desvenlafaxine
Brand names: Pristiq
Pristiq is a medicine used to treat depression in adults. It belongs to a class of drugs called serotonin-norepinephrine reuptake inhibitors (SNRIs).
Drug Pricing (NADAC)
Generic Price
$3.54/unit
Generic Available
Yes (8 manufacturers)
Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →
What it does
Pristiq is used to treat major depressive disorder (MDD) in adults.
Common side effects
Feeling sick to your stomach, Feeling dizzy, Trouble sleeping
Key warnings
Antidepressants may increase the risk of suicidal thoughts and behaviors in children, adolescents, and young adults.
How It Works
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.
How to Take It
Take Pristiq exactly as your doctor tells you. The usual dose is 50 mg once a day. You can take it with or without food, but try to take it at the same time each day. Swallow the tablet whole with fluid; do not crush, chew, or dissolve it.
Pregnancy & Breastfeeding
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.
Missed Dose
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and take your next dose at the regular time.
Storage
Store Pristiq at room temperature, between 68° to 77°F (20° to 25°C).
Side Effects (from patient reports)
Based on 1,956 FDA adverse event reports.
FDA Adverse Event Report Analysis
Detailed analysis of 3,267 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2008–2025.
Total Reports
3,267
Death-Related Reports
360
Hospitalization Reports
975
Top Indication
Product Used For Unknown Indication
Gender Distribution
Age Distribution
Most Reported Adverse Reactions (FAERS)
| # | Reaction | Reports |
|---|---|---|
| 1 | DRUG INEFFECTIVE | 278 |
| 2 | TOXICITY TO VARIOUS AGENTS | 233 |
| 3 | OFF LABEL USE | 208 |
| 4 | NAUSEA | 206 |
| 5 | COMPLETED SUICIDE | 186 |
| 6 | ANXIETY | 180 |
| 7 | OVERDOSE | 174 |
| 8 | FATIGUE | 166 |
| 9 | DRUG INTERACTION | 164 |
| 10 | DEPRESSION | 161 |
| 11 | HEADACHE | 159 |
| 12 | DIZZINESS | 133 |
| 13 | PAIN | 117 |
| 14 | SEROTONIN SYNDROME | 115 |
| 15 | INSOMNIA | 114 |
Reactions in Death Reports
Reactions in Hospitalization Reports
Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation
Serious Warnings
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.
Known Drug Interactions
Examples NSAIDs, aspirin, and warfarin Drugs that are Primarily Metabolized by CYP2D6 Clinical Impact Concomitant use of PRISTIQ increases C max and AUC of a drug primarily metabolized by CYP2D6 which may increase the risk of toxicity of the CYP2D6 substrate drug [see Clinical Pharmacology (12.3) ] .
Mechanism: Taking these two drugs together can increase the risk of bleeding. This happens because both medications can interfere with how your blood cells stick together to form clots.
What to do: Tell your doctor if you notice any unusual bruising or bleeding while taking these medications. Your healthcare provider may need to adjust your treatment plan.
• In a patient who is being treated with linezolid or intravenous methylene blue. Examples selegiline, tranylcypromine, isocarboxazid, phenelzine, linezolid, methylene blue Other Serotonergic Drugs Clinical Impact Concomitant use of PRISTIQ with other serotonergic drugs increases the risk of serotonin syndrome.
Mechanism: Both of these drugs increase the levels of a brain chemical called serotonin. If serotonin levels get too high, it can cause a serious and potentially life-threatening reaction called serotonin syndrome.
What to do: Avoid taking these two medications at the same time. If you are prescribed linezolid, your doctor will likely have you stop taking desvenlafaxine temporarily.
Examples selegiline, tranylcypromine, isocarboxazid, phenelzine, linezolid, methylene blue Other Serotonergic Drugs Clinical Impact Concomitant use of PRISTIQ with other serotonergic drugs increases the risk of serotonin syndrome.
Mechanism: These medications both raise serotonin levels in your body. Combining them can lead to a dangerous condition called serotonin syndrome, which affects your heart rate, blood pressure, and muscles.
What to do: Do not take these drugs together. You must typically wait at least 14 days after stopping one before starting the other to avoid a dangerous interaction.
Examples selegiline, tranylcypromine, isocarboxazid, phenelzine, linezolid, methylene blue Other Serotonergic Drugs Clinical Impact Concomitant use of PRISTIQ with other serotonergic drugs increases the risk of serotonin syndrome.
Mechanism: Both drugs increase the amount of serotonin in the brain. Taking them together can cause serotonin levels to become dangerously high, leading to a serious condition called serotonin syndrome.
What to do: Do not take these medications together. Your doctor will likely wait at least 14 days after you stop one before starting the other.
Examples selegiline, tranylcypromine, isocarboxazid, phenelzine, linezolid, methylene blue Other Serotonergic Drugs Clinical Impact Concomitant use of PRISTIQ with other serotonergic drugs increases the risk of serotonin syndrome.
Mechanism: These medications both raise serotonin levels in your body. Combining them can lead to too much serotonin, which can cause a dangerous reaction.
What to do: Avoid using these drugs at the same time. Talk to your doctor about a safe schedule for switching between these medications.
Common Questions
Can I stop taking Pristiq suddenly?
What should I do if I feel worse after starting Pristiq?
Can I drink alcohol while taking Pristiq?
Does Pristiq interact with other medications?
What if Pristiq doesn't seem to be working?
Can Pristiq cause weight gain?
Is it safe to breastfeed while taking Pristiq?
What if I have kidney problems?
What if I have liver problems?
Can Pristiq cause high blood pressure?
What are the common side effects of desvenlafaxine?
Does desvenlafaxine interact with other medications?
What drug class is desvenlafaxine?
Is desvenlafaxine safe during pregnancy?
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Medication Guides
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FDA requirements, cost savings, and when the difference matters
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Common Drug Interactions
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What the FDA Data Shows for desvenlafaxine
The FDA label for desvenlafaxine (sold under brand names such as Pristiq) classifies it as a prescription-only medication in the Serotonin-Norepinephrine Reuptake Inhibitor (SNRI) class. Pristiq is used to treat major depressive disorder (MDD) in adults. Official labeling lists 9 commonly reported side effects, including Feeling sick to your stomach, Feeling dizzy, Trouble sleeping.
Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 1,956 voluntary reports. The database also lists 19 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated moderate severity. NADAC pricing from CMS shows a generic unit cost of $3.54.
Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history, and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.
Data Sources
Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).
FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.
Last updated: November 13, 2025
Read our methodology — how this data is sourced, computed, and verified.
All federal data sources used on this page
- FDA Orange Book — approved drug products with therapeutic equivalence. accessdata.fda.gov/cder/ob
- FDA DailyMed — NIH-hosted drug labeling for FDA-approved meds. dailymed.nlm.nih.gov
- FDA Adverse Event Reporting System (FAERS) — post-marketing safety surveillance. fda.gov/drugs/faers
- NLM RxNorm — standardized clinical drug nomenclature. nlm.nih.gov/research/umls/rxnorm
- CMS Medicare Part B Drug Average Sales Price Files — federal drug pricing data. cms.gov/medicare/part-b-drugs/asp
- FDA Drug Shortages Database — current and resolved drug shortage tracking. accessdata.fda.gov/drugshortages