Desvenlafaxine

Desvenlafaxine is a synthetic form of the isolated major active metabolite of Venlafaxine, and is categorized as a Serotonin-Norepinephrine Reuptake Inhibitor (SNRI). It works by blocking the transporter reuptake protein for key neurotransmitters affecting mood, thereby leaving more active neurotransmitters in the synapse. The neurotransmitters affected are Serotonin (5-hydroxytryptamine) and Norepinephrine (Noradrenaline). It is approximately 10 times more potent at inhibiting Serotonin uptake than Norepinephrine uptake.

• Major Depressive Disorder (MDD)

Desvenlafaxine is a synthetic form of the isolated major active metabolite of Venlafaxine, and is categorized as a Serotonin-Norepinephrine Reuptake Inhibitor (SNRI). It works by blocking the transporter reuptake protein for key neurotransmitters affecting mood, thereby leaving more active neurotransmitters in the synapse. The neurotransmitters affected are Serotonin and Norepinephrine.

Desvenlafaxine inhibits the reuptake of serotonin and norepinephrine, increasing their activity in the central nervous system, which helps improve mood and alleviate depression.

Adult: 50 mg once daily orally. Doses up to 400 mg/day have been studied, but no additional benefit was observed with doses >50 mg/day.
Moderate renal impairment (CrCl 30-50): 50 mg once daily.
Severe renal impairment or ESRD (CrCl <30): 50 mg every other day.

Take at approximately the same time each day. Swallow the tablet whole, do not chew, crush or break. May be taken with or without food.

If you miss a dose of Desvenlafaxine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose. Do not double the dose.

Common (>10%): Nausea, dizziness, insomnia, hyperhidrosis, constipation, somnolence, decreased appetite, anxiety, dry mouth, sexual dysfunction.

Risk of suicidal thinking and behavior (especially in 18-24 year olds). Monitor for unusual changes in mood or behavior. Caution while driving (drowsiness, dizziness). Avoid alcohol. Do not stop abruptly (gradual dose reduction recommended).

Hypersensitivity; concomitant use with MAOI or within 14 days of discontinuing MAOI; wait at least 7 days after stopping Desvenlafaxine before starting MAOI.

Iobenguane I-123: May diminish therapeutic effect.
CNS depressants: May enhance adverse effects.
Sibutramine, MAOIs: May increase risk of serotonin syndrome.
Alpha/beta-agonists: May enhance tachycardic and vasopressor effect.
CYP2D6 substrates: May increase concentration.
CYP3A4 substrates: May decrease exposure.
NSAIDs, aspirin, warfarin: May enhance antiplatelet/anticoagulant effect.

Caution is advised when consuming alcohol with Desvenlafaxine. Please consult your doctor.

Pregnancy Category C. Desvenlafaxine may be unsafe during pregnancy. Animal studies have shown harmful effects on the developing baby. Use only if clearly needed.

Desvenlafaxine is probably unsafe during breastfeeding. The drug may pass into breastmilk and harm the baby.

Safety and effectiveness in children and adolescents have not been established.

No specific dosage adjustment is necessary for elderly patients.

Renal impairment: CrCl 30-50: 50 mg once daily; CrCl <30 or ESRD: 50 mg every other day.
Hepatic impairment: 50 mg once daily; doses >100 mg/day are not advised.

Treatment of overdose should be symptomatic. Overdose may increase risk of serotonin syndrome.

Keep below 30°C temperature, away from light & moisture. Keep out of reach of children.

Desvenlafaxine