Home Drug Guide Desvenlafaxine

Drug Guide

Generic Name

Desvenlafaxine

Brand Names Khedezla

Classification

Therapeutic: Antidepressant

Pharmacological: Serotonin-Norepinephrine Reuptake Inhibitor (SNRI)

FDA Approved Indications

  • Major Depressive Disorder

Mechanism of Action

Desvenlafaxine inhibits the reuptake of serotonin and norepinephrine in the central nervous system, increasing their levels in the synaptic cleft and helping to alleviate depression symptoms.

Dosage and Administration

Adult: Starting dose is 50 mg once daily, which may be increased to a maximum of 400 mg per day based on response and tolerability.

Pediatric: Not approved for use in pediatric patients.

Geriatric: Start at lower doses due to increased risk of side effects; monitor closely.

Renal Impairment: Dose adjustment may be necessary; refer to specific guidelines.

Hepatic Impairment: Use with caution; lower initial doses recommended.

Pharmacokinetics

Absorption: Well absorbed orally with approximately 80% bioavailability.

Distribution: Widely distributed; protein binding approximately 30%.

Metabolism: Primarily metabolized by conjugation (glucuronidation).

Excretion: Excreted mainly via urine; some in feces.

Half Life: Approximately 11 hours.

Contraindications

  • Hypersensitivity to desvenlafaxine or venlafaxine.
  • Use of monoamine oxidase inhibitors (MAOIs) within 14 days.
  • History of medication-induced mania/hypomania.

Precautions

  • History of hypertension or uncontrolled high blood pressure.
  • Increased risk of suicidal thoughts particularly in young adults and adolescents.
  • Serotonin syndrome risk with concomitant serotonergic drugs.
  • Monitor blood pressure regularly.

Adverse Reactions - Common

  • Nausea (Likely)
  • Dizziness (Likely)
  • Insomnia (Likely)
  • Sweating (Likely)
  • Dry mouth (Likely)

Adverse Reactions - Serious

  • Serotonin syndrome (Rare)
  • Hypertension (Less common)
  • Hypertension with medication overdose (Rare)
  • Changes in mood or behavior, including suicidal thoughts (Monitor closely during initial therapy or dose changes.)

Drug-Drug Interactions

  • MAO inhibitors (risk of serotonin syndrome)
  • Other serotonergic drugs (e.g., triptans, other antidepressants)
  • Blood pressure medications (additive effects)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor mood, suicidal ideation, blood pressure, and adverse effects.

Diagnoses:

  • Risk for injury related to dizziness or hypertension.
  • Risk for suicide.

Implementation: Administer once daily; take with or without food. Educate patient about potential adverse effects. Regularly monitor blood pressure and mental status.

Evaluation: Assess mood improvement, monitor side effects, and verify blood pressure stability.

Patient/Family Teaching

  • Do not abruptly stop medication.
  • Report worsening mood, suicidal thoughts, or unusual side effects.
  • Avoid alcohol and other CNS depressants.
  • Be aware of signs of serotonin syndrome and hypertensive episodes.

Special Considerations

Black Box Warnings:

  • Increased risk of suicidal thoughts in children, adolescents, and young adults.
  • Serotonin syndrome risk.

Genetic Factors: Genetic variations may affect metabolism, but specific pharmacogenetic guidance is limited.

Lab Test Interference: None significant.

Overdose Management

Signs/Symptoms: Dizziness, somnolence, seizures, hypertension, serotonin syndrome symptoms.

Treatment: Supportive care, activated charcoal if ingestion was recent, manage blood pressure and seizures if they occur, serotonin syndrome management with supportive measures and specific therapies.

Storage and Handling

Storage: Store at room temperature, 20°C to 25°C (68°F to 77°F).

Stability: Stable in original container, away from light and moisture.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.