Class: Serotonin/Norepinephrine Reuptake Inhibitor
Dosage Forms. Extended Release Tablet: 50 mg, 100 mg
Common FDA Label Indication, Dosing, and Titration.
1. Depression: 50 mg po daily
1. Menopausal flushing: 100 mg po daily
MOA. Desvenlafaxine is a potent reuptake inhibitor of serotonin and norepinephrine, like many TCAs, but lacks effects on muscarinic, α-adrenergic, or histamine receptors.
Drug Characteristics: Desvenlafaxin
Medication Safety Issues: Desvenlafaxine
Drug Interactions: Desvenlafaxine
Adverse Reactions: Desvenlafaxine
Efficacy Monitoring Parameters. Improvement in symptoms of depression (suicidal thoughts or intent, change in appetite, lack of energy, change in sleep patterns, etc).
Toxicity Monitoring Parameters. Worsening of depression, suicidality, or unusual changes in behavior, especially at the initiation of therapy or with dosage increases or decreases; signs/symptoms of abnormal bleeding, monitor BP, LFT, and serum cholesterol levels, in case of severe impairment at baseline and periodically during therapy; signs/symptoms of hyponatremia, especially in patients on concomitant diuretics, volume-depleted patients, and elderly.
Key Patient Counseling Points. Take with food, but avoid alcohol. Symptomatic improvement may not be evident for a few weeks. Do not discontinue drug abruptly, as this may precipitate withdrawal symptoms such as dysphoric mood, irritability, and agitation. Avoid activities requiring mental alertness or coordination until drug effects are realized, as this medicine may cause dizziness or somnolence.
Clinical Pearls. Safety and efficacy not established in children. Medication guide required at dispensing.