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Desvenlafaxine Vs. Venlafaxine: Drug Comparison

Compare common side effects, interactions, warnings, and more.

Medical Review byMike Bohl, MD, MBA, MPH, MS, ALMNov 4, 2024

Medication Name

Desvenlafaxine

*image for illustrative purpose only

Summary

Prescription only

Desvenlafaxine is the active ingredient in the brand-name medication Pristiq®. The information below is about brand name Pristiq. According to the FDA, “Generic medicines use the same active ingredients as brand-name medicines and work the same way, so they have the same risks and benefits as the brand-name medicines.”

Pristiq (desvenlafaxine) is a serotonin-norepinephrine reuptake inhibitor (SNRI) used to treat major depressive disorder (MDD) by increasing the available levels of serotonin and norepinephrine in the brain, which helps improve mood and emotional balance. Its FDA-approved indication is for the treatment of major depressive disorder in adults. Off-label uses may include managing anxiety disorders, hot flashes related to menopause, and other mood disorders. Pristiq comes in extended-release tablet form, taken once daily. Common side effects include nausea, dizziness, dry mouth, male sexual dysfunction, and insomnia. It carries a boxed warning for an increased risk of suicidal thoughts and behaviors in children, adolescents, and young adults, particularly during the initial stages of treatment.

Prescription only

Venlafaxine is the active ingredient in the brand-name medication Effexor XR®. The information below is about brand name Effexor XR. According to the FDA, “Generic medicines use the same active ingredients as brand-name medicines and work the same way, so they have the same risks and benefits as the brand-name medicines.”

Effexor XR (venlafaxine extended-release) is a serotonin-norepinephrine reuptake inhibitor (SNRI) used to treat mood disorders by increasing the available levels of serotonin and norepinephrine in the brain, which helps regulate mood and anxiety. Its FDA-approved indications include major depressive disorder (MDD), generalized anxiety disorder (GAD), social anxiety disorder, and panic disorder. Off-label uses may include treatment for migraine prevention as well as treatment for premenstrual dysphoric disorder (PMDD) and neuropathic pain. Effexor XR comes in extended-release capsules, taken once daily. Common side effects include nausea, dizziness, insomnia, and sweating. It has a boxed warning for an increased risk of suicidal thoughts and behaviors in children, adolescents, and young adults, particularly during the early stages of treatment.

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Drug Category

Serotonin and norepinephrine reuptake inhibitor (SNRI)

Serotonin and norepinephrine reuptake inhibitor (SNRI)

Approved Uses

Pristiq (desvenlafaxine succinate) is indicated:

  • For the treatment of adults with major depressive disorder (MDD)

Effexor XR (venlafaxine hydrochloride) is indicated for the treatment of adults with:

  • Major depressive disorder (MDD)

  • Generalized anxiety disorder (GAD)

  • Social anxiety disorder (SAD)

  • Panic disorder (PD)

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Dosage

  • Typically taken orally once daily

  • Comes in 25 mg, 50 mg, and 100 mg extended-release tablets

  • Typically taken orally once daily

  • Comes in 37.5 mg, 75 mg, and 150 mg extended-release capsules

Known Common Side Effects

Most common adverse reactions (incidence ≥5% and twice the rate of placebo in the 50 or 100 mg dose groups) were:

  • Nausea

  • Dizziness

  • Insomnia

  • Excessive sweating

  • Constipation

  • Sleepiness

  • Decreased appetite

  • Anxiety

  • Specific male sexual function disorders

Most common adverse reactions (incidence ≥5% and at least twice the rate of placebo):

  • Nausea

  • Sleepiness

  • Dry mouth

  • Sweating

  • Abnormal ejaculation

  • Anorexia

  • Constipation

  • Impotence (men)

  • Libido decreased

Interactions & Contraindications

  • Hypersensitivity to desvenlafaxine succinate, venlafaxine hydrochloride, or any excipients in the Pristiq formulation

  • Serotonin syndrome and MAOIs

  • Hypersensitivity to venlafaxine hydrochloride, desvenlafaxine succinate, or any excipients in the Effexor XR formulation

  • Concomitant use of monoaminoxidase inhibitors (MAOIs) or within 14 days of discontinuing an MAOI

Warnings & Precautions

  • Serotonin syndrome

  • Elevated blood pressure

  • Increased risk of bleeding

  • Angle closure glaucoma

  • Activation of mania/hypomania

  • Discontinuation syndrome

  • Seizure

  • Low blood sodium: Can occur in association with SIADH.

  • Interstitial lung disease and eosinophilic pneumonia

  • Sexual dysfunction

  • Serotonin syndrome

  • Elevated blood pressure

  • Increased risk of bleeding

  • Angle‑closure glaucoma

  • Activation of mania or hypomania

  • Discontinuation syndrome

  • Seizures

  • Low blood sodium

  • Interstitial lung disease and eosinophilic pneumonia

  • Sexual dysfunction

  • Pregnancy: Third trimester use may increase risk for symptoms of poor neonatal adaptation (respiratory distress, temperature instability, feeding difficulty, hypotonia, tremor, irritability) in the neonate

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Boxed Warning

WARNING: SUICIDAL THOUGHTS AND BEHAVIORS

Increased the risk of suicidal thoughts and behaviors in children, adolescents and young adults taking antidepressants.

Closely monitor for clinical worsening and emergence of suicidal thoughts and behaviors.

Pristiq is not approved for use in pediatric patients.

WARNING: SUICIDAL THOUGHTS AND BEHAVIORS

Increased risk of suicidal thoughts and behavior in pediatric patients and young adults taking antidepressants. Closely monitor all antidepressant-treated patients for clinical worsening and emergence of suicidal thoughts and behaviors.

Effexor XR is not approved for use in pediatric patients.

References

*This information is from the label for brand name Pristiq®. See the Full Prescribing Information for more complete information. Desvenlafaxine, the active ingredient in Pristiq, may also be the active ingredient in other medications, and this information may not be accurate for all medications that include the active ingredient desvenlafaxine.

*This information is from the label for brand name Effexor XR®. See the Full Prescribing Information for more complete information. Venlafaxine, the active ingredient in Effexor XR, may also be the active ingredient in other medications, and this information may not be accurate for all medications that include the active ingredient venlafaxine.

The information provided here is NOT MEDICAL ADVICE and is for informational and educational purposes only. The drug comparison tool does not determine eligibility for medications or treatments provided via the Hims/Hers platform. Consultation with a healthcare provider is required to assess suitability for any medical treatment based on individual health and medical history. All product names and associated trademarks are the property of their respective owners.

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