Drug reference

desvenlafaxine

Serotonin-Norepinephrine Reuptake Inhibitor · Antidepressant, Anxiolytic

Serotonin-Norepinephrine Reuptake InhibitorAntidepressant, Anxiolytic

CDSCO approved

EXCRETION

—

not curated

INTERACTIONS

12 major

incl. contraindicated

PREGNANCY

—

not curated

Top interactionssee all 12 →

Monoamine Oxidase Inhibitors (maois) E.g., Phenelzine, Selegiline, MoclobemideContraindicatedDatabase
AlfentanilSevereDatabaseDDInter
AlmotriptanSevereDatabaseDDInter
AmitriptylineSevereDatabaseDDInter

Mechanism

Desvenlafaxine inhibits both the neuronal serotonin/5HT transporter (SERT) and the neuronal NE transporter (NET), enhancing both serotonergic and noradrenergic neurotransmission. Initial inhibition of SERT activates 5HT1A and 5HT1D autoreceptors, decreasing transmission until desensitization. Repeated treatment reduces expression of SERT or NET, leading to increased neurotransmitter clearance.

Indications

depressionanxiety disorderspain (off-label)

Pharmacokinetics

Half-life

11 hours

Bioavailability

Protein binding

ODV: 30 ± 12%

Metabolism

hepatic and renal excretion

Excretion

ODV: 29 ± 7%

Side effects

Common

nauseaconstipationinsomniaheadachessexual dysfunction

Serious

discontinuation syndrome (most intense)
serotonin syndrome (with MAOIs)
suicidal thoughts or behavior (black-box warning)

Drug interactions

Monoamine Oxidase Inhibitors (maois) E.g., Phenelzine, Selegiline, Moclobemide

Contraindicated

Database

Potentially fatal serotonin syndrome (hyperthermia, rigidity, myoclonus, autonomic instability, mental status changes).

Desvenlafaxine is contraindicated with MAOIs. A washout period of at least 14 days is required between discontinuing an MAOI and starting desvenlafaxine, and at least 7 days between discontinuing desvenlafaxine and starting an MAOI.

Alfentanil

Severe

Database

Drug interaction classified as: synergy

Source: DDInter

Almotriptan

Severe

Database

Drug interaction classified as: synergy

Source: DDInter

Amitriptyline

Severe