Pristiq

Generic Name: desvenlafaxine (des VEN la FAX een)
Brand Names: Pristiq

What is Pristiq?

Pristiq (desvenlafaxine) is an antidepressant in a group of drugs called selective serotonin and norepinephrine reuptake inhibitors (SNRIs). Pristiq affects chemicals in the brain that may become unbalanced and cause depression.

Pristiq is used to treat major depressive disorder.

Pristiq may also be used for purposes not listed in this medication guide.

Important information about Pristiq

You should not take Pristiq if you are allergic to desvenlafaxine or venlafaxine (Effexor), or if you are also using a monoamine oxidase inhibitor (MAOI) such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate).

Video: Treatment for Depression

Do not take Pristiq together with venlafaxine (Effexor).

You may have thoughts about suicide when you first start taking an antidepressant such as Pristiq, especially if you are younger than 24 years old. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

It may take several weeks before your symptoms improve. Keep using Pristiq as directed and tell your doctor if your symptoms do not improve after a few weeks of treatment.

Before taking Pristiq

You should not take Pristiq if you are allergic to desvenlafaxine or venlafaxine (Effexor), or if you are also using a monoamine oxidase inhibitor (MAOI) such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate). You must wait at least 14 days after stopping an MAOI before you can take Pristiq. After you stop taking Pristiq, you must wait at least 7 days before you start taking an MAOI.

Do not take Pristiq together with venlafaxine (Effexor).

To make sure you can safely take Pristiq, tell your doctor if you have any of these other conditions:

• bipolar disorder (manic depression);

• liver disease;

• kidney disease;

• heart disease, high blood pressure, high cholesterol, or a history of stroke;

• kidney disease;

• glaucoma;

• seizures or epilepsy;

• a history of stroke;

• a bleeding or blood clotting disorder;

• low levels of sodium in your blood; or

• if you are switching to Pristiq from another antidepressant.

You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Tell your doctor if you have worsening symptoms of depression or suicidal thoughts during the first several weeks of treatment, or whenever your dose is changed.

Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

FDA pregnancy category C. Pristiq may cause problems in a newborn baby if the mother takes the medication late in pregnancy (during the third trimester). Tell your doctor if you are pregnant or plan to become pregnant during treatment. Desvenlafaxine can pass into breast milk and may harm a nursing baby. Do not use Pristiq without telling your doctor if you are breast-feeding a baby. Do not give Pristiq to anyone under 18 years old without the advice of a doctor.

See also: Pristiq pregnancy and breastfeeding warnings (in more detail)

How should I take Pristiq?

Take Pristiq exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Pristiq can be taken with or without food. Try to take the medicine at the same time each day.

Do not crush, chew, break, or dissolve the extended-release Pristiq tablet. Swallow it whole. Breaking the pill may cause too much of the drug to be released at one time. It may take several weeks before your symptoms improve. Keep using Pristiq as directed and tell your doctor if your symptoms do not improve after a few weeks of treatment. Do not stop using Pristiq suddenly, or you could have unpleasant symptoms. Ask your doctor how to avoid these symptoms when you stop using Pristiq.

Your blood pressure will need to be checked often. Visit your doctor regularly.

Pristiq can cause you to have a false positive drug screening test. If you provide a urine sample for drug screening, tell the laboratory staff that you are taking desvenlafaxine.

Store Pristiq at room temperature away from moisture and heat.

See also: Pristiq dosage (in more detail)

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include vomiting, agitation, fast heart rate, and numbness or tingly feeling.

What should I avoid while taking Pristiq?

Drinking alcohol can increase certain side effects of desvenlafaxine. Pristiq may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Avoid exposure to sunlight or tanning beds. Pristiq can make you sunburn more easily. Wear protective clothing and use sunscreen (SPF 15 or higher) when you are outdoors.

Pristiq side effects

Get emergency medical elp if you have any of these signs of an allergic reaction to Pristiq: skin rash or hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have a serious side effect while taking Pristiq such as:

• seizure (convulsions);

• agitation, hallucinations, fever, fast heart rate, overactive reflexes, nausea, vomiting, diarrhea, loss of coordination;

• blurred vision, eye pain, or seeing halos around lights;

• cough, chest tightness, trouble breathing;

• easy bruising or bleeding (nosebleeds, bleeding gums), blood in your urine or stools, coughing up blood;

• very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, feeling like you might pass out;

• severe skin reaction - fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling;

• headache, trouble concentrating, memory problems, weakness, feeling unsteady, confusion, hallucinations, fainting, shallow breathing or breathing that stops;

Less serious Pristiq side effects may include:

• increased sweating;

• dizziness, drowsiness;

• loss of appetite;

• tightness in your jaw;

• mild nausea, constipation;

• sleep problems (insomnia); or

• decreased sex drive, impotence, or difficulty having an orgasm.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Pristiq side effects (in more detail)

What other drugs will affect Pristiq?

Ask your doctor before taking any medicine for pain, arthritis, fever, or swelling. This includes aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn, Naprelan, Treximet), celecoxib (Celebrex), indomethacin (Indocin), meloxicam (Mobic), and others. Taking any of these drugs with Pristiq may cause you to bruise or bleed easily.

Before using Pristiq, tell your doctor if you regularly use other medicines that make you sleepy (such as cold or allergy medicine, sedatives, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures or anxiety). They can add to sleepiness caused by Pristiq.

Tell your doctor about all other medications you use, especially:

• a blood thinner such as warfarin (Coumadin, Jantoven);

• a diuretic (water pill);

• linezolid (Zyvox);

• lithium (Eskalith, Lithobid);

• metoclopramide (Reglan, Metozolv);

• midazolam (Versed);

• St. John's wort;

• tramadol (Ultram, Ultracet, Rybix, Ryzolt, Synapryn);

• tryptophan (sometimes called L-tryptophan);

• an antibiotic such as clarithromycin (Biaxin), erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin, Pediazole), rifampin (Rifater, Rifadin, Rifamate), or telithromycin (Ketek);

• antifungal medication such as itraconazole (Sporanox), ketoconazole (Nizoral), miconazole (Oravig), or voriconazole (Vfend);

• heart or blood pressure medication such as nicardipine (Cardene) or quinidine (Quin-G);

• the hepatitis C medications boceprevir (Victrelis) or telaprevir (Incivek);

• HIV/AIDS medicine such as atazanavir (Reyataz), delavirdine (Rescriptor), fosamprenavir (Lexiva), indinavir (Crixivan), nelfinavir (Viracept), ritonavir (Norvir, Kaletra), or saquinavir (Invirase);

• migraine headache medication such as sumatriptan (Imitrex, Treximet), rizatriptan (Maxalt), and others; or

• any other antidepressant.

This list is not complete and there are many other drugs that can interact with Pristiq. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor. Keep a list of all your medicines and show it to any healthcare provider who treats you.

Where can I get more information?

• Your pharmacist can provide more information about Pristiq.