Pristiq 100mg Tablet
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Indications & Clinical Uses
- Pristiq 100 mg extended-release tablets contain desvenlafaxine succinate, a serotonin-norepinephrine reuptake inhibitor (SNRI) and the active metabolite of venlafaxine.
- Pristiq is approved for the treatment of major depressive disorder (MDD) in adults; it is not approved for use in children or adolescents.
- It is taken once daily as an extended-release tablet that releases the medicine gradually over the day.
- Pristiq is marketed by Wyeth Pharmaceuticals, a Pfizer company, in the United States; the same active ingredient is available generically as desvenlafaxine extended-release tablets.
- Current US labelling lists 50 mg and 100 mg strengths, with 50 mg being the usual effective dose for most adults; higher doses have not shown extra benefit for most patients but do increase side effects.
- Pristiq is a self-administered oral medicine taken at home.
Side Effects
- Pristiq carries a boxed warning: antidepressants, including Pristiq, increased the risk of suicidal thoughts and behaviour in children, adolescents and young adults in short-term studies; anyone starting Pristiq should be watched closely for worsening depression or new suicidal thoughts, especially in the first weeks of treatment or after a dose change, and Pristiq is not approved for pediatric patients.
- The most common side effects, affecting 5% or more of people and at least twice the rate seen with placebo, are nausea, dizziness, insomnia, excessive sweating, constipation, drowsiness, reduced appetite, anxiety and sexual problems, particularly in men.
- Seek urgent medical help for agitation, hallucinations, fever, muscle stiffness or a fast heartbeat, which can signal serotonin syndrome, or for unusual bleeding or bruising.
- Do not stop Pristiq abruptly, as this can cause dizziness, irritability and other withdrawal symptoms; your prescriber will taper the dose gradually.
Precautions & Warnings
- Pristiq is contraindicated with monoamine oxidase inhibitors (MAOIs) used for psychiatric disorders, either during treatment or within 7 days of stopping Pristiq (MAOIs require at least 14 days after stopping before starting Pristiq), and with linezolid or intravenous methylene blue, because of the risk of serotonin syndrome.
- It should be used cautiously in people with high blood pressure, since desvenlafaxine can raise blood pressure and heart rate; blood pressure should be checked before starting and periodically during treatment.
- Pristiq can raise cholesterol and should be used with care in people with a history of seizures, glaucoma, or a low sodium level, which is more likely in older adults.
- Abrupt discontinuation should be avoided; the dose is tapered gradually.
- There are limited data on use in pregnancy; using Pristiq in the third trimester has been linked to withdrawal or serotonin-related symptoms in newborns, and it should be used only if the benefit outweighs the risk.
- Pristiq passes into breast milk.
Avoid Interactions
- Do not combine Pristiq with MAOIs, or start it within 7 days of stopping an MAOI, and wait at least 14 days after stopping Pristiq before starting an MAOI, because of a serious risk of serotonin syndrome.
- Avoid combining Pristiq with linezolid or intravenous methylene blue for the same reason.
- Taking Pristiq with other serotonergic drugs, such as SSRIs, other SNRIs, triptans, tramadol, St John's Wort or lithium, increases serotonin syndrome risk; watch for agitation, fever, tremor and rapid heartbeat.
- Combining Pristiq with NSAIDs, aspirin, warfarin or other blood thinners can increase the risk of bleeding, including gastrointestinal bleeding.
- Drugs metabolised by CYP2D6 may need dose adjustment when combined with Pristiq.
- Alcohol is best avoided or limited, as it can add to dizziness and drowsiness.
- Tell your healthcare provider and pharmacist about all medicines, herbal products and supplements you take before starting Pristiq.
References
Frequently Asked Questions
Pristiq (desvenlafaxine) is an SNRI antidepressant used to treat major depressive disorder in adults. It works by increasing serotonin and norepinephrine levels in the brain. Pristiq is not approved for children or adolescents and is taken once daily by mouth.
Take one Pristiq extended-release tablet by mouth once daily, at the same time each day, with or without food. Swallow it whole with liquid; do not split, crush or chew it, or the extended-release effect is lost.
Common Pristiq side effects are nausea, dizziness, insomnia, sweating and constipation. Its boxed warning covers a higher risk of suicidal thoughts in children, teens and young adults starting antidepressants. Get urgent help for agitation, fever, a fast heartbeat or unusual bleeding.
Do not take Pristiq with MAOIs, linezolid or IV methylene blue - the combination can cause dangerous serotonin syndrome. Limit alcohol, since it adds to dizziness. Tell your prescriber about other antidepressants, triptans, tramadol and blood thinners, which raise bleeding or serotonin syndrome risk.
No. Stopping Pristiq abruptly can cause dizziness, irritability, nausea and other withdrawal symptoms. Your prescriber will lower the dose gradually over time instead of stopping it all at once, even if you feel well and want to come off treatment.
Pristiq should be used in pregnancy only if clearly needed, since taking it late in pregnancy has been linked to withdrawal-like symptoms in newborns. Desvenlafaxine also passes into breast milk. Discuss the risks and benefits with your prescriber before starting or stopping Pristiq.

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