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desvenlafaxine vs levomilnacipran

Side-by-side comparison of desvenlafaxine and levomilnacipran Data from FDA drug databases (Orange Book, NDC Directory, recalls, shortages) covering 20,000+ approved drugs, plus CMS pricing; see our methodology.

Drug Class
desvenlafaxine Serotonin-Norepinephrine Reuptake Inhibitor (SNRI)
levomilnacipran Serotonin-Norepinephrine Reuptake Inhibitor (SNRI)
Type
desvenlafaxine Prescription
levomilnacipran Prescription
Summary
desvenlafaxine

Pristiq is a medicine used to treat depression in adults. It belongs to a class of drugs called serotonin-norepinephrine reuptake inhibitors (SNRIs).

levomilnacipran

Fetzima is a medicine used to treat major depressive disorder (MDD) in adults. It helps to improve your mood by affecting certain chemicals in the brain.

What It Treats
desvenlafaxine

Pristiq is used to treat major depressive disorder (MDD) in adults. MDD can cause you to feel sad, lose interest in activities, and have trouble with daily life. This medicine can help improve your mood and energy levels.

levomilnacipran

Fetzima is used to treat major depressive disorder (MDD) in adults. MDD can cause you to feel sad, lose interest in activities, and have trouble with daily life. Fetzima can help improve your mood and reduce these symptoms.

How It Works
desvenlafaxine

Pristiq works by affecting certain chemicals in the brain. It increases the levels of serotonin and norepinephrine. These chemicals help regulate mood and can improve symptoms of depression.

levomilnacipran

Fetzima is a type of drug called a serotonin-norepinephrine reuptake inhibitor (SNRI). It works by increasing the levels of serotonin and norepinephrine in your brain. These chemicals can help improve your mood and reduce symptoms of depression.

Common Side Effects
desvenlafaxine
  • Feeling sick to your stomach
  • Feeling dizzy
  • Trouble sleeping
  • Increased sweating
  • Constipation
levomilnacipran
  • Nausea
  • Constipation
  • Increased sweating
  • Increased heart rate
  • Erectile dysfunction
FAERS Reports
desvenlafaxine
  • The medicine is not working 278
  • Harmful effect from different substances 233
  • Using the medicine for a condition it's not approved for 208
  • Feeling sick to your stomach 206
  • Death by suicide 186
levomilnacipran
  • Using the medicine for something it's not approved for 327
  • The medicine is not working 246
  • Pain 210
  • Throwing up 208
  • Trouble remembering things 189
Serious Warnings
desvenlafaxine

Antidepressants may increase the risk of suicidal thoughts and behaviors in children, adolescents, and young adults. If you are started on Pristiq, your doctor will monitor you closely for worsening depression or suicidal thoughts. Families and caregivers should also watch for these changes.

levomilnacipran

Antidepressants may increase the risk of suicidal thoughts and behaviors in young adults. Your doctor should closely watch you for worsening depression or suicidal thoughts. Fetzima is not approved for use in children.

Pregnancy
desvenlafaxine

Tell your doctor if you are pregnant or plan to become pregnant. Taking Pristiq late in pregnancy may cause problems in the newborn. There is a pregnancy registry to monitor outcomes in women exposed to antidepressants during pregnancy. You can register by calling 1-844-405-6185.

levomilnacipran

Tell your doctor if you are pregnant or plan to become pregnant. Using Fetzima in the last months of pregnancy may cause problems in the newborn. There is a pregnancy registry for women who take antidepressants during pregnancy.

Also Compare — Nearby Drugs

How to Read This desvenlafaxine vs levomilnacipran Comparison

desvenlafaxine is classified in the Serotonin-Norepinephrine Reuptake Inhibitor (SNRI) drug class, while levomilnacipran sits within the Serotonin-Norepinephrine Reuptake Inhibitor (SNRI) class. Because both drugs share the same classification, they are often considered interchangeable in theory — but clinical outcomes rarely track that cleanly. Both drugs are prescription-only, so a licensed provider must authorize use.

Adverse event totals above are pulled from the FDA's Adverse Event Reporting System (FAERS). For these top-ranked reactions alone, desvenlafaxine has 1,111 submissions while levomilnacipran has 1,180. Those figures reflect cumulative reporting volume — not per-patient risk — so older, widely dispensed drugs typically look worse on count alone. No direct interaction between these two drugs is listed in our FDA-derived dataset, though co-prescription still warrants pharmacist review. Serious warnings, pregnancy guidance, and contraindications can differ even when indications overlap.

A table cannot substitute for clinical judgment. Effectiveness, tolerability, drug-drug interactions with your other medications, kidney and liver function, pregnancy status, insurance formulary, and price all feed into a decision that only a licensed prescriber can make responsibly. Data here is sourced from FDA Structured Product Labels (SPL) and FAERS, both of which update as manufacturers and clinicians submit new information. This page is for educational purposes only, is not medical advice, and should not be used to self-switch between desvenlafaxine and levomilnacipran — always consult your physician or pharmacist first.

Important: This comparison is for informational purposes only. Drug effects vary between individuals. Always consult your doctor or pharmacist for personalized medical advice.