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Advise patients, their families, and their caregivers about the benefits and risks associated with treatment with Pristiq (Desvenlafaxine) and counsel them in its appropriate use.

Advise patients, their families, and their caregivers to read the Medication Guide and assist them in understanding its contents. The complete text of the Medication Guide is reprinted at the end of this document.

Suicide Risk

Advise patients, their families and caregivers to look for the emergence of suicidality, especially early during treatment and when the dose is adjusted up or down.

Concomitant Medication

Advise patients taking Pristiq (Desvenlafaxine) not to use concomitantly other products containing desvenlafaxine or venlafaxine. Healthcare professionals should instruct patients not to take Pristiq with an MAOI or within 14 days of stopping an MAOI and to allow 7 days after stopping this medicine before starting an MAOI.

Serotonin Syndrome or Neuroleptic Malignant Syndrome (NMS)-like Reactions

Caution patients about the risk of serotonin syndrome or Neuroleptic Malignant Syndrome (NMS)-like reactions, particularly with the concomitant use of PRISTIQ and triptans, tramadol, tryptophan supplements, other serotonergic agents, or antipsychotic drugs.

Elevated Blood Pressure

Advise patients that they should have regular monitoring of blood pressure when taking Pristiq (Desvenlafaxine Succinate).

Abnormal Bleeding

Patients should be cautioned about the concomitant use of Pristiq and NSAIDs, warfarin, aspirin, or other drugs that affect coagulation since combined use of psychotropic drugs that interfere with serotonin reuptake and these agents has been associated with an increased risk of bleeding.

Narrow-angle Glaucoma

Advise patients with raised intraocular pressure or those at risk of acute narrow-angle glaucoma (angle-closure glaucoma) that mydriasis has been reported and they should be monitored.

Activation of Mania / Hypomania

Advise patients, their families and caregivers to observe for signs of activation of hypomania / mania.

Cardiovascular / Cerebrovascular Disease

Caution is advised in administering Pristiq (Desvenlafaxine) to patients with cardiovascular, cerebrovascular, or lipid metabolism disorders.

Serum Cholesterol and Triglyceride Elevation

Advise patients that elevations in total cholesterol, LDL and triglycerides may occur and that measurement of serum lipids may be considered.


Advise patients not to stop taking Desvenlafaxine (Pristiq) without talking first with their healthcare professional. Patients should be aware that discontinuation effects may occur when stopping this medicine.

Switching Patients from other Antidepressants to Pristiq

Discontinuation symptoms have been reported when switching patients from other antidepressants, including venlafaxine, to Pristiq (Desvenlafaxine). Tapering of the initial antidepressant may be necessary to minimize discontinuation symptoms.

Interference with Cognitive and Motor Performance

Caution patients about operating hazardous machinery, including automobiles, until they are reasonably certain that Pristiq (Desvenlafaxine Succinate) therapy does not adversely affect their ability to engage in such activities.


Advise patients to avoid alcohol while taking Desvenlafaxine (Pristiq).

Allergic Reactions

Advise patients to notify their physician if they develop allergic phenomena such as hives, rash, swelling, or difficulty breathing.


Advise patients to notify their physician if they become pregnant or intend to become pregnant during therapy.


Advise patients to notify their physician if they are breastfeeding an infant.

Residual Inert Matrix Tablet

Patients receiving Pristiq (Desvenlafaxine) may notice an inert matrix tablet passing in the stool or via colostomy. Patients should be informed that the active medication has already been absorbed by the time the patient sees the inert matrix tablet.

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