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Pristiq Side Effects

Generic Name: desvenlafaxine

Note: This page contains side effects data for the generic drug desvenlafaxine. It is possible that some of the dosage forms included below may not apply to the brand name Pristiq.

It is possible that some side effects of Pristiq may not have been reported. These can be reported to the FDA here. Always consult a healthcare professional for medical advice.

For the Consumer

Applies to desvenlafaxine: oral tablet extended release

As well as its needed effects, desvenlafaxine (the active ingredient contained in Pristiq) may cause unwanted side effects that require medical attention.

If any of the following side effects occur while taking desvenlafaxine, check with your doctor immediately:

Less common
  • Chills
  • cold sweats
  • confusion
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • fast, pounding, or irregular pulse
  • headache
  • numbness or tingling in the arms or legs
  • shakiness in the legs, arms, hands, or feet
  • trembling or shaking of the hands or feet
  • trouble thinking, speaking, or walking
  • weakness
Incidence not known
  • Blistering, peeling, or loose skin
  • blood in the stool or urine
  • chest tightness
  • convulsions (seizures)
  • cough
  • diarrhea
  • dilated or enlarged pupils (black part of the eye)
  • feeling irritated
  • fever
  • hives, itching, rash
  • hoarseness
  • joint pain, stiffness, or swelling
  • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
  • loss of bladder control
  • muscle pain
  • muscle spasm or jerking of all extremities
  • nosebleeds
  • red skin lesions, often with a purple center
  • red, irritated eyes
  • red skin
  • sore throat
  • sores, ulcers, or white spots in the mouth or on the lips
  • sudden loss of consciousness
  • swelling of the eyelids, face, lips, hands, or feet
  • talking, feeling, or acting with excitement
  • trouble breathing or swallowing
  • unusual bruising
  • unusual tiredness or weakness
  • vomiting blood

Some desvenlafaxine side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned about them:

More common
  • Bigger, dilated, or enlarged pupils (black part of the eye)
  • decreased appetite
  • inability to have an orgasm
  • inability to have or keep an erection
  • increased sensitivity of the eyes to light
  • loss of sexual ability, desire, drive, or performance
  • sleepiness or unusual drowsiness
  • sleeplessness
Less common
  • Change in taste
  • continuous ringing, buzzing, or other unexplained noise in the ears
  • decreased weight
  • difficult urination
  • fear or nervousness
  • hearing loss
  • increased sensitivity of the eyes to light
  • jitteriness
  • lack or loss of strength
  • loss of taste

For Healthcare Professionals

Applies to desvenlafaxine: oral tablet extended release


General side effects including fatigue (up to 11%), chills (up to 4%), feeling jittery (up to 3%), and asthenia (up to 2%) have been reported.


Psychiatric side effects including insomnia (up to 15%), anxiety (up to 5%), abnormal dreams (up to 4%), nervousness (up to 2%), and irritability (up to 2%) have been reported. Depersonalization and hypomania have been reported infrequently.

Nervous system

Nervous system side effects including headache (up to 29%), dizziness (up to 16%), somnolence (up to 12%), tremor (up to 9%), paraesthesia (up to 3%), dysgeusia (up to 2%), and disturbance in attention (up to 2%) have been reported. Convulsion, syncope, and extrapyramidal disorders have been reported infrequently. Postmarketing reports have included anxiety, insomnia and vertigo.


Proteinuria was not associated with increases in BUN or creatinine and was generally transient.

Metabolic side effects including decreased appetite (up to 10%) and decreased weight (up to 2%) have been reported. Increased total cholesterol (up to 10%), increased LDL cholesterol (up to 2%), fasting triglycerides greater than or equal to 327 mg/dl (up to 6%), and proteinuria greater than or equal to trace, have been reported in the fixed dose controlled studies.


Respiratory side effects including yawning (up to 4%) have been reported. Epistaxis has been reported infrequently.


Ocular side effects including mydriasis (up to 6%) and blurred vision (up to 4%) have been reported.


Cardiovascular side effects including palpitations (up to 3%), tachycardia (up to 2%), hot flushes (up to 2%), and increased blood pressure (up to 2%) have been reported. Orthostatic hypotension has been reported infrequently. In clinical studies, there were uncommon reports of ischemic cardiac adverse events, including myocardial ischemia, myocardial infarction, and coronary occlusion requiring revascularization; these patients had multiple underlying cardiac risk factors.


Dermatologic side effects including hyperhidrosis (up to 21%), rash (up to 2%), and angioedema have been reported. Severe cutaneous reactions (such as Stevens-Johnson Syndrome, toxic epidermal necrolysis, and/or erythema multiforme) have been reported with other SNRIs.


Gastrointestinal side effects including nausea (up to 41%), dry mouth (up to 25%), diarrhea (up to 11%), constipation (up to 14%), and vomiting (up to 9%) have been reported. Postmarketing reports have included decreased appetite.


Genitourinary side effects including urinary hesitation (up to 2%) have been reported. Effects found in men only have included erectile dysfunction (up to 11%), anorgasmia (up to 8%), delayed ejaculation (up to 7%), decreased libido (up to 6%), ejaculation disorder (up to 5%), abnormal orgasm (up to 3%), ejaculation failure (up to 2%), and sexual dysfunction (up to 2%). Effects found in women only have included anorgasmia (up to 3%).


Hepatic side effects including abnormal liver function tests have been reported infrequently.


In general, discontinuation events occurred more frequently with longer duration of therapy.

Other side effects including tinnitus (up to 2%) have been reported.

Adverse events reported in association with abrupt discontinuation, dose reduction, or tapering of treatment clinical studies on patients with major depressive disorder at a rate of greater than or equal to 5% include: dizziness, nausea, headache, irritability, insomnia, diarrhea, anxiety, abnormal dreams, fatigue, and hyperhidrosis.

Bruxism has also been reported.


Endocrine side effects including increased blood prolactin levels have been reported infrequently.

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