Pristiq - Comprehensive Usage Guide: instructions, indications, composition, side effects

• Active Ingredient: Desvenlafaxine succinate
• Excipients: May include microcrystalline cellulose, colloidal silicon dioxide, magnesium stearate, hypromellose, edetate disodium, and other inactive ingredients depending on the formulation.

Extended-Release Tablets: Available in various strengths, including 25 mg, 50 mg, and 100 mg tablets.

Pristiq belongs to the pharmacological group of serotonin-norepinephrine reuptake inhibitors (SNRIs) (ATC code: N06AX23).

• Pharmacodynamics: Desvenlafaxine selectively inhibits the reuptake of serotonin and norepinephrine in the central nervous system, thereby enhancing neurotransmission and exerting antidepressant effects.
• Pharmacokinetics: After oral administration, desvenlafaxine is rapidly absorbed, with peak plasma concentrations achieved within 4 hours. It undergoes extensive hepatic metabolism via the cytochrome P450 enzyme system and is excreted primarily in urine.

Pristiq is indicated for the treatment of:

• Major depressive disorder (MDD)
• Generalized anxiety disorder (GAD)

Pristiq is contraindicated in individuals with:

• Hypersensitivity to desvenlafaxine or any component of the formulation
• Concurrent use with monoamine oxidase inhibitors (MAOIs) or within 14 days of discontinuing MAOI therapy

Desvenlafaxine may interact with various medications, including:

• MAOIs
• Serotonergic drugs (e.g., SSRIs, tricyclic antidepressants)
• Drugs metabolized by the CYP3A4 enzyme system (e.g., ketoconazole, erythromycin)
• Drugs that increase serotonin levels (e.g., triptans, tramadol)

• Pristiq tablets should be taken orally once daily with or without food, swallowed whole and not divided, crushed, chewed, or dissolved.
• The dosage should be individualized based on the patient’s response and tolerance, with initial doses typically lower for certain populations (e.g., elderly patients, patients with hepatic impairment).
• Gradual dose titration may be necessary to minimize the risk of adverse effects.
• It may take several weeks for the full therapeutic effect of Pristiq to be achieved, and treatment should be continued even if symptomatic improvement is observed.

• Pristiq should be used with caution during pregnancy, especially during the third trimester, due to the potential risk of neonatal complications such as persistent pulmonary hypertension of the newborn (PPHN).
• Breastfeeding is not recommended during Pristiq treatment due to the excretion of desvenlafaxine and its metabolites in breast milk.

• The recommended starting dose for MDD and GAD is 50 mg/day, with adjustments made based on clinical response and tolerability, up to a maximum dose of 100 mg/day.
• Dosage adjustments may be necessary in patients with renal impairment to prevent drug accumulation and minimize the risk of adverse effects.

In the event of Pristiq overdose, supportive measures should be initiated, and symptomatic treatment may be necessary. Close monitoring of vital signs and cardiac function is essential.

Common side effects of Pristiq may include:

• Nausea
• Headache
• Dizziness
• Insomnia
• Dry mouth
• Constipation

Serious adverse effects such as serotonin syndrome, suicidal ideation, and hypertensive crisis are rare but require immediate medical attention if they occur.

• Pristiq tablets should be stored at room temperature (20-25°C) in a dry place, protected from light and moisture.

These comprehensive instructions provide valuable information on the composition, pharmacological properties, indications, contraindications, interactions, administration, side effects, and storage of Pristiq, facilitating safe and effective antidepressant therapy. Always consult a healthcare professional for personalized medical advice.