Desvenlafaxine
Pronunciation: (dez-ven-la-FAKS-een).
- Generic name
- desvenlafaxine
- Brand names
- Desvenlafaxine, Desfax, Khedezla, ElevaFX, Desvalex, Pristiq
- Drug class
- Serotonin-Norepinephrine Reuptake Inhibitor (SNRI)
Availability and supply rules vary by country
Trade names by country: United States · Canada
Australia: · Full directory
What desvenlafaxine is and how it works
Uses, formulations, monitoring, and supply rules can differ by patient, product, and country. Follow the exact local product information and professional advice.
Mechanism of action: how desvenlafaxine works
Desvenlafaxine is a selective serotonin and norepinephrine reuptake inhibitor (SNRI). It increases the levels of serotonin and norepinephrine in the synaptic cleft by inhibiting their reuptake into presynaptic neurons, thereby enhancing neurotransmission and improving mood in patients with depression. (1)
What desvenlafaxine is used for
Major Depressive Disorder
The only FDA-approved indication for desvenlafaxine. (2)
Before taking desvenlafaxine
Do not take / not appropriate for
- Contraindicated in patients with hypersensitivity to desvenlafaxine, venlafaxine, or any excipients. (Contraindication) (2)
- Do not use with MAOIs or within 14 days of discontinuing an MAOI. Use caution in patients with hypertension, cardiovascular disease, seizure disorders, bipolar disorder, glaucoma, or renal/hepatic impairment. (Contraindication) (2)
Tell your clinician about
(2)How to take desvenlafaxine
- General Instructions: Take desvenlafaxine exactly as prescribed by your healthcare provider. It is usually taken once daily, at the same time each day, with or without food.. Adult Dosing: The typical starting dose for adults is 50 mg once daily. Dose adjustments may be made based on response and tolerability, but doses above 50 mg/day are not generally recommended.. Pediatric Dosing: Desvenlafaxine is not approved for use in children or adolescents under 18 years of age.. Administration: Swallow the extended-release tablet whole; do not crush, chew, or divide. Take with water. If stomach upset occurs, take with food.. When To Stop: Do not stop taking desvenlafaxine abruptly without consulting your doctor, as this may cause withdrawal symptoms. Your doctor will guide you on how to safely discontinue.. Storage: Store at room temperature (20°C to 25°C/68°F to 77°F), away from moisture and heat. Keep out of reach of children.
- This page does not provide a dose calculator. Dosing must follow the prescriber, pharmacist, or product label.
Procedures and treatment changes
Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (2)
Missed dose
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular schedule. Do not take two doses at once.
Overdose
In case of overdose, seek emergency medical attention or call your local poison control center immediately. Symptoms may include rapid heartbeat, severe drowsiness, seizures, or serotonin syndrome. (2)
Side effects
Side effects and their urgency vary; report severe, persistent, or concerning symptoms to a healthcare professional.
Nausea
Incidence: Reported in the clinician-authored database; frequency not established
Dizziness
Incidence: Reported in the clinician-authored database; frequency not established
Insomnia
Incidence: Reported in the clinician-authored database; frequency not established
Sweating
Incidence: Reported in the clinician-authored database; frequency not established
Dry mouth
Incidence: Reported in the clinician-authored database; frequency not established
Sexual dysfunction
Incidence: Reported in the clinician-authored database; frequency not established
Increased blood pressure
Incidence: Reported in the clinician-authored database; frequency not established
Serotonin syndrome
Incidence: Reported in the clinician-authored database; frequency not established
New or worsening depression, agitation, irritability, or suicidal thoughts, especially in the first weeks of treatment or after a dose change
(2)Signs of serotonin syndrome: agitation, hallucinations, fast heartbeat, high fever, muscle stiffness or twitching, loss of coordination, nausea, vomiting, or diarrhea
(1)Eye pain, vision changes, or swelling/redness in or around the eye — possible angle-closure glaucoma
(1)Signs of an allergic reaction: rash, hives, itching, swelling of the face/lips/tongue/throat, or difficulty breathing
(2)Serious warnings
BOXED WARNING (FDA) — serious
Symptoms: BOXED WARNING (FDA): Antidepressants, including desvenlafaxine, increased the risk of suicidal thoughts and behavior in children, adolescents, and young adults in short-term studies. Anyone taking desvenlafaxine should be monitored closely for worsening mood or emerging suicidal thoughts, especially during the first months of treatment or after a dose change; this monitoring is especially important for patients under 25. Desvenlafaxine is not approved for use in pediatric patients.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (2)
May increase blood pressure — serious
Symptoms: May increase blood pressure; monitor regularly. Risk of serotonin syndrome, especially with other serotonergic drugs. May cause angle-closure glaucoma in susceptible individuals. Use caution in patients with a history of seizures or bipolar disorder.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (2)
Contraindications — serious
Symptoms: Contraindications: hypersensitivity to desvenlafaxine, venlafaxine, or any excipients; concurrent use with an MAOI or within 14 days of stopping an MAOI (and an MAOI should not be started within 7 days of stopping desvenlafaxine); concurrent use with linezolid or intravenous methylene blue. Use caution in patients with hypertension, cardiovascular disease, seizure disorders, bipolar disorder, glaucoma, or renal/hepatic impairment.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (2)
Interactions
| Medicine or test | Effect | Action |
|---|---|---|
| Recorded interactions | Desvenlafaxine can interact with other medications that affect serotonin levels, such as SSRIs, SNRIs, MAOIs, triptans, and certain pain medications (e.g., tramadol). Combining these can increase the risk of serotonin syndrome. It may also interact with blood thinners, NSAIDs, and drugs affecting blood pressure. Always inform your healthcare provider of all medications and supplements you are taking. | (1) |
| MAOIs, linezolid, intravenous methylene blue | Contraindicated combination — risk of serious, potentially fatal serotonin syndrome. Do not use desvenlafaxine with an MAOI or within 14 days of stopping one; do not start an MAOI within 7 days of stopping desvenlafaxine; do not use with linezolid or IV methylene blue. | (2) |
| CYP2D6-metabolized drugs | The FDA label notes desvenlafaxine can raise blood levels of drugs metabolized by CYP2D6; dose reduction of the CYP2D6 substrate by up to half may be needed when combined with higher desvenlafaxine doses. Any such adjustment must be made by the prescriber. | (2) |
Pregnancy, breastfeeding, kidney/liver function, age
Pregnancy
Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. The FDA label notes that use late in the third trimester has been associated with a neonatal discontinuation/adaptation syndrome (feeding or breathing difficulty, jitteriness) requiring extended hospital observation, and that SNRI use close to delivery has been associated with a less than two-fold increase in postpartum hemorrhage risk. Discuss any pregnancy or plan for pregnancy with your prescriber before making any change in treatment. (2)
Breastfeeding
Desvenlafaxine passes into breast milk at low levels. In limited published data, no adverse reactions were reported in breastfed infants of mothers taking desvenlafaxine, but the infant should be monitored, and breastfeeding should be discussed with the prescriber to weigh benefits and risks. (2)
Children
Frequency: Not applicable.. Weight Based: Not recommended for pediatric use.. Max Daily Dose: Not applicable.. Max Single Dose: Not applicable.. Age Restrictions: Not approved for use in children or adolescents under 18 years of age; the FDA boxed warning on suicidal thoughts/behavior applies specifically to children, adolescents, and young adults. (2)
Renal_impairment
Renal impairment: no adjustment needed for mild impairment. Moderate impairment (creatinine clearance 30-50 mL/min): maximum 50 mg once daily. Severe impairment or end-stage renal disease (creatinine clearance under 30 mL/min): maximum 25 mg once daily or 50 mg every other day; dose adjustments should follow hemodialysis. Hepatic impairment: moderate to severe impairment (Child-Pugh 7-15): maximum 100 mg once daily; doses above this are not recommended. (2)
Hepatic_impairment
Renal impairment: no adjustment needed for mild impairment. Moderate impairment (creatinine clearance 30-50 mL/min): maximum 50 mg once daily. Severe impairment or end-stage renal disease (creatinine clearance under 30 mL/min): maximum 25 mg once daily or 50 mg every other day; dose adjustments should follow hemodialysis. Hepatic impairment: moderate to severe impairment (Child-Pugh 7-15): maximum 100 mg once daily; doses above this are not recommended. (2)
Monitoring
(2)Storage
Store at room temperature, 20°C to 25°C (68°F to 77°F); brief excursions between 15°C and 30°C (59°F to 86°F) are permitted. Keep away from moisture and heat, and out of reach of children.
Study the drug class: SNRIs and other antidepressants
Professional information
Clinician-facing context only. This section does not replace current product labeling.
General
Indication: Major Depressive Disorder
Dose summary: Initial dose of 50 mg orally once daily, with or without food; doses above 50 mg/day have not shown additional benefit in trials.
Renal context: Moderate renal impairment (CrCl 30-50 mL/min): max 50 mg/day. Severe impairment/ESRD (CrCl <30 mL/min): max 25 mg/day or 50 mg every other day. Hepatic impairment (Child-Pugh 7-15): max 100 mg/day. (1) (2)
Frequently asked questions
How long does it take for desvenlafaxine to work?
It may take 1 to 2 weeks to notice some improvement in symptoms, but full benefits are usually seen after 4 to 6 weeks of consistent use.
Can I stop taking desvenlafaxine suddenly?
No, do not stop desvenlafaxine abruptly. Stopping suddenly can cause withdrawal symptoms such as dizziness, irritability, nausea, and headache. Always consult your doctor for a safe discontinuation plan.
Is desvenlafaxine addictive?
Desvenlafaxine is not considered addictive, but stopping it suddenly can cause withdrawal symptoms. It should be discontinued gradually under medical supervision.
Can I drink alcohol while taking desvenlafaxine?
It is best to avoid alcohol while taking desvenlafaxine, as it can increase the risk of side effects such as drowsiness and impaired judgment.
What should I do if I miss a dose?
Take the missed dose as soon as you remember, unless it is almost time for your next dose. Do not double up doses.
Is desvenlafaxine safe during pregnancy or breastfeeding?
Desvenlafaxine should be used during pregnancy or breastfeeding only if the potential benefit justifies the potential risk. Discuss with your doctor before use.
Can desvenlafaxine be used in children?
Desvenlafaxine is not approved for use in children or adolescents under 18 years of age.
What happens if I take too much Desvenlafaxine?
Taking too much Desvenlafaxine can lead to serious symptoms such as seizures, increased heart rate, severe dizziness, and serotonin syndrome. If you suspect an overdose, it is crucial to seek emergency medical attention immediately. Do not attempt to manage an overdose at home, as prompt professional intervention is necessary to prevent severe complications.
Is Desvenlafaxine safe during pregnancy?
Desvenlafaxine's safety during pregnancy is not fully established, and it is categorized as a medication where the risks and benefits must be carefully weighed. There may be potential risks to the fetus, particularly if taken during the third trimester. It is essential to consult your doctor immediately if you are pregnant, planning to become pregnant, or breastfeeding, to discuss the best course of action.
What is the mechanism of action of desvenlafaxine?
Desvenlafaxine is a selective serotonin and norepinephrine reuptake inhibitor (SNRI). It increases the levels of serotonin and norepinephrine in the synaptic cleft by inhibiting their reuptake into presynaptic neurons, thereby enhancing neurotransmission and improving mood in patients with depression. (1)
What is the generic name of Desvenlafaxine?
The generic name is desvenlafaxine. It is sold under brand names including Desvenlafaxine, Desfax, Khedezla, ElevaFX, Desvalex, Pristiq.
What class of drug is desvenlafaxine?
Desvenlafaxine is classed as: Serotonin-Norepinephrine Reuptake Inhibitor (SNRI).
References
- Desvenlafaxine — MedGuideGlobal medicine recordMedGuideGlobal clinician-authored medicine record · Global (internal database) · accessed 2026-08-06 · source 1
- PRISTIQ (desvenlafaxine) extended-release tablets, for oral use — prescribing informationU.S. Food and Drug Administration · United States · dated 2026 · accessed 2026-08-06 · source 2
- DESVENLAFAXINE TABLET, EXTENDED RELEASE [ACTAVIS PHARMA, INC.] — US prescribing information (DailyMed SPL)U.S. National Library of Medicine (DailyMed) · US · accessed 2026-08-14 · source 3
- Desvenlafaxine — patient drug information (MedlinePlus)U.S. National Library of Medicine (MedlinePlus) · US · accessed 2026-08-14 · source 4
- Pristiq Extended-Release — FDA approval record (Drugs@FDA NDA021992)U.S. Food and Drug Administration · US · accessed 2026-08-14 · source 5
- desvenlafaxine — RxNorm normalized drug concept (RXCUI 683693)U.S. National Library of Medicine (RxNorm) · US · accessed 2026-08-14 · source 6
Brand names by country
Single-ingredient desvenlafaxine names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.
Priority countries
United States
- Pristiq Extended-Release25 mg, 50 mg, 100 mg · wyeth pharmaceuticals llc, a subsidiary of pfizer inc.
Canada
- PRISTIQ