Pristiq

Pristiq is used to treat major depressive disorder.

Product dosage: 100mg
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Synonyms Khedezla

Pristiq (desvenlafaxine) is a serotonin-norepinephrine reuptake inhibitor (SNRI) approved by the FDA for the treatment of major depressive disorder (MDD) in adults. As the major active metabolite of venlafaxine, it offers a refined mechanism of action with a potentially favorable tolerability profile for many patients. This extended-release formulation is designed to provide steady-state plasma concentrations with once-daily dosing, supporting consistent therapeutic effect. Clinical studies demonstrate its efficacy in improving mood, energy levels, and interest in daily activities as part of a comprehensive treatment plan.

Features

• Contains desvenlafaxine succinate, the primary active metabolite of venlafaxine
• Available in 25 mg, 50 mg, and 100 mg extended-release tablets
• Once-daily oral administration simplifies dosing regimen
• Designed for 24-hour controlled release of active ingredient
• Manufactured under strict pharmaceutical quality controls

Benefits

• Effectively alleviates core symptoms of major depressive disorder, including persistent sadness and loss of interest
• Dual mechanism targets both serotonin and norepinephrine pathways for comprehensive neurochemical support
• Extended-release formulation maintains stable drug levels, reducing peak-to-trough fluctuations
• May improve energy levels and reduce fatigue associated with depression
• Demonstrated efficacy in multiple randomized controlled trials with significant symptom improvement
• Flexible dosing options allow for individualized treatment approaches

Common use

Pristiq is primarily indicated for the treatment of major depressive disorder (MDD) in adult patients. The medication works by increasing the levels of serotonin and norepinephrine in the brain—two neurotransmitters known to play crucial roles in mood regulation. Healthcare providers may prescribe Pristiq as a first-line treatment or after other antidepressants have proven ineffective or poorly tolerated. Treatment typically begins at a lower dose with gradual titration based on individual response and tolerability. The therapeutic effects usually become apparent within 2-4 weeks of initiation, though full benefits may require 6-8 weeks of consistent dosing.

Dosage and direction

The recommended starting dose for Pristiq is 50 mg once daily, taken orally with or without food. Tablets should be swallowed whole and not crushed, chewed, or dissolved. Dosage may be adjusted based on individual patient response and tolerability, with maximum recommended dose of 400 mg per day, though most patients respond to 50 mg daily. For patients with hepatic impairment or severe renal impairment (CrCl <30 mL/min), a reduced dose of 50 mg every other day is recommended. Dose adjustments should be made under medical supervision, typically at intervals of no less than one week. Abrupt discontinuation should be avoided; instead, gradual tapering is recommended when discontinuing treatment.

Precautions

Patients should be monitored for clinical worsening, suicide risk, and unusual changes in behavior, especially during initial treatment and dose adjustments. Pristiq may increase blood pressure; regular monitoring is advised. Caution is recommended in patients with a history of mania/hypomania, seizures, or angle-closure glaucoma. The medication may affect platelet aggregation and increase bleeding risk. Patients should be advised about the potential for serotonin syndrome, particularly when used with other serotonergic drugs. Discontinuation symptoms including dizziness, nausea, headache, and irritability may occur if stopped abruptly. Use during pregnancy only if potential benefit justifies potential risk to the fetus.

Contraindications

Pristiq is contraindicated in patients with known hypersensitivity to desvenlafaxine, venlafaxine, or any excipients in the formulation. Concomitant use with monoamine oxidase inhibitors (MAOIs) is contraindicated due to risk of serotonin syndrome; at least 14 days should elapse between discontinuing an MAOI and initiating Pristiq therapy, and vice versa. The medication is not recommended for patients with severe hepatic impairment or end-stage renal disease. Use is contraindicated in patients with uncontrolled narrow-angle glaucoma.

Possible side effects

Common adverse reactions (≥5% and twice placebo) include nausea, dizziness, insomnia, hyperhidrosis, constipation, somnolence, decreased appetite, anxiety, and specific male sexual function disorders. Less frequent but potentially serious side effects may include increases in blood pressure, abnormal bleeding, angle-closure glaucoma, hyponatremia, interstitial lung disease, and eosinophilic pneumonia. Some patients may experience weight changes, with clinical trials showing mean weight loss of approximately 0.5-1.0 kg. Sexual dysfunction including decreased libido, orgasm delay, and erectile dysfunction has been reported. Most side effects are dose-dependent and may diminish with continued treatment.

Drug interaction

Pristiq has significant interaction potential with MAOIs, with risk of serious, sometimes fatal, reactions. Concomitant use with other serotonergic drugs (SSRIs, SNRIs, triptans, tramadol) may increase serotonin syndrome risk. Drugs that interfere with serotonin reuptake should be used with caution. Pristiq may increase bleeding risk when used with NSAIDs, aspirin, warfarin, or other anticoagulants. CYP3A4 inhibitors may increase desvenlafaxine levels. The medication may reduce the efficacy of tamoxifen through CYP2D6 inhibition. Concurrent use with drugs that affect platelet function or coagulation should be carefully monitored.

Missed dose

If a dose is missed, patients should take it as soon as they remember unless it is close to the time of the next scheduled dose. In that case, the missed dose should be skipped and the regular dosing schedule resumed. Doubling of doses is not recommended. Patients should be advised to maintain a consistent dosing schedule and consider setting daily reminders. If multiple doses are missed, patients should contact their healthcare provider for guidance on resuming therapy, as dose adjustment or re-titration may be necessary.

Overdose

Pristiq overdose may manifest as serotonin syndrome symptoms including tachycardia, hypertension, hyperthermia, agitation, confusion, and neuromuscular abnormalities. Other symptoms may include dizziness, nausea, vomiting, and somnolence. Fatal outcomes have been reported primarily with mixed overdoses involving multiple drugs. There is no specific antidote for desvenlafaxine overdose. Management should include supportive care and symptomatic treatment. Gastric lavage may be considered if performed soon after ingestion. Activated charcoal may be administered. Monitoring of cardiac function and vital signs is essential. Forced diuresis, dialysis, hemoperfusion, and exchange transfusion are unlikely to be beneficial due to high volume of distribution.

Storage

Store Pristiq tablets at room temperature between 20°C to 25°C (68°F to 77°F), with excursions permitted between 15°C to 30°C (59°F to 86°F). Keep in original container with lid tightly closed to protect from moisture and light. Keep out of reach of children and pets. Do not use beyond the expiration date printed on the packaging. Properly dispose of unused medication through medication take-back programs or according to FDA-recommended disposal methods. Do not flush medications down the toilet unless specifically instructed to do so.

Disclaimer

This information is provided for educational purposes only and does not constitute medical advice. Pristiq is a prescription medication that should be used only under the supervision of a qualified healthcare professional. Individual results may vary. Patients should consult their healthcare provider for personalized medical advice, including information about potential benefits and risks. Never adjust dosage or discontinue medication without medical supervision. The complete prescribing information should be reviewed before initiating therapy.

Reviews

Clinical trials demonstrate Pristiq’s efficacy with significant improvement in Montgomery-Åsberg Depression Rating Scale (MADRS) scores compared to placebo. Many patients report improved mood, increased energy, and better overall functioning within several weeks of treatment initiation. Some users note gastrointestinal side effects during the initial treatment period that often diminish with continued use. Healthcare providers frequently cite the once-daily dosing and relatively straightforward titration schedule as practical advantages. Long-term studies support maintained efficacy with continued treatment, though individual responses vary. Patient satisfaction surveys indicate improved quality of life measures among responders to therapy.