(Legend)

Generic Name

• Desvenlafaxine
  T½ = 11 h
  Pregnancy category C

Trade Name

• Pristiq

Dose Range/Adult Daily Dose

• Adults: 50 mg po once daily; in clinical studies (50–400 mg/d) there did not seem to be additional benefit above 50 mg/d.
  The recommended dose with moderate renal impairment (24-h CrCl = 30–50 mL/min) is 50 mg/d; with severe renal impairment (24-h CrCl <30 mL/min) or end-stage renal disease (ESRD) 50 mg every other day. Extended release formulation (once-daily dosing) should not be chewed or crushed

Use/Common Side Effects (CSE)

• Use: Major depressive disorder in adults only
  CSE: Anxiety, dizziness, headache, abnormal dreams, insomnia, nervousness, weakness, mydriasis, rhinitis, visual disturbances, anorexia, constipation, diarrhea, dry mouth, dyspepsia, nausea, vomiting, weight loss, sexual dysfunction, ecchymoses, paresthesias, chills

Geriatric & Dose Considerations

• Caution in elderly with CV disease, hypertension, liver or renal impairment, and hx of increased intraocular pressure, or narrowangle glaucoma. Monitor for suicidality and see dosing for renal impairment.

Classification

• Antidepressant [SNRI]

Assessment Cautions

• Concurrent MAOI therapy is contraindicated. Use with alcohol, CNS depressants not recommended. Beware of multiple drug-drug interactions; no adjustment needed for mild/moderate hepatic/renal impairment (hepatic impairment: max dose 100 mg/d). Caution with preexisting hypertension; hypertension dose-related. Assess: monitor for suicidality early on and throughout Rx. Also BP before/after Rx (↓ dose or D/C). Taper slowly to D/C.