Indications for: Desvenlafaxine
Major depressive disorder.
Swallow whole. 50mg once daily. Moderate renal impairment (CrCl 30–50mL/min): max 50mg/day. Severe renal impairment (CrCl <30mL/min), ESRD: max 50mg every other day. Do not give supplemental dose after dialysis. Moderate-to-severe hepatic impairment: max 100mg/day. Withdraw gradually.
During or within 14 days of MAOIs (see Interactions). Concomitant linezolid or IV methylene blue.
Increased risk of suicidal thinking and behavior in children, adolescents, and young adults; monitor for clinical worsening or unusual changes. Screen for bipolar disorder. Monitor for serotonin syndrome; discontinue immediately if occurs. Pre-existing hypertension, cardio- or cerebrovascular disease. Monitor BP before and during treatment; consider dose reduction or discontinuation if elevated BP persists. Increased risk of bleeding. Avoid in untreated anatomically narrow angles. History of mania/hypomania. Seizure disorder. Renal or hepatic impairment. Avoid abrupt cessation. Reevaluate periodically. Write ℞ for smallest practical amount. Elderly. Pregnancy; see full labeling for effects on mother and neonates. Nursing mothers.
See Contraindications. Allow ≥14 days after MAOI discontinuance before starting desvenlafaxine; allow ≥7 days after desvenlafaxine discontinuance before starting an MAOI. Increased risk of serotonin syndrome with other serotonergic drugs (eg, triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, tryptophan, buspirone, amphetamines, St. John's Wort) or with drugs that impair serotonin metabolism (eg, MAOIs, linezolid, IV methylene blue). Avoid alcohol. Increased risk of bleeding with aspirin, NSAIDs, warfarin, or other drugs that affect coagulation; monitor closely. May be affected by CYP2D6 substrates. False (+) urine immunoassay screening tests for PCP and amphetamine.
Nausea, dizziness, insomnia, hyperhidrosis, constipation, somnolence, decreased appetite, anxiety, specific male sexual dysfunction; hyponatremia (esp. in elderly); rare: interstitial lung disease or eosinophilic pneumonia (consider discontinuing if occurs).
Formerly known under the brand name Khedezla.