Devert-50/Devert-100 Drug Interactions

Monoamine Oxidase Inhibitors (MAOIs): Adverse reactions, some of which were serious, were recently reported in patients who discontinued monoamine oxidase inhibitor (including reversible MAOIs, such as linezolid and intravenous methylene blue), and began treatment with antidepressants with pharmacologic properties similar to desvenlafaxine (SNRIs or SSRIs), or who have recently discontinued an SSRI or SNRI therapy before starting an MAOI. Concomitant use of desvenlafaxine in patients taking monoamine oxidase inhibitors (MAOIs) is contraindicated.
At least 14 days should elapse between discontinuation of an MAOI and initiation of therapy with Desvenlafaxine. In addition, there must be an interval of at least 7 days after stopping Desvenlafaxine before starting a MAOI.
Serotonin syndrome: As with other serotonergic agents, serotonin syndrome, a potentially fatal condition, can occur with treatment with desvenlafaxine, particularly with concomitant use of other agents that may affect the serotonergic neurotransmitter system (including triptans, SSRIs, other SNRIs, lithium, sibutramine, fentanyl and its analogues, tramadol, dextromethorphan, tapentadol, meperidine, methadone, pentazocine, or St. John's Wort [Hypericum perforatum]), with drugs which impair the metabolism of serotonin (such as MAOIs, including linezolid [an antibiotic which is areversible nonselective MAOI] and methylene blue) or with serotonin precursors (such as tryptophan supplements).
If a concomitant treatment with desvenlafaxine and an SSRI, an SNRI or an agonist of the 5-hydroxytryptamine [triptan] receptor is clinically justified, a careful observation of the patient is recommended, particularly during treatment initiation and dose increases. Concomitant use of desvenlafaxine with serotonin precursors (such as tryptophan supplements) is not recommended.
Alcohol: A clinical study has shown that desvenlafaxine does not increase the impairment of mental and motor skills caused by ethanol. However, as with all CNS-active drugs, patients should be advised to avoid alcohol consumption while taking desvenlafaxine.
Drugs Metabolized by CYP2D6: Concomitant use of Desvenlafaxine with drugs that are metabolized by CYP2D6 (e.g. desipramine, atomoxetine, dextromethorphan, metoprolol, nebivolol, perphenazine, and tolterodine) increases Cmax and AUC of drugs primarily metabolized by CYP2D6 which may result to increased risk of toxicity of CYP2D6 substrate drug. Reduction of the dose by up to one-half if co-administered with 400 mg of Desvenlafaxine, original dose if with 100 mg or lower of Desvenlafaxine.
Drugs with no Clinically Significant Interactions: No Dose adjustment required for drugs that are mainly metabolized in by CYP3A4 (e.g. midazolam), CYP2D6 and CYP3A4 (e.g. tamoxifen, aripiprazole) when administered concomitantly.
Drug-Laboratory Interactions: Patients taking Desvenlafaxine may have false positive result on urine immunoassay screening test for phenycyclidine (PCP) and amphetamine due to the lack of specificity of the tests. Confirmatory tests such as gas chromatography and mass spectrometry will differentiate Desvenlafaxine from phenycyclidine (PCP) and amphetamine. A false positive result can also be expected for several days following discontinuation of Desvenlafaxine therapy.
Concomitant use with other CNS-Active Drugs: The risk of concomitant administration with a CNS-active drug has not been evaluated. Caution is advised when desvenlafaxine is taken in combination with other CNS-active drugs.
P-glycoprotein Transporter: Desvenlafaxine is not a substrate or an inhibitor for the P-glycoprotein transporter.
Electroconvulsive Therapy: There are no clinical data establishing the risks and/or benefits of electroconvulsive therapy combined with desvenlafaxine treatment for MDD.