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Desvenlafaxine (Pristiq) is a medication used to treat depression and other mood disorders but comes with important safety information that should be considered before and during its use. Below are key warnings and precautions to keep in mind:

• Suicidal Thoughts and Behaviors: This medication may increase the risk of suicidal thoughts or behaviors, particularly in individuals under 25 years old. Be vigilant for any mood or behavior changes, especially during the initial months of treatment or following any dose adjustments. Report any unusual changes to your healthcare provider immediately.

• Serotonin Syndrome: There is a rare risk of developing serotonin syndrome, a potentially life-threatening condition, when taking desvenlafaxine, especially if used with other drugs that increase serotonin levels. Symptoms include fast heartbeat, sweating, muscle stiffness, fever, and confusion. Seek medical attention if these occur.

• High Blood Pressure: Desvenlafaxine can raise blood pressure. If you have pre-existing high blood pressure or heart conditions, discuss with your doctor whether this medication is appropriate. Regular blood pressure monitoring is advised during treatment.

• Increased Bleeding Risk: The risk of bleeding or bruising may rise when taken with blood thinners like aspirin or NSAIDs. Report any unusual bruising, bleeding, or changes in stool color to your healthcare provider promptly.

• Worsening of Glaucoma: Individuals with narrow-angle glaucoma may experience worsening symptoms. Notify your doctor and eye care professional if you experience any vision changes.

• Emergence of Mania: For those with bipolar disorder, using desvenlafaxine alone can trigger a manic episode. Ensure your healthcare provider evaluates your mental health history before prescribing this medication.

• Withdrawal Symptoms: Abruptly stopping desvenlafaxine can lead to withdrawal effects. Work with your healthcare provider to taper off the medication safely.

• Seizures: There have been reports of seizures in some individuals taking desvenlafaxine. Inform your healthcare provider if you have a history of seizures.

• Low Sodium Levels: Rarely, this medication can lower blood sodium levels, especially in older adults or those on diuretics. Watch for symptoms like confusion, weakness, or memory issues and contact your doctor if they occur.

• Lung Problems and Pneumonia: In rare cases, desvenlafaxine has been linked to lung issues. Seek medical advice if you develop a persistent cough, breathing difficulties, or chest discomfort.

Contraindications:

• Avoid using desvenlafaxine if you have an allergy to venlafaxine (Effexor).
• Do not take it if you are currently using a monoamine oxidase inhibitor (MAOI) or have recently stopped using one within the specified washout periods.

Always discuss your medical history and any other medications you are taking with your healthcare provider to ensure desvenlafaxine is safe for you.

Common side effects:

• Nausea
• Dizziness
• Dry mouth
• Excessive sweating
• Constipation
• Trouble sleeping
• Feeling tired
• Loss of appetite
• Sleepiness

• Low sex drive

  Less common but important to monitor:

• Vomiting
• Blurred vision
• Ringing in the ears
• Tremors
• Unusual dreams
• Anxiety

• Trouble with erections

  Serious side effects:

• Serotonin syndrome
• High blood pressure
• Unusual bleeding or bruising
• Seizures
• Low sodium levels
• Serious allergic reaction

Interactions with high risk of serious adverse effects and should be avoided:

• MAO inhibitors (isocarboxazid, Linezolid, methylene blue, moclobemide, phenelzine, procarbazine, Rasagiline, safinamide, Selegiline, Tranylcypromine)

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Aspirin
• Other drugs that increase serotonin (including SSRIs like Fluoxetine, SNRIs like Duloxetine, St. John's wort, Tryptophan)
• Antiplatelet drugs (such as Clopidogrel)
• NSAIDs (such as Ibuprofen, Naproxen)
• Blood thinners (such as Dabigatran, Warfarin)
• Drugs that cause drowsiness (such as opioid pain relievers, alcohol, marijuana, sleep or anxiety medications, muscle relaxants, antihistamines)

Interactions with low risk that usually do not require a change in therapy:

• Venlafaxine