Desvenlafaxine (des-ven-la-FAX-een)

Treats depression. This medicine is a serotonin and norepinephrine reuptake inhibitor (SNRI).

Brand Name(s):

Pristiq

When This Medicine Should Not Be Used:

How to Use This Medicine:

Long Acting Tablet

• Your doctor will tell you how much of this medicine to use and how often. Your dose may need to be changed several times in order to find out what works best for you. Do not use more medicine or use it more often than your doctor tells you to.
• You may take this medicine with or without food.
• It is best to take this medicine at the same time each day.
• Swallow the extended-release tablet whole with water. Do not dissolve, crush, break, or chew it.
• This medicine should come with a Medication Guide. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions. Ask your pharmacist for the Medication Guide if you do not have one. Your doctor might ask you to sign some forms to show that you understand this information.

If a dose is missed:

• If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.

How to Store and Dispose of This Medicine:

• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
• Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any leftover medicine after you have finished your treatment. You will also need to throw away old medicine after the expiration date has passed.
• Keep all medicine away from children and never share your medicine with anyone.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Do not take a MAO inhibitor (such as isocarboxazid, phenelzine, selegiline, tranylcypromine, Eldepryl®, Marplan®, Nardil®, or Parnate®) while you are being treated with this medicine.
• Make sure your doctor knows if you are also using other medicines to treat depression (such as desipramine, fluoxetine, paroxetine, venlafaxine, Celexa®, Effexor®, Lexapro?, Norpramin®, Paxil®, or Zoloft®), medicines to treat migraine headaches (such as eletriptan, sumatriptan, Imitrex®, or Relpax®), pain or arthritis medicine, also called "NSAIDs" (such as aspirin, ibuprofen, tramadol, Aleve®, Celebrex®, or Ultram®), or a blood thinner (such as warfarin or Coumadin®).
• Tell your doctor if you are also using diuretics or "water pills" (such as hydrochlorothiazide [HCTZ], furosemide, or Lasix®), ketoconazole (Nizoral®), linezolid (Zyvox®), lithium (Lithane®, Lithobid®, or Eskalith®), midazolam (Versed®), sibutramine (Meridia®), tryptophan supplements, or St. John's wort.
• Tell your doctor if you are using any medicines that make you sleepy. These include sleeping pills, cold and allergy medicine, narcotic pain relievers, and sedatives.
• Do not drink alcohol while you are using this medicine.

Warnings While Using This Medicine:

• Make sure your doctor knows if you are pregnant, trying to become pregnant, or breastfeeding. Tell your doctor if you have liver disease, kidney disease, heart disease, had a recent heart attack or stroke, narrow-angle glaucoma (increased pressure inside the eye), high blood pressure, bleeding problems, high cholesterol in the blood, or low sodium in the blood. Tell your doctor if you have a history of seizures or if you have bipolar disorder.
• For some children, teenagers, and young adults, this medicine can increase thoughts of suicide. Tell your doctor or your child's doctor right away if you or your child start to feel more depressed and have thoughts about hurting yourselves. Report any unusual thoughts or behaviors that trouble you or your child, especially if they are new or are getting worse quickly. Make sure the doctor knows if you or your child have trouble sleeping, get upset easily, have a big increase in energy, or start to act reckless. Also tell the doctor if you or your child have sudden or strong feelings, such as feeling nervous, angry, restless, violent, or scared. Let the doctor know if you, your child, or anyone in your family has bipolar disorder or has tried to commit suicide.
• This medicine may cause serious conditions called serotonin syndrome or neuroleptic malignant syndrome (NMS)-like reactions when taken alone or with certain medicines. Talk with your doctor if you have concerns about this and check with your doctor first before taking any other medicines.
• You may need to have your blood pressure and pulse checked before starting and while you are using this medicine. If you notice any changes in your blood pressure or pulse rate, call your doctor right away. If you have questions about this, talk to your doctor.
• Hyponatremia (low sodium in the blood) may occur while you are using this medicine. Check with your doctor right away if you have a headache; difficulty concentrating; memory changes; confusion; or weakness and unsteadiness on your feet. Symptoms of a severe hyponatremia include: seeing, hearing, or feeling things that are not there; fainting; or seizures.
• This medicine may cause serious lung problems (such as interstitial lung disease, eosinophilic pneumonia). Check with your doctor right away and stop using this medicine if you have chest discomfort or tightness, a cough, difficult or labored breathing, shortness of breath, or wheezing.
• Check with your doctor right away if you develop any allergic reactions to this medicine such as rash, hives, swelling, or difficulty breathing.
• This medicine may make you dizzy or drowsy. Avoid driving, using machines, or doing anything else that could be dangerous if you are not alert.
• Do not stop using this medicine suddenly without asking your doctor. You may need to slowly decrease your dose before stopping it completely.
• Your doctor will need to check your progress at regular visits while you are using this medicine. Be sure to keep all appointments. Blood tests may be needed to check for unwanted effects such as increased cholesterol and fats in the blood.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Blurred vision or enlarged pupils (black part of eye).
• Chest pain, cough, or shortness of breath.
• Confusion, weakness, and muscle twitching.
• Decrease in how much or how often you urinate.
• Fast, pounding, or uneven heartbeat.
• Feeling more excited or energetic than usual.
• Fever or chills.
• Numbness, tingling, or burning pain in your hands, arms, legs, or feet.
• Seeing, hearing, or feeling things that are not there.
• Seizures or tremors.
• Unusual behavior or thoughts of hurting yourself or others.
• Unusual bleeding or bruising.

If you notice these less serious side effects, talk with your doctor:

• Anxiety, nervousness, trouble sleeping, or unusual dreams.
• Constipation, diarrhea, nausea, or vomiting.
• Decreased weight.
• Dizziness.
• Dry mouth or loss of taste.
• Headache.
• Increased sweating.
• Loss or appetite.
• Ringing in your ears.
• Skin rash.
• Sleepiness or trouble sleeping.
• Tiredness.
• Trouble having sex.
• Warmth or redness in your face, neck, arms, or upper chest.

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088