition for the first several weeks. It can take up to 2 months for this drug to work well.

This drug is used for long-term treatment.

Important considerations for taking this drug
take this drug with or without food You can take this drug with or without food
timing Take this drug at the time(s) recommended by your doctor
Don’t cut or crush Don’t cut or crush the tablet
storage Store this drug carefully See Details
medication is refillable A prescription for this medication is refillable See Details
Travel Travel See Details
Clinical monitoring Clinical monitoring See Details
not usually stocked Not every pharmacy stocks this drug. When filling your prescription, be sure to call ahead
hidden costs Hidden costs See Details
prior authorization required Insurance See Details

Store this drug carefully

  • Store this drug at room temperature between 68°F and 77°F (20°C and 25°C).
  • Keep this drug away from light.
  • Don’t store this medication in moist or damp areas, such as bathrooms.

A prescription for this medication is refillable

You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

  • Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
  • Don’t worry about airport x-ray machines. They can’t hurt your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled box with you.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Clinical monitoring

Your doctor may monitor certain health issues. This can help make sure you stay safe while you take desvenlafaxine. These issues include: 

  • Kidney and liver function. Blood tests can check how well your kidneys are working. If your kidneys aren’t working well, your doctor may decide to lower your dose of this drug.
  • Mental health. Your doctor may ask you different questions to check your symptoms of depression. This can help your doctor know how well this drug is working.
  • Blood pressure. Your doctor may monitor your blood pressure. This can help make sure this drug is not raising your blood pressure too much.

Hidden costs

You may need to have blood tests during your treatment with this drug. The cost of these tests will depend on your insurance coverage.

Insurance

Many insurance companies require a prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.

Are there any alternatives?

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.

What does the pill look like?

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Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on November 30, 2015

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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