Do not take Pristiq with a monoamine oxidase inhibitor, also called an MAOI. Combining these medications can cause a serious and potentially life-threatening reaction.
You should not start Pristiq within 14 days after stopping an MAOI. You should also wait at least 7 days after stopping Pristiq before starting an MAOI. Examples include isocarboxazid, phenelzine, selegiline, and tranylcypromine. Certain medications, such as linezolid and intravenous methylene blue, can also act like MAOIs and may cause a dangerous interaction.
Always tell your healthcare provider and pharmacist that you take Pristiq before starting an antibiotic, receiving an injection, or taking another medication.
Do not stop Pristiq suddenly
Do not stop taking Pristiq or change your dose without speaking with your healthcare provider. Stopping the medication suddenly may cause withdrawal symptoms and may allow your depression to return or become worse.
Withdrawal symptoms may include dizziness, nausea, headache, irritability, anxiety, sweating, trouble sleeping, unusual dreams, flu-like symptoms, or electric-shock-like sensations.
Your healthcare provider may gradually reduce your dose over time to help lower the risk of these symptoms.
Changes in mood or suicidal thoughts
Depression and other mental health conditions can sometimes cause thoughts of suicide or self-harm. In some people, these thoughts may appear or become worse when antidepressant treatment begins or when the dose changes. The risk may be higher in children, teenagers, and young adults.
Contact your healthcare provider immediately if you or someone close to you notices new or sudden changes such as:
- Thoughts of suicide or self-harm
- Worsening depression
- Severe anxiety or panic attacks
- Unusual agitation, irritability, or aggression
- Restlessness or impulsive behaviour
- Extreme changes in mood
- Trouble sleeping that becomes severe
Seek emergency help if you believe you may act on thoughts of harming yourself.
Allergic reactions
Do not take Pristiq if you are allergic to desvenlafaxine, venlafaxine, or any ingredient in the medication. Desvenlafaxine is closely related to venlafaxine, so an allergy to one may increase the risk of reacting to the other.
Tell your healthcare provider about all medication allergies and previous adverse reactions before beginning treatment.
Stop taking the medication and seek immediate medical attention if you develop swelling of the face, lips, tongue, or throat, difficulty breathing or swallowing, severe dizziness, hives, or a widespread rash.
Bleeding risk
Pristiq may increase your risk of bruising or bleeding. The risk may be greater if you also take medications that affect blood clotting, such as aspirin, ibuprofen, naproxen, warfarin, apixaban, rivaroxaban, clopidogrel, or other blood thinners.
Tell your healthcare provider if you have a bleeding disorder, a history of stomach ulcers, or unusual bleeding.
Contact your healthcare provider if you notice frequent nosebleeds, unexplained bruising, bleeding gums, blood in your urine, black stools, or bleeding that takes longer than usual to stop.
Blood pressure and heart rate
Pristiq may raise your blood pressure and heart rate. Your healthcare provider may check your blood pressure before treatment and regularly while you are taking the medication.
Tell your healthcare provider if you have high blood pressure, heart disease, or an irregular heartbeat. Contact them if you develop a severe headache, chest pain, a pounding heartbeat, shortness of breath, or significant dizziness.
Serotonin syndrome
Pristiq increases serotonin activity in the brain. Taking it with other medications or supplements that also increase serotonin may cause serotonin syndrome, a rare but potentially life-threatening condition.
Medications that may increase this risk include other antidepressants, MAOIs, certain migraine medications, some opioid pain medicines, lithium, buspirone, amphetamines, and the herbal supplement St. John’s wort.
Seek immediate medical attention if you develop agitation, confusion, hallucinations, fever, heavy sweating, a fast heartbeat, muscle stiffness, shaking, poor coordination, nausea, vomiting, or diarrhea.
Kidney and liver conditions
Tell your healthcare provider if you have kidney or liver disease. These conditions may affect how your body processes and removes Pristiq.
People with kidney problems may need a lower dose or a different dosing schedule. Your healthcare provider will determine the safest dose based on your kidney and liver function.
Older adults and other medical conditions
Older adults may be more sensitive to side effects such as dizziness, low sodium levels, bleeding, or changes in blood pressure. These effects may increase the risk of confusion, weakness, or falls.
Tell your healthcare provider if you have glaucoma, seizures, high blood pressure, bipolar disorder, low sodium levels, or a history of bleeding problems before taking Pristiq.
Pristiq may increase pressure inside the eye in people with narrow-angle glaucoma. It may also increase the risk of seizures in susceptible patients. Your healthcare provider will determine whether additional monitoring or another treatment is needed.
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