What are the risks of taking Pristiq?
| Pristiq can cause serious health problems in certain groups of people. You should talk to your doctor or pharmacist if you have any concerns or questions about other treatment options. Suicidal thoughts and behaviors: Risk factors: Adolescents younger than 24 years of age.
Like other antidepressants, Pristiq increased the risk of suicidal thoughts and behavior, especially during the first few weeks of treatment. Patients should be monitored closely for worsening or the emergence of suicidal thoughts and behaviors. Advise family members and caregivers of the need for close observation and communication with the prescriber.
Serotonin syndrome:- Risk factors: taking other medications that affect the brain’s serotonin level, such as antidepressants, lithium, and migraine medications.
This condition is when there is too much serotonin in the body; this condition is rare but can be life-threatening. You should watch out for symptoms such as fever, sweating, fast heartbeat, nausea and vomiting, agitation, and hallucinations. The risk of serotonin syndrome increases if you take Pristiq with other serotonergic drugs such as antidepressants, lithium, or migraines medications such as triptans. If you experience these symptoms, you should stop taking Pristiq and seek emergency medical care immediately.
High blood pressure:Risk factor: pre-existing high blood pressure or heart problems
Pristiq can cause a rise in blood pressure. If you already have hypertension (high blood pressure), your blood pressure should be controlled before you start taking Pristiq. You should monitor your blood pressure regularly while taking Pristiq. Let your doctor know if your blood pressure remains high for an extended period while taking Pristiq. Your doctor may decide to reduce the dose or discontinue Pristiq.
Increased risk of bleeding:- Risk factors: Taking other drugs that increase the risk of bleeding, such as aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), warfarin, and other blood thinners.
Drugs that increase serotonin levels, such as selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs), including Pristiq, may increase the risk of bleeding. The risk of bleeding increases even more if you take aspirin, NSAIDs such as ibuprofen (Motrin, Advil), naproxen (Aleve), or other blood thinners. If you are taking warfarin, blood work needs to be done to monitor your coagulation status when initiating, dose titrating, or discontinuing Pristiq. Let your doctor know if you have unusual bruising, blood in urine, black-colored stools, unusual nose, or gum bleeding. Your doctor may need to change the Pristiq dose if you are on a blood thinner.
Withdrawal symptoms:- Risk factors: Sudden discontinuation of Pristiq
Sudden discontinuation of Pristiq can cause withdrawal symptoms, including agitation, nausea, flu-like symptoms, anxiety, and trouble sleeping (insomnia). Talk to your healthcare provider if you want to discontinue Pristiq. The dose of Pristiq should be slowly and gradually decreased as instructed by a healthcare professional.
Mania:- Risk factors: Personal or family history of bipolar disorder
When someone with bipolar disorder is treated with an antidepressant alone, a manic episode can happen (euphoria, great excitement, delusions, and overactivity). Make sure you let your doctor know if you have bipolar disorder, as Pristiq should be prescribed with extreme caution in patients with a personal or family history of mania.
Worsening of glaucoma:- Risk factor: Narrow-angle glaucoma
If you have narrow-angle glaucoma, Pristiq can worsen this eye condition. Let your doctor or eye doctor know if you experience any changes to your vision while taking Pristiq. Pristiq should not be prescribed to people who have untreated narrow-angle glaucoma.
Low blood sodium (hyponatremia):- Risk factors: elderly patients; taking diuretics (water pills); or being dehydrated
SSRIs and SNRIs, including Pristiq, can cause low blood sodium. Elderly patients are at higher risk of developing low blood sodium. If you are taking a diuretic (water pill) or being dehydrated, your risk of developing low blood sodium also increases. Signs and symptoms of low blood sodium include headaches, difficulty concentrating, unusual memory problems, confusion, weakness, and unsteadiness, leading to falls. Let your doctor know if you experience any of these signs and symptoms. Blood tests must be done regularly to ensure your blood sodium levels are within normal ranges.
Pneumonia and lung problems:- It is not common, but people who take Pristiq can develop lung problems and pneumonia; these lung problems can cause lung damage in the long run. Let your healthcare provider know if you have an unexplained cough, shortness of breath, difficulty breathing that does not go away or gets worse over time.
Sexual dysfunction:- The use of SNRIs, including Pristiq, may cause sexual problems. Before starting Pristiq, you should let your doctor know if you have any problem with sexual dysfunction. Inform your doctor about any changes in sexual function while taking Pristiq. angle glaucoma.
Seizures:- Risk factor: history of seizures
Pristiq can increase the risk of having seizures. Let your healthcare provider know if you have seizure problems before starting Pristiq.
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What should I tell my doctor before starting Pristiq?
You should not take Pristiq if you are allergic to desvenlafaxine or venlafaxine (Effexor).
Pristiq is not approved for use in anyone younger than 18 years old.
During the first 4 to 6 weeks of antidepressant therapy, young adults under 24 years old have an increased risk of suicidal thoughts and ideation. You should let your doctor know if there is any change in your mood and behavior. Ask your family, friends, or caregiver to be alert to changes in your mood or symptoms of depression.
Let your doctor know if you are pregnant or planning to be pregnant. Taking Pristiq during the third trimester can cause bleeding problems after giving birth. However, do not stop taking Pristiq without your doctor’s instructions. Your depression may relapse if you stop taking your antidepressant.
Let your healthcare provider know if you plan to breastfeed, as Pristiq may not be safe for the baby.
Tell your doctor if you are taking opioid medication, stimulant medication, medicine for depression, herbal treatment (such as St. John’s wort), medicine for Parkinson’s disease, migraine headache, infections (such as linezolid), or anti-nausea and vomiting pills. Drug interactions between these medication classes and Pristiq can cause a serious condition called serotonin syndrome.
Monoamine oxidase inhibitors (MAOIs) can also interact with Pristiq. Some examples of MAOIs are linezolid (Zyvox), intravenous methylene blue, isocarboxazid, phenelzine, and tranylcypromine. Do not use Pristiq within 7 days or 14 days after using an MAOI. This drug interaction can cause serious medical complications.
Tell your doctor if you have any of these conditions:
- High blood pressure, high cholesterol, heart disease, or stroke
- Major depressive disorder (depression), suicidal thoughts
- Bipolar disorder (manic depression)
- Liver or kidney problems
- Glaucoma
- Seizures or epilepsy
- Low blood sodium
- A bleeding or clotting disorder
- Sexual problems
- Lung or breathing problems
What proper medical care should I take while on Pristiq?
- Keep all your doctor and blood work appointments to ensure the safety and efficacy of Pristiq therapy.
- Avoid driving, operating hazardous machinery, or performing activities requiring mental alertness at the beginning of therapy because Pristiq can impair your thinking or reactions.
- Avoid drinking alcohol while taking Pristiq; alcohol can make the adverse effects from Pristiq worse.
- Ask your healthcare professionals before using a nonsteroidal anti-inflammatory drug (NSAID) such as aspirin, ibuprofen, or naproxen.
- If you have surgery, including dental surgery, you should tell your dentist that you are taking Pristiq.
What drugs can interact with Pristiq?
Taking Pristiq with other medications that make you drowsy can worsen this side effect.
Talk to your healthcare provider before taking a sleep aid, an opioid pain killer, a muscle relaxer, or medication for anxiety or seizures.
Other drugs, including prescription medications, over-the-counter products, and herbal medicines, can increase your risk of bleeding if you take them with Pristiq:
- Warfarin (Coumadin) or other blood thinners
- NSAIDs (nonsteroidal anti-inflammatory drugs) such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib (Celebrex), diclofenac (Flector), indomethacin, meloxicam (Mobic), and others.
This is not a complete list. Other drugs, including prescriptions, over-the-counter products, herbal supplements, and vitamins, may interact with Pristiq. Not all potential drug interactions are listed in this guide. It is highly recommended to keep a list of all the drug products you are using (prescriptions, over-the-counter products, herbal supplements, natural products, and vitamins) and share it with your doctor and pharmacist.
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