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What is this medication?

Desvenlafaxine, Pristiq/Khedezla
Antidepressant, Serotonin/Norepinephrine Reuptake Inhibitor

Desvenlafaxine, Pristiq/Khedezla is officially indicated for major depressive disorder.  It is also prescribed off-label for vasomotor symptoms associated with menopause.  (may be used for conditions not listed)

“ALERT: US Boxed Warning

Suicidal thoughts and behavior:
Antidepressants increased the risk of suicidal thoughts and behavior in children, adolescents, and young adults in short-term studies. These studies did not show an increase in the risk of suicidal thoughts and behaviors with antidepressant use in adults older than 24 years; there was a reduction in risk with antidepressant use in adults 65 years and older. In patients of all ages who are started on antidepressant therapy, monitor closely for worsening and for emergence of suicidal thoughts and behaviors. Advise families and caregivers of the need for close observation and communication with the prescriber. Desvenlafaxine is not approved for use in pediatric patients.”

How does this medication work?

Desvenlafaxine, Pristiq/Khedezla is a potent and selective inhibitor of serotonin and norepinephrine reuptake.  It does not affect dopamine, muscarinic, histamine 1, or alpha 2 adrenergic receptors or MAO.

How should I take this medication?

Oral: 50-100mg once daily.  Dosages over 50mg daily were not shown to have any improvement in symptoms, but higher rates of side effects in clinical trials however some experts still recommend higher dosages if inadequate response to 50mg/day.

How to Take: Follow instructions provided by physician/pharmacy label, swallow whole with or without food, take consistently at same times each day unless otherwise directed, store at room temperature.

You Need to Avoid: This medication can increase the psychomotor impairment from alcohol consumption so extra care should be taken if choosing to consume alcohol.  Do not stop this medication without tapering dose down over time to prevent withdrawal symptoms (nausea, diarrhea, sweating, headaches, agitation, insomnia, anxiety, tremor, vertigo, dizziness). 

What should I watch for while using this medication?

Before starting Desvenlafaxine, Pristiq/Khedezla make sure your physician is aware of any allergies or medications you currently take, if you have liver disease, if you have bipolar disorder, kidney disease, a seizure disorder, cardiovascular disease, or are pregnant or breastfeeding.  This medication has risk of causing serotonin syndrome especially if combined with other serotonergic drugs.  It can cause suicidal ideation, usually in young patients, with major depressive disorder so must be used with caution and any major changes in personality or mood should be reported to physician immediately.

What if I miss a dose?

If you miss a dose of medication, try to take it as soon as possible.  However, if it is almost time for your next dose, take only that scheduled dose.  Do not take double or extra doses.

How should I store this medication?

Keep out of the reach of children at all times.  Store at room temperature, 59 to 86° F (15 to 30° C).  Protect from light.  Keep the container tightly closed.  Properly dispose of any unused medication after the expiration date.

What are the possible side effects of using this medication?

Insomnia, dizziness, hyperhidrosis (excessive sweating), nausea and dry mouth

Note this is not a complete list of side effects, only the common ones.