Pristiq Tablet: Uses, Dosage, Side Effects, Precautions and Alternates

Quick overview

Pristiq Tablet contains the active ingredient desvenlafaxine and belongs to a class of medicines called SNRIs (serotonin-norepinephrine reuptake inhibitors). It is a prescription medicine used to treat major depressive disorder (MDD) in adults. It works by increasing levels of serotonin and norepinephrine in the brain to help improve depression symptoms over time.

What is Pristiq Tablet

Pristiq is a brand-name prescription antidepressant that contains desvenlafaxine. It belongs to a group of medicines called SNRIs, which affect brain chemicals that may be unbalanced in people with depression.

Pristiq Tablet uses

• Treats major depressive disorder (MDD) in adults

Benefits of Pristiq Tablet

• Can improve mood, sleep, appetite, and concentration over time in people with depression
• May reduce the chance of depression relapsing if treatment is continued as recommended

How Pristiq Tablet works

Depression is linked to unbalanced levels of brain chemicals called serotonin and norepinephrine, which help carry messages between nerve cells and regulate mood. Pristiq works by increasing the levels of these two chemicals in the brain, which can improve depression symptoms over time. It is not meant to make you feel instantly happy.

Pristiq Tablet dosage

Take at the same time each day, with or without food. Swallow the tablet whole with water; do not crush, chew, break, or dissolve it, since this can release the drug too fast and increase side effects. If you miss a dose, take it as soon as you remember, but skip it if it's almost time for your next dose — never take two doses at once. It may take several weeks to notice symptom improvement, so continue taking it as directed even if it doesn't seem to be working right away. Do not stop taking this medicine suddenly without talking to your doctor, since stopping abruptly can cause withdrawal symptoms. You may notice part of the tablet shell in your stool; this is normal and does not mean you missed your dose. If switching from another antidepressant, your doctor will usually reduce the old medicine's dose slowly to help prevent withdrawal reactions.

Use exactly as prescribed by your doctor or pharmacist.

Available forms and strengths

• Extended-release tablet

Side effects of Pristiq Tablet

Common

• Dizziness
• Drowsiness
• Anxiety
• Increased sweating
• Nausea
• Decreased appetite
• Constipation
• Dry mouth
• Fatigue
• Sleep problems (insomnia)
• Decreased sex drive, impotence, or difficulty having an orgasm

Serious

• Signs of allergic reaction: skin rash or hives, difficulty breathing, swelling of face, lips, tongue, or throat
• New or sudden changes in mood or behavior, including worse depression or anxiety, panic attacks, trouble sleeping, impulsiveness, irritability, agitation, hostility, aggression, restlessness, or thoughts about suicide or hurting yourself
• Seizures
• Easy bruising or bleeding (nosebleeds, bleeding gums), blood in urine or stools, coughing up blood
• Blurred vision, eye pain or swelling, or seeing halos around lights (possible sign of closed-angle glaucoma)
• Cough, chest discomfort, trouble breathing (possible lung problems)
• Low blood sodium: headache, confusion, problems with thinking or memory, weakness, feeling unsteady
• Serotonin syndrome: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea
• New or worsened high blood pressure

Warnings and precautions

• This medicine carries the FDA's most serious warning: antidepressants, including Pristiq, can increase the risk of suicidal thoughts and actions in some children and young adults under 25, especially in the first few months of treatment or after a dose change. Pristiq is not approved for anyone under 18.
• Do not take this medicine within 7 days before or 14 days after using an MAO inhibitor (such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine), as this can cause a dangerous drug interaction.
• Do not stop taking this medicine suddenly without talking to your doctor first, as this can cause unpleasant or serious withdrawal symptoms.
• Taking this medicine with certain other drugs that raise serotonin (like other antidepressants, St. John's wort, tryptophan, triptans, tramadol, or fentanyl) can cause a dangerous condition called serotonin syndrome.
• Using NSAIDs (like aspirin, ibuprofen, or naproxen) together with this medicine may increase the chance of bruising or bleeding.
• Ask your doctor before taking Pristiq if you are pregnant. Taking it late in pregnancy may increase the risk of high blood pressure during pregnancy and excessive bleeding after giving birth, and may cause complications in the baby. 
• Do not start or stop taking it without your doctor's advice, since stopping could cause your depression to come back.
• It may not be safe to breastfeed while using this medicine. Small amounts may pass into breast milk, and not enough is known about how this affects a nursing baby. Ask your doctor about the risks.
• If you have kidney problems, your body may not clear this medicine as well as normal, so your doctor may need to lower your dose.
• If you have liver problems, your body may not clear this medicine as well as normal, so your doctor may need to lower your dose.
• Avoid drinking alcohol while taking this medicine, since it can increase side effects like drowsiness, dizziness, and sexual problems, and can also worsen depression.
• This medicine may affect your thinking or reactions. Avoid driving or doing anything that requires alertness until you know how it affects you.

Storage

• Store at room temperature away from moisture and heat
• Do not store at a temperature higher than 86°F (30°C)
• Keep in a tightly sealed container away from light
• Avoid storing in places that could get damp, such as bathrooms
• Keep out of the reach of children and pets
• Dispose of unused or expired medicine properly; ask your pharmacist for guidance on safe disposal rather than flushing or pouring it down a drain unless instructed

When to see a doctor

• Get emergency help right away if you have signs of a severe allergic reaction: rash or hives, difficulty breathing, or swelling of the face, lips, tongue, or throat.
• Call your doctor right away if you have sudden mood or behavior changes, worsening depression or anxiety, panic attacks, feel impulsive, irritable, agitated, hostile, aggressive, restless, or have thoughts of suicide or hurting yourself.
• Call your doctor immediately if you have a seizure, easy bruising or bleeding, blood in urine or stools, coughing up blood, blurred vision or eye pain, cough or chest discomfort with trouble breathing, or signs of low blood sodium like headache, confusion, or unsteadiness.
• Seek medical attention right away if you notice symptoms of serotonin syndrome, such as agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.
• If you think you've taken too much of this medicine, contact your doctor or local poison control center right away, or go to the nearest emergency room if symptoms are severe.

Alternatives

• Escitalopram
• Sertraline
• Duloxetine
• Venlafaxine