Letrozolum Genthon

Letrozolum Genthon may be available in the countries listed below.

Ingredient matches for Letrozolum Genthon

Letrozole

Letrozole is reported as an ingredient of Letrozolum Genthon in the following countries:

• Slovakia

International Drug Name Search

Isometeptene

Isometeptene may be available in the countries listed below.

Ingredient matches for Isometeptene

Isometheptene Mucate

Isometeptene (DCIT) is known as Isometheptene Mucate in the US.

International Drug Name Search

Glossary

DCIT	Denominazione Comune Italiana

Click for further information on drug naming conventions and International Nonproprietary Names.

Isoconazole

Scheme

Rec.INN

ATC (Anatomical Therapeutic Chemical Classification)

D01AC05,G01AF07

CAS registry number (Chemical Abstracts Service)

0027523-40-6

Chemical Formula

C18-H14-Cl4-N2-O

Molecular Weight

416

Therapeutic Category

Antifungal agent

Chemical Name

1H-Imidazole, 1-[2-(2,4-dichlorophenyl)-2-[(2,6-dichlorophenyl)methoxy]ethyl]-

Foreign Names

• Isoconazolum (Latin)
• Isoconazol (German)
• Isoconazole (French)
• Isoconazol (Spanish)

Generic Names

• Isoconazole (OS: BAN, USAN, DCF)
• Isoconazolo (OS: DCIT)
• Diclonazol (IS)
• FF 149 (IS)
• Isoconazol (PH: Ph. Eur. 6)
• Isoconazole (PH: BP 2010, Ph. Eur. 6)
• Isoconazolum (PH: Ph. Eur. 6)
• Isoconazole Nitrate (OS: BANM)
• R 15454 (IS: Janssen)
• Isoconazole (nitrate d') (PH: Ph. Eur. 6)
• Isoconazole Nitrate (PH: BP 2010, Ph. Eur. 6)
• Isoconazoli nitras (PH: Ph. Eur. 6)
• Isoconazolnitrat (PH: Ph. Eur. 6)

Brand Names

• Fungocamt
  Farmaceutica Latina, Peru



• Ginerella (Isoconazole and Metronidazole)
  Omdica, Peru



• Icaden
  Schering, Colombia; Schering, Dominican Republic



• Isoconazol Farmindustria
  Farmindustria, Peru



• Isoconazol Genfar
  Genfar, Colombia; Genfar, Ecuador; Genfar, Peru



• Isomicol
  Mediline, Peru



• Micelfen
  Omdica, Peru



• Sox
  Biogen, Peru



• Travogen
  Schering, United Arab Emirates; Schering, Bahrain; Schering, Cyprus; Schering, Egypt; Schering, Iraq; Schering, Jordan; Schering, Kuwait; Schering, Lebanon; Schering, Libya; Schering, Qatar; Schering, Saudi Arabia; Schering, Sudan; Schering, Yemen



• Vocozole
  Simed, Tunisia



• Adestan
  Bayer Yakuhin, Japan



• Adestan G
  Bayer Yakuhin, Japan



• Assent
  Sato Seiyaku, Japan



• Azonit
  Pharma International, Oman



• Fazol G
  Sinclair, France



• Fazol
  Sinclair, France



• Gyno Icaden
  Schering, Brazil



• Gyno-Travogen
  Agis, Israel; Bayer, Austria; Bayer, Switzerland; Bayer, Turkey; Schering, United Arab Emirates; Schering, Bahrain; Schering, Cyprus; Schering, Egypt; Schering, Ethiopia; Schering, Georgia; Schering, Hong Kong; Schering, Iraq; Schering, Jordan; Schering, Kuwait; Schering, Lebanon; Schering, Sri Lanka; Schering, Luxembourg; Schering, Libya; Schering, Poland; Schering, Qatar; Schering, Romania; Schering, Saudi Arabia; Schering, Sudan; Schering, Singapore; Schering, Yemen



• Icaden
  Bayer, Peru; Schering, Brazil; Schering, Colombia; Schering, Dominican Republic; Schering, Mexico



• Ilana
  Procaps, Colombia



• Isogen
  Pharma Clal, Israel; Purzer, Taiwan



• Maxaderm (Isoconazole and Diflucortolone)
  Cipla Medpro, South Africa



• Mupaten
  Schering, Argentina



• Nocazin
  AstraZeneca, Mexico



• Noginox
  Galeno, Colombia; La Santé, Venezuela



• Scheriderm
  Schering, Peru



• Travocort (Isoconazole and Diflucortolone)
  Bayer, Belgium; Bayer, Switzerland; Bayer, Croatia (Hrvatska); Bayer Schering, South Africa; Intendis, Austria; Intendis, Germany; Intendis, Luxembourg; Intendis, Poland; Schering, Oman; Transfarma Medica Indah, Indonesia



• Travogen
  Bayer, Belgium; Bayer, Switzerland; Bayer Schering, Greece; Intendis, Austria; Intendis, Estonia; Intendis, Italy; Intendis, Lithuania; Intendis, Luxembourg; Intendis, Latvia; Intendis, Malta; Intendis, Poland; Intendis, Russian Federation; Intendis, Turkey; Schering, United Arab Emirates; Schering, Bahrain; Schering, Cyprus; Schering, Egypt; Schering, Hong Kong; Schering, Iraq; Schering, Jordan; Schering, Kuwait; Schering, Lebanon; Schering, Sri Lanka; Schering, Luxembourg; Schering, Libya; Schering, Oman; Schering, Philippines; Schering, Qatar; Schering, Romania; Schering, Saudi Arabia; Schering, Sudan; Schering, Singapore; Schering, Thailand; Schering, Yemen



• Ufarin
  Schering, Chile



• Valinastin
  Fuji Yakuhin, Japan



• Vocort (Isoconazole and Diflucortolone)
  Philadelphia, Oman

International Drug Name Search

Glossary

BAN	British Approved Name
BANM	British Approved Name (Modified)
DCF	Dénomination Commune Française
DCIT	Denominazione Comune Italiana
IS	Inofficial Synonym
OS	Official Synonym
PH	Pharmacopoeia Name
Rec.INN	Recommended International Nonproprietary Name (World Health Organization)
USAN	United States Adopted Name

Click for further information on drug naming conventions and International Nonproprietary Names.

Trivedon

Trivedon may be available in the countries listed below.

Ingredient matches for Trivedon

Trimetazidine

Trimetazidine is reported as an ingredient of Trivedon in the following countries:

• Romania

International Drug Name Search

Amos Anti Melkziektestoot

Amos Anti Melkziektestoot may be available in the countries listed below.

In some countries, this medicine may only be approved for veterinary use.

Ingredient matches for Amos Anti Melkziektestoot

Colecalciferol

Colecalciferol is reported as an ingredient of Amos Anti Melkziektestoot in the following countries:

• Netherlands

International Drug Name Search

Grifopril

Grifopril may be available in the countries listed below.

Ingredient matches for Grifopril

Enalapril

Enalapril maleate (a derivative of Enalapril) is reported as an ingredient of Grifopril in the following countries:

• Chile

International Drug Name Search

Cemaquin-Teva

Cemaquin-Teva may be available in the countries listed below.

Ingredient matches for Cemaquin-Teva

Ascorbic Acid

Ascorbic Acid is reported as an ingredient of Cemaquin-Teva in the following countries:

• Switzerland

Benzethonium Chloride

Benzethonium Chloride is reported as an ingredient of Cemaquin-Teva in the following countries:

• Switzerland

International Drug Name Search

Syntocinon

In the US, Syntocinon (oxytocin systemic) is a member of the drug class uterotonic agents and is used to treat Abortion, Labor Induction and Postpartum Bleeding.

US matches:

• Syntocinon

UK matches:

• Syntocinon 5IU/ml and 10IU/ml
• Syntocinon Ampoules 10 IU/ml (SPC)
• Syntocinon Ampoules 5 IU/ml (SPC)

Ingredient matches for Syntocinon

Oxytocin

Oxytocin is reported as an ingredient of Syntocinon in the following countries:

• Argentina


• Australia


• Austria


• Bangladesh


• Belgium


• Brazil


• Chile


• Colombia


• Croatia (Hrvatska)


• Denmark


• Ethiopia


• Finland


• France


• Germany


• Ghana


• Hong Kong


• Iceland


• India


• Indonesia


• Ireland


• Italy


• Kenya


• Libya


• Luxembourg


• Malaysia


• Malta


• Mexico


• Netherlands


• New Zealand


• Nigeria


• Norway


• Peru


• Philippines


• Portugal


• Serbia


• Singapore


• Slovenia


• South Africa


• Spain


• Sudan


• Sweden


• Switzerland


• Tanzania


• Tunisia


• United Kingdom


• Venezuela


• Zimbabwe

International Drug Name Search

Glossary

SPC	Summary of Product Characteristics (UK)

Click for further information on drug naming conventions and International Nonproprietary Names.

Eryc

Eryc is a brand name of erythromycin, approved by the FDA in the following formulation(s):

ERYC (erythromycin - capsule, delayed rel pellets; oral)

• 
  Manufacturer: HOSPIRA
  
  Approved Prior to Jan 1, 1982
  
  Strength(s): 250MG ^[RLD][AB]

Has a generic version of Eryc been approved?

Yes. The following products are equivalent to Eryc:

ERYC (erythromycin capsule, delayed rel pellets; oral)

• 
  Manufacturer: WARNER CHILCOTT
  
  Approved Prior to Jan 1, 1982
  
  Strength(s): 250MG ^[AB]

erythromycin capsule, delayed rel pellets; oral

• 
  Manufacturer: ARBOR PHARMS INC
  
  Approval date: December 22, 1986
  
  Strength(s): 250MG ^[AB]

Note: Fraudulent online pharmacies may attempt to sell an illegal generic version of Eryc. These medications may be counterfeit and potentially unsafe. If you purchase medications online, be sure you are buying from a reputable and valid online pharmacy. Ask your health care provider for advice if you are unsure about the online purchase of any medication.

See also: About generic drugs.

Related Patents

There are no current U.S. patents associated with Eryc.

See also...

• Eryc Delayed-Release Particles Capsules Consumer Information (Wolters Kluwer)
• Eryc Consumer Information (Cerner Multum)
• Erythromycin Consumer Information (Drugs.com)
• E. E. S. Suspension Consumer Information (Wolters Kluwer)
• Erythromycin Consumer Information (Wolters Kluwer)
• Erythromycin Base and Stearate Consumer Information (Wolters Kluwer)
• Erythromycin Delayed-Release Particles Capsules Consumer Information (Wolters Kluwer)
• Erythromycin Delayed-Release Tablets Consumer Information (Wolters Kluwer)
• Erythromycin Ethylsuccinate Consumer Information (Wolters Kluwer)
• Erythromycin Ethylsuccinate Drops Consumer Information (Wolters Kluwer)
• Erythromycin Ethylsuccinate Suspension Consumer Information (Wolters Kluwer)
• Erythromycin Filmtabs Consumer Information (Wolters Kluwer)
• Erythromycin Lactobionate Consumer Information (Wolters Kluwer)
• Erythromycin Consumer Information (Cerner Multum)
• E.E.S. 100 Advanced Consumer Information (Micromedex)
• E.E.S. 200 Advanced Consumer Information (Micromedex)
• E.E.S. 400 Advanced Consumer Information (Micromedex)
• Erythrocin Stearate Advanced Consumer Information (Micromedex)
• Novo-Rythro Estolate Suspension Advanced Consumer Information (Micromedex)
• Novo-Rythro Ethyl Succinate Suspension Advanced Consumer Information (Micromedex)
• Novo-Rythro Stearate Advanced Consumer Information (Micromedex)
• Erythromycin Oral, Parenteral Advanced Consumer Information (Micromedex)
• Erythromycin AHFS DI Monographs (ASHP)

Vasopren

Vasopren may be available in the countries listed below.

Ingredient matches for Vasopren

Enalapril

Enalapril is reported as an ingredient of Vasopren in the following countries:

• Georgia

International Drug Name Search

Beta HC

Generic Name: hydrocortisone topical (hye droe KOR ti sone)

Brand Names: Ala-Cort, Ala-Scalp HP, Aquanil HC, Beta HC, Caldecort, Cortaid, Cortaid Intensive Therapy, Cortaid Maximum Strength, Cortaid with Aloe, Cortalo with Aloe, Corticaine, Cortizone for Kids, Cortizone-10, Cortizone-10 Intensive Healing Formula, Cortizone-10 Plus, Cortizone-5, Dermarest Dricort, Dermarest Eczema Medicated, Dermarest Plus Anti-Itch, Dermtex HC, Genasone/Aloe, Gly-Cort, Gynecort Maximum Strength, Hycort, Hydrocortisone 1% In Absorbase, Hydrocortisone with Aloe, Hydrocortisone-Aloe, Hytone, Instacort, Itch-X Lotion, Locoid, Locoid Lipocream, Locoid Lotion, Massengill Medicated Soft Cloth, MD Hydrocortisone, Neutrogena T-Scalp, NuCort with Aloe, NuZon, Pandel, Recort Plus, Rederm, Sarnol-HC, Scalacort, Texacort, U-Cort, Westcort

What is Beta HC (hydrocortisone topical)?

Hydrocortisone is a topical steroid. It reduces the actions of chemicals in the body that cause inflammation, redness, and swelling.

Hydrocortisone topical is used to treat inflammation of the skin caused by a number of conditions such as allergic reactions, eczema, or psoriasis.

Hydrocortisone topical may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about Beta HC (hydrocortisone topical)?

There are many brands and forms of hydrocortisone topical available and not all brands are listed on this leaflet.

Use this medication exactly as directed on the label, or as it has been prescribed by your doctor. Do not use the medication in larger amounts or for longer than recommended.

Do not cover treated skin areas with a bandage or other covering unless your doctor has told you to. If you are treating the diaper area of a baby, do not use plastic pants or tight-fitting diapers. Covering the skin that is treated with hydrocortisone topical can increase the amount of the drug your skin absorbs, which may lead to unwanted side effects. Follow your doctor's instructions.

Avoid using this medication on your face, near your eyes, or on body areas where you have skin folds or thin skin.

Do not use this medication on a child without a doctor's advice. Children are more sensitive to the effects of hydrocortisone topical.

Hydrocortisone topical will not treat a bacterial, fungal, or viral skin infection.

Contact your doctor if your condition does not improve or if it gets worse after using this medication for several days.

What should I discuss with my healthcare provider before using Beta HC (hydrocortisone topical)?

Do not use this medication if you are allergic to hydrocortisone.

Hydrocortisone topical will not treat a bacterial, fungal, or viral skin infection.

FDA pregnancy category C. It is not known whether hydrocortisone topical is harmful to an unborn baby. Before using this medication, tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether hydrocortisone topical passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. Do not use this medication on a child without a doctor's advice. Children are more sensitive to the effects of hydrocortisone topical.

How should I use Beta HC (hydrocortisone topical)?

Use this medication exactly as directed on the label, or as it has been prescribed by your doctor. Do not use the medication in larger or smaller amounts, or use it for longer than recommended.

Hydrocortisone topical will not treat a bacterial, fungal, or viral skin infection.

Wash your hands before and after each application, unless you are using hydrocortisone topical to treat a hand condition.

Apply a small amount to the affected area and rub it gently into the skin.

Avoid using this medication on your face, near your eyes or mouth, or on body areas where you have skin folds or thin skin.

Do not cover treated skin areas with a bandage or other covering unless your doctor has told you to. If you are treating the diaper area of a baby, do not use plastic pants or tight-fitting diapers. Covering the skin that is treated with hydrocortisone topical can increase the amount of the drug your skin absorbs, which may lead to unwanted side effects. Follow your doctor's instructions. Contact your doctor if your condition does not improve or if it gets worse after using this medication for several days. It is important to use hydrocortisone topical regularly to get the most benefit. Store hydrocortisone topical at room temperature away from moisture and heat.

What happens if I miss a dose?

Use the medication as soon as you remember. If it is almost time for the next dose, skip the missed dose and use the medicine at the next regularly scheduled time. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine, or if anyone has accidentally swallowed it. An overdose of hydrocortisone topical applied to the skin is not expected to produce life-threatening symptoms.

What should I avoid while using Beta HC (hydrocortisone topical)?

Avoid getting this medication in your eyes, mouth, and nose, or on your lips. If it does get into any of these areas, wash with water. Do not use hydrocortisone topical on sunburned, windburned, irritated, or broken skin. Also avoid using this medication in open wounds.

Avoid using skin products that can cause irritation, such as harsh soaps or shampoos or skin cleansers, hair coloring or permanent chemicals, hair removers or waxes, or skin products with alcohol, spices, astringents, or lime. Do not use other medicated skin products unless your doctor has told you to.

Beta HC (hydrocortisone topical) side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using hydrocortisone topical and call your doctor at once if you have any of these serious side effects:

• 
  

  blurred vision, or seeing halos around lights;

  
  


• 
  

  uneven heartbeats;

  
  


• 
  

  sleep problems (insomnia);

  
  


• 
  

  weight gain, puffiness in your face; or

  
  


• 
  

  feeling tired.

  
  

Less serious side effects may include:

• 
  

  skin redness, burning, itching, or peeling;

  
  


• 
  

  thinning of your skin;

  
  


• 
  

  blistering skin; or

  
  


• 
  

  stretch marks.

  
  

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Beta HC (hydrocortisone topical)?

It is not likely that other drugs you take orally or inject will have an effect on topically applied hydrocortisone. But many drugs can interact with each other. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.

More Beta HC resources

• Beta HC Side Effects (in more detail)
• Beta HC Use in Pregnancy & Breastfeeding
• Beta HC Drug Interactions
• Beta HC Support Group
• 0 Reviews for Beta HC - Add your own review/rating

• Beta HC Advanced Consumer (Micromedex) - Includes Dosage Information


• Anusol-HC Cream MedFacts Consumer Leaflet (Wolters Kluwer)


• Carmol HC Prescribing Information (FDA)


• Carmol HC MedFacts Consumer Leaflet (Wolters Kluwer)


• Cortizone-10 Cream MedFacts Consumer Leaflet (Wolters Kluwer)


• Hydrocortisone Acetate Monograph (AHFS DI)


• Hydrocortisone with Aloe Cream MedFacts Consumer Leaflet (Wolters Kluwer)


• Hytone Prescribing Information (FDA)


• Instacort Gel MedFacts Consumer Leaflet (Wolters Kluwer)


• Locoid Cream MedFacts Consumer Leaflet (Wolters Kluwer)


• Locoid Lipocream Prescribing Information (FDA)


• Locoid Lotion Prescribing Information (FDA)


• Nutracort Lotion MedFacts Consumer Leaflet (Wolters Kluwer)


• Pandel Prescribing Information (FDA)


• Pediaderm HC Lotion MedFacts Consumer Leaflet (Wolters Kluwer)


• ProctoCream-HC Cream MedFacts Consumer Leaflet (Wolters Kluwer)


• Proctocort Prescribing Information (FDA)


• Texacort Prescribing Information (FDA)


• U-cort Prescribing Information (FDA)


• Westcort Prescribing Information (FDA)

Compare Beta HC with other medications

• Anal Itching
• Aphthous Stomatitis, Recurrent
• Atopic Dermatitis
• Dermatitis
• Eczema
• Gingivitis
• Proctitis
• Pruritus
• Psoriasis
• Seborrheic Dermatitis
• Skin Rash

Where can I get more information?

• Your pharmacist can provide more information about hydrocortisone topical.

See also: Beta HC side effects (in more detail)

Interdoxin

Interdoxin may be available in the countries listed below.

Ingredient matches for Interdoxin

Doxycycline

Doxycycline hyclate (a derivative of Doxycycline) is reported as an ingredient of Interdoxin in the following countries:

• Indonesia

International Drug Name Search

Amoxipenil

Amoxipenil may be available in the countries listed below.

Ingredient matches for Amoxipenil

Amoxicillin

Amoxicillin trihydrate (a derivative of Amoxicillin) is reported as an ingredient of Amoxipenil in the following countries:

• Argentina


• Chile

International Drug Name Search

Mavitalon

Mavitalon may be available in the countries listed below.

Ingredient matches for Mavitalon

Diltiazem

Diltiazem hydrochloride (a derivative of Diltiazem) is reported as an ingredient of Mavitalon in the following countries:

• Greece

International Drug Name Search

Illina

Illina may be available in the countries listed below.

Ingredient matches for Illina

Ethinylestradiol

Ethinylestradiol is reported as an ingredient of Illina in the following countries:

• Germany

Levonorgestrel

Levonorgestrel is reported as an ingredient of Illina in the following countries:

• Germany

International Drug Name Search

Deleta

Deleta may be available in the countries listed below.

Ingredient matches for Deleta

Flupentixol

Flupentixol is reported as an ingredient of Deleta in the following countries:

• Bangladesh

Melitracen

Melitracen is reported as an ingredient of Deleta in the following countries:

• Bangladesh

International Drug Name Search

Ranperidon

Ranperidon may be available in the countries listed below.

Ingredient matches for Ranperidon

Risperidone

Risperidone is reported as an ingredient of Ranperidon in the following countries:

• Poland

International Drug Name Search

Unacefin

Unacefin may be available in the countries listed below.

Ingredient matches for Unacefin

Ceftriaxone

Ceftriaxone is reported as an ingredient of Unacefin in the following countries:

• Turkey

International Drug Name Search

drospirenone and estradiol

Generic Name: drospirenone and estradiol (droh SPYE re none ES tra dye ole)

Brand Names: Angeliq

What is drospirenone and estradiol?

Drospirenone is a female hormone that helps regulate ovulation and menstruation.

Estradiol is a female hormone involved in development and maintenance of the female reproductive system.

Drospirenone and estradiol is used to treat the symptoms of menopause such as hot flashes or vaginal changes (itching, burning, dryness, urination problems). It is also used to prevent thinning of the bones (osteoporosis).

Drosperinone and estradiol also treats the symptoms of premenstrual dysphoric disorder (PMDD). The symptoms of PMDD include depression, anxiety, persistent anger or irritability, trouble concentrating, sleep or appetite changes, and feeling out of control. PMDD also includes physical symptoms such as breast tenderness, headache, joint or muscle pain, bloating, and weight gain.

PMDD is not the same condition as premenstrual syndrome (PMS). This medication is not meant to treat PMS.

Drospirenone and estradiol may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about drospirenone and estradiol?

This medication can cause birth defects in an unborn baby. Do not use if you are pregnant. Use an effective form of birth control, and tell your doctor if you become pregnant during treatment. Drospirenone may raise potassium levels in your blood. Other medical conditions can also affect potassium levels. Before using drospirenone and estradiol, tell your doctor about all of your current and past medical conditions, and about all the medicines you use. Stop using this medication and call your doctor at once if you feel short of breath, have sudden numbness or weakness on one side of the body, sudden headache, confusion, or problems with vision, speech, or balance.

Call your doctor right away if you have a breast lump, unusual vaginal bleeding, or jaundice (yellowing of the skin or eyes).

What should I discuss with my doctor before taking drospirenone and estradiol?

Drospirenone may raise potassium levels in your blood. Other medical conditions can also affect potassium levels. Before using drospirenone and estradiol, tell your doctor if you have any of the following:

• a history of liver disease;


• a history of jaundice (yellowing of the skin or eyes) during a pregnancy or while using birth control pills;


• kidney disease;


• 
  

  adrenal insufficiency;

  
  


• 
  

  hemophilia or other bleeding disorder;

  
  


• 
  

  a history of stroke or blood clot;

  
  


• 
  

  unusual vaginal bleeding; or

  
  


• 
  

  any type of breast, uterine, or hormone-dependent cancer.

  
  

Certain medicines can also affect potassium levels. Tell your doctor if you use any of the following drugs:

• 
  

  heparin;

  
  


• 
  

  aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs) such as celecoxib (Celebrex), diclofenac (Voltaren), ibuprofen (Motrin, Advil), indomethacin, naproxen (Aleve, Naprosyn), piroxicam (Feldene);

  
  


• 
  

  a diuretic ("water pill") such as spironolactone (Aldactone), triamterene (Dyrenium, Dyazide, Maxzide), amiloride (Midamor), or eplerenone (Inspra);

  
  


• 
  

  a potassium supplement such as Klor-Con, K-Dur, K-Tab;

  
  


• 
  

  an ACE inhibitor such as benazepril (Lotensin), lisinopril (Prinivil, Zestril), enalapril (Vasotec); or

  
  


• 
  

  blood pressure medicine such as candesartan (Atacand), losartan (Cozaar), telmisartan (Micardis).

  
  

If you have any of the following conditions, you may not be able to use drospirenone and estradiol, or you may need a dosage adjustment or special tests during treatment:

• 
  

  high blood pressure, angina, heart disease, high cholesterol or triglycerides;

  
  


• liver or kidney disease;


• 
  

  asthma;

  
  


• 
  

  epilepsy;

  
  


• 
  

  migraines, depression;

  
  


• 
  

  diabetes;

  
  


• 
  

  gallbladder disease;

  
  


• 
  

  uterine fibroids; or

  
  


• 
  

  you have had a hysterectomy (uterus removed).

  
  

FDA pregnancy category X. This medication can cause birth defects. Do not use this medication if you are pregnant. Tell your doctor right away if you become pregnant during treatment. Drospirenone and estradiol may affect breast milk. Do not take drospirenone and estradiol without telling your doctor if you are breast-feeding a baby.

Estradiol may increase your risk of developing a condition that may lead to uterine cancer. Taking the combination of drospirenone and estradiol may reduce this risk. Talk with your doctor about your individual situation, and report any unusual vaginal bleeding right away.

How should I take drospirenone and estradiol?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger or smaller amounts, or take it for longer than recommended by your doctor.

Take each dose with a full glass of water.

Try to take drospirenone and estradiol at the same time each day.

Store drospirenone and estradiol at room temperature away from moisture and heat.

See also: Drospirenone and estradiol dosage (in more detail)

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine.

An overdose of drospirenone and estradiol is not expected to produce life-threatening symptoms.

What should I avoid while taking drospirenone and estradiol

There are no restrictions on food, beverages, or activity while taking drospirenone and estradiol unless your doctor directs otherwise.

Drospirenone and estradiol side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using this medication and call your doctor at once if you have any of these serious side effects:

• 
  

  chest pain;

  
  


• 
  

  shortness of breath;

  
  


• 
  

  sudden numbness or weakness, especially on one side of the body;

  
  


• 
  

  sudden headache, confusion, problems with vision, speech, or balance;

  
  


• 
  

  unusual vaginal bleeding;

  
  


• 
  

  stomach pain, swelling, or tenderness;

  
  


• 
  

  jaundice (yellowing of the skin or eyes); or

  
  


• 
  

  breast lump.

  
  

Continue using drospirenone and estradiol and talk with your doctor if you have any of these less serious side effects:

• 
  

  nausea and vomiting;

  
  


• 
  

  breast tenderness or enlargement;

  
  


• 
  

  swelling of your hands or feet;

  
  


• 
  

  darkened skin, especially on your face;

  
  


• 
  

  changes in your menstrual periods;

  
  


• 
  

  headache, migraine, dizziness, or fainting;

  
  


• 
  

  problems with contact lenses;

  
  


• 
  

  depression;

  
  


• 
  

  vaginal yeast infections; or

  
  


• 
  

  enlargement of uterine fibroids.

  
  

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. You may report side effects to FDA at 1-800-FDA-1088.

Drospirenone and estradiol Dosing Information

Usual Adult Dose for Postmenopausal Symptoms:

1 tablet orally each day.

What other drugs will affect drospirenone and estradiol?

Before taking this medication, tell your doctor if you are using any of the following drugs:

• 
  

  insulin or diabetes medicine taken by mouth, including glipizide (Glucotrol), glyburide (Diabeta, Micronase, Glynase), chlorpropamide (Diabinese), tolazamide (Tolinase), tolbutamide (Orinase), and others; or

  
  


• 
  

  a blood thinner such as warfarin (Coumadin).

  
  

If you are using any of these drugs, you may not be able to use dropirenone and estradiol.

There may be other drugs not listed that can affect drospirenone and estradiol. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

More drospirenone and estradiol resources

• Drospirenone and estradiol Side Effects (in more detail)
• Drospirenone and estradiol Dosage
• Drospirenone and estradiol Use in Pregnancy & Breastfeeding
• Drospirenone and estradiol Drug Interactions
• Drospirenone and estradiol Support Group
• 6 Reviews for Drospirenone and estradiol - Add your own review/rating

Compare drospirenone and estradiol with other medications

• Postmenopausal Symptoms

Where can I get more information?

• Your pharmacist has additional information about drospirenone and estradiol written for health professionals that you may read.

See also: drospirenone and estradiol side effects (in more detail)

Dymadon

In the US, Dymadon is a member of the drug class miscellaneous analgesics and is used to treat Fever, Muscle Pain, Pain and Sciatica.

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Paracetamol

Paracetamol is reported as an ingredient of Dymadon in the following countries:

• Australia

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Frenatermin

Frenatermin may be available in the countries listed below.

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Ibuprofen

Ibuprofen sodium (a derivative of Ibuprofen) is reported as an ingredient of Frenatermin in the following countries:

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Aprotinin

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In some countries, this medicine may only be approved for veterinary use.

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Dichlorvos is reported as an ingredient of Pecusanol in the following countries:

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Lisinopril dihydrate (a derivative of Lisinopril) is reported as an ingredient of Lisinopril AbZ in the following countries:

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Lorabid

In the US, Lorabid (loracarbef systemic) is a member of the drug class second generation cephalosporins and is used to treat Bladder Infection, Bronchitis, Impetigo, Kidney Infections, Otitis Media, Pneumonia, Sinusitis, Skin Infection, Strep Throat, Tonsillitis/Pharyngitis and Upper Respiratory Tract Infection.

US matches:

• Lorabid


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Loracarbef

Loracarbef is reported as an ingredient of Lorabid in the following countries:

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Loracarbef monohydrate (a derivative of Loracarbef) is reported as an ingredient of Lorabid in the following countries:

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Pemilaston

Pemilaston may be available in the countries listed below.

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Pemirolast

Pemirolast potassium salt (a derivative of Pemirolast) is reported as an ingredient of Pemilaston in the following countries:

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Acetazolamid Pharmedic may be available in the countries listed below.

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Acetazolamide

Acetazolamide is reported as an ingredient of Acetazolamid Pharmedic in the following countries:

• Vietnam

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Detrusitol

Detrusitol may be available in the countries listed below.

UK matches:

• Detrusitol 1mg & 2mg film-coated tablets (SPC)
• Detrusitol XL 4mg (SPC)

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Tolterodine

Tolterodine tartrate (a derivative of Tolterodine) is reported as an ingredient of Detrusitol in the following countries:

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Glossary

SPC	Summary of Product Characteristics (UK)

Click for further information on drug naming conventions and International Nonproprietary Names.

Imipénem

Imipénem may be available in the countries listed below.

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Imipenem

Imipénem (DCF) is known as Imipenem in the US.

International Drug Name Search

Glossary

DCF	Dénomination Commune Française

Click for further information on drug naming conventions and International Nonproprietary Names.

Colpotrofin

Colpotrofin may be available in the countries listed below.

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Promestriene

Promestriene is reported as an ingredient of Colpotrofin in the following countries:

• Spain

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Tulobunist

Tulobunist may be available in the countries listed below.

Ingredient matches for Tulobunist

Tulobuterol

Tulobuterol is reported as an ingredient of Tulobunist in the following countries:

• Japan

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Septalone

Septalone may be available in the countries listed below.

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Chlorhexidine

Chlorhexidine digluconate (a derivative of Chlorhexidine) is reported as an ingredient of Septalone in the following countries:

• Israel

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Diverticulitis with Hemorrhage Medications

There are currently no drugs listed for "Diverticulitis with Hemorrhage".

Learn more about Diverticulitis with Hemorrhage

Micromedex Care Notes:

• Diverticulitis
• Diverticulosis

Medical Encyclopedia:

• Diverticulitis

Drug List:

Patox

Patox may be available in the countries listed below.

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Ciprofloxacin

Ciprofloxacin hydrochloride (a derivative of Ciprofloxacin) is reported as an ingredient of Patox in the following countries:

• Mexico

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A-vitamin Medic

A-vitamin Medic may be available in the countries listed below.

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Retinol

Retinol is reported as an ingredient of A-vitamin Medic in the following countries:

• Denmark

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Nuriban

Nuriban may be available in the countries listed below.

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Furosemide

Furosemide diolamine (a derivative of Furosemide) is reported as an ingredient of Nuriban in the following countries:

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Ibufix

Ibufix may be available in the countries listed below.

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Ibuprofen

Ibuprofen is reported as an ingredient of Ibufix in the following countries:

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Desvenlafaxine Succinate

Class: Selective Serotonin- and Norepinephrine-reuptake Inhibitors
Chemical Name: RS-4-[2-dimethylamino-1-(1-hydroxycyclohexyl)ethyl]phenol
Molecular Formula: C₁₆H₂₅NO₂•C₄H₆O₄•H₂O
CAS Number: 386750-22-7
Brands: Pristiq

• Suicidality


• 
  

  Antidepressants may increase risk of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults (18–24 years of age) with major depressive disorder and other psychiatric disorders; balance this risk with clinical need.^{1 7 8} Desvenlafaxine is not approved for use in pediatric patients.¹ (See Pediatric Use under Cautions.)

  
  


• 
  

  In pooled data analyses, risk of suicidality was not increased in adults >24 years of age and apparently was reduced in adults ≥65 years of age with antidepressant therapy compared with placebo.^{1 7 8}

  
  


• 
  

  Depression and certain other psychiatric disorders are themselves associated with an increased risk of suicide.^{1 7 8 9}

  
  


• 
  

  Appropriately monitor and closely observe all patients who are started on desvenlafaxine therapy for clinical worsening, suicidality, or unusual changes in behavior; involve family members and/or caregivers in this process.^{1 7 8 9} (See Worsening of Depression and Suicidality Risk under Cautions.)

  
  

Introduction

A selective serotonin- and norepinephrine-reuptake inhibitor (SNRI); an antidepressant.^{1 3 4 5 6 19}

Uses for Desvenlafaxine Succinate

Major Depressive Disorder

Treatment of major depressive disorder in adults.^{1 3 5 6}

Efficacy of long-term use (i.e., >8 weeks) not established by controlled studies.¹ If desvenlafaxine is used for extended periods, the need for continued therapy should be reassessed periodically.¹

Desvenlafaxine Succinate Dosage and Administration

General

• 
  

  Allow at least 14 days to elapse between discontinuance of an MAO inhibitor and initiation of desvenlafaxine and at least 7 days to elapse between discontinuance of desvenlafaxine and initiation of an MAO inhibitor.¹

  
  


• 
  

  If switching from another antidepressant (including venlafaxine) to desvenlafaxine, may be necessary to taper dosage of the previous antidepressant to minimize discontinuance symptoms.^a

  
  


• 
  

  Monitor for possible worsening of depression, suicidality, or unusual changes in behavior, especially at the beginning of therapy or during periods of dosage adjustments.^{1 7 8 9} (See Worsening of Depression and Suicidality Risk under Cautions.)

  
  


• 
  

  Avoid abrupt discontinuance.¹ Taper dosage gradually and monitor for withdrawal symptoms.^{1 25 26} If intolerable symptoms occur following dosage reduction or discontinuance, consider reinstituting previously prescribed dosage, then resume more gradual dosage reductions.¹ (See Worsening of Depression and Suicidality Risk and also see Withdrawal of Therapy under Cautions.)

  
  


• 
  

  If used during pregnancy, consider cautiously tapering dosage during third trimester prior to delivery.^{1 2 15} (See Pregnancy under Cautions.)

  
  


• 
  

  Sustained therapy may be required; periodically reassess need for continued therapy.^{1 28}

  
  

Administration

Oral Administration

Administer orally with or without food at approximately the same time each day.¹

Swallow extended-release tablets whole with fluid; do not divide, crush, chew, or dissolve.¹

Dosage

Available as desvenlafaxine succinate; dosage expressed in terms of desvenlafaxine.¹

Adults

Major Depressive Disorder

Oral

50 mg once daily.¹ Although efficacy established at dosages of 50–400 mg once daily in clinical studies, no additional benefit observed with dosages >50 mg once daily; adverse effects and discontinuances were more frequent at higher dosages.¹

Optimum duration not established; may require several months or longer of sustained antidepressant therapy.^{1 28} Long-term efficacy (i.e., >8 weeks) of desvenlafaxine at a dosage of 50 mg once daily not studied.¹ Periodically reassess need for continued therapy.^{1 28}

Special Populations

Hepatic Impairment

Oral

Initially, 50 mg once daily.^a Dosage increases to >100 mg daily not recommended.^a

Renal Impairment

Oral

Mild renal impairment (Cl_cr 50–80 mL/minute): No dosage adjustment needed.¹

Moderate renal impairment (Cl_cr 30–50 mL/minute): 50 mg once daily.¹ Do not increase dosage.^a

Severe renal impairment (Cl_cr< 30 mL/minute) or end-stage renal disease: 50 mg every other day.¹ Do not increase dosage and do not give supplemental doses after dialysis.^a

Geriatric Patients

No specific dosage recommendations at this time, but consider possibility of age-related decreases in renal function when selecting dosage.¹ May administer drug every other day if poorly tolerated.¹

Cautions for Desvenlafaxine Succinate

Contraindications

• 
  

  Known hypersensitivity to desvenlafaxine, venlafaxine, or any ingredient in the formulation.¹

  
  


• 
  

  Concurrent or recent (i.e., within 2 weeks) therapy with an MAO inhibitor.¹ Allow at least 7 days to elapse after discontinuing desvenlafaxine before initiating an MAO inhibitor.¹ (See Serotonin Syndrome or Neuroleptic Malignant Syndrome [NMS]-like Reactions under Cautions.)

  
  

Warnings/Precautions

Warnings

Worsening of Depression and Suicidality Risk

Possible worsening of depression and/or the emergence of suicidal ideation and behavior (suicidality) or unusual changes in behavior in both adult and pediatric patients with major depressive disorder, whether or not they are taking antidepressants; may persist until clinically important remission occurs.^{1 7 8 9 18} (See Boxed Warning and also see Pediatric Use under Cautions.) However, suicide is a known risk of depression and certain other psychiatric disorders, and these disorders themselves are the strongest predictors of suicide. ^{1 7 8 9}

Appropriately monitor and closely observe patients receiving desvenlafaxine for any reason, particularly during initiation of therapy (i.e., the first few months) and during periods of dosage adjustments.^{1 7 8 9}

Anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia, hypomania, and/or mania may be precursors to emerging suicidality.^{1 8 9} Consider changing or discontinuing therapy in patients whose depression is persistently worse or in those with emerging suicidality or symptoms that might be precursors to worsening depression or suicidality, particularly if severe, abrupt in onset, or not part of the patient’s presenting symptoms.^{1 8} If decision is made to discontinue drug therapy, taper desvenlafaxine dosage as rapidly as is feasible but consider risks of abrupt discontinuance.^{1 25 26} (See General under Dosage and Administration.)

Prescribe in smallest quantity consistent with good patient management to reduce risk of overdosage.^{1 8}

Bipolar Disorder

May unmask bipolar disorder.¹ (See Activation of Mania/Hypomania under Cautions.) Desvenlafaxine is not approved for use in treating bipolar depression.¹

Screen for risk of bipolar disorder by obtaining detailed psychiatric history (e.g., family history of suicide, bipolar disorder, depression) prior to initiating therapy.¹

Other Warnings and Precautions

Serotonin Syndrome or Neuroleptic Malignant Syndrome (NMS)-like Reactions

Potentially life-threatening serotonin syndrome or neuroleptic malignant syndrome (NMS)-like reactions reported during concurrent therapy with SSRIs or SNRIs and other serotonergic drugs (e.g., 5-HT₁ receptor agonists [“triptans”]), drugs that impair serotonin metabolism (e.g., MAO inhibitors), or antipsychotics or other dopamine antagonists.¹ (See Contraindications under Cautions and see Interactions.)

Symptoms of serotonin syndrome may include mental status changes (e.g., agitation, hallucinations, coma), autonomic instability (e.g., tachycardia, labile BP, hyperthermia), neuromuscular aberrations (e.g., hyperreflexia, incoordination), and/or GI symptoms (e.g., nausea, vomiting, diarrhea).¹

Severe serotonin syndrome may resemble NMS, which is characterized by hyperthermia, muscle rigidity, autonomic instability with possible rapid fluctuation of vital signs, and mental status changes.¹

Monitor patients receiving desvenlafaxine for the development of serotonin syndrome or NMS-like signs and symptoms.¹ If serotonin syndrome or NMS signs and symptoms occur, discontinue desvenlafaxine and any concurrently administered serotonergic or antidopaminergic agents, including antipsychotic agents, and initiate supportive and symptomatic treatment.¹

Risk of Sustained Hypertension

Sustained hypertension (i.e., treatment-emergent increases in supine DBP ≥90 mm Hg and ≥10 mm Hg above baseline for 3 consecutive visits) reported; potential adverse consequences.¹ Elevated BP requiring immediate treatment also reported.¹

Control preexisting hypertension before initiating desvenlafaxine therapy and regularly monitor BP during therapy.¹ Exercise caution in patients with preexisting hypertension or other underlying conditions that may be compromised by increases in BP.¹ If sustained increases in BP occur, consider desvenlafaxine dosage reduction or discontinuance.¹

Abnormal Bleeding

Case reports and epidemiologic studies have demonstrated an association between the use of drugs that interfere with serotonin reuptake and the occurrence of GI bleeding.^{1 21} Possible increased risk of bleeding with SSRIs and SNRIs, including desvenlafaxine; events ranged from ecchymoses, hematomas, epistaxis, and petechiae to life-threatening hemorrhages.^{1 21} Concurrent administration of aspirin, NSAIAs, warfarin, and other anticoagulants may increase risk.¹ (See Drugs Affecting Hemostasis under Interactions and also see Advice to Patients.)

Mydriasis

Mydriasis reported.¹ Monitor patients with elevated IOP or at risk of angle-closure glaucoma.¹

Activation of Mania/Hypomania

Possible activation of mania and hypomania; use with caution in patients with personal or family history of mania or hypomania.¹ (See Bipolar Disorder under Cautions.)

Cardiovascular/Cerebrovascular Disease

Increases in BP and small increases in heart rate reported; use with caution in patients with cardiovascular, cerebrovascular, or lipid metabolism disorders.¹

Effects on Cholesterol and Lipoproteins

Dose-dependent, possibly clinically significant increases in fasting serum total cholesterol, LDL cholesterol, and triglycerides reported; consider measuring serum lipid concentrations during therapy.¹

Withdrawal of Therapy

Withdrawal effects reported with abrupt discontinuance or dosage reduction; reactions included dizziness, nausea, headache, irritability, insomnia, diarrhea, anxiety, fatigue, abnormal dreams, and hyperhidrosis and occurred more frequently with longer duration of therapy.¹ Withdrawal effects also reported upon discontinuance of other SNRIs and SSRIs, particularly when abrupt; events generally are self-limiting, but may be serious.¹

If intolerable symptoms occur following dosage reduction or discontinuance, consider reinstituting previously prescribed dosage, then resume more gradual dosage reductions.¹

Seizures

Seizures reported in premarketing clinical studies.¹ Desvenlafaxine has not been studied in patients with a history of seizures; use with caution in such patients.¹

Hyponatremia/SIADH

Possible hyponatremia or SIADH; use with caution in patients who are volume-depleted, elderly, or taking diuretics.¹ Initiate appropriate medical intervention and consider drug discontinuance in patients with symptomatic hyponatremia.¹

Concomitant Administration of Drugs Containing Desvenlafaxine and Venlafaxine

Do not use products containing desvenlafaxine and products containing venlafaxine concomitantly with Pristiq (desvenlafaxine succinate); desvenlafaxine is the principal active metabolite of venlafaxine.¹ (See Serotonin Syndrome or Neuroleptic Malignant Syndrome [NMS]-like Reactions under Cautions.)

Interstitial Lung Disease and Eosinophilic Pneumonia

Interstitial lung disease and eosinophilic pneumonia associated with venlafaxine (parent drug of desvenlafaxine) reported rarely; consider possibility in patients treated with desvenlafaxine who present with progressive dyspnea, cough, or chest discomfort.¹ Promptly evaluate patients with these symptoms and consider discontinuance of desvenlafaxine.¹

Specific Populations

Pregnancy

Category C.¹

Possible complications, sometimes severe and requiring prolonged hospitalization, respiratory support, enteral nutrition, and other forms of supportive care in neonates exposed to SNRIs or SSRIs late in the third trimester; may arise immediately upon delivery.^{1 12 13 14 15 16 17}

Carefully consider the potential risks and benefits of treatment when used during the third trimester of pregnancy.^{1 13 14 15} Consider cautiously tapering dosage during the third trimester prior to delivery.^{1 14 15 16 17}

Lactation

Distributed into milk; discontinue nursing or the drug.¹

Pediatric Use

Safety and effectiveness not established in pediatric patients <18 years of age.^{1 6} Possible adverse effects on weight, height, appetite, BP, and serum cholesterol concentrations reported in pediatric patients receiving venlafaxine, the parent drug of desvenlafaxine.²

FDA warns that a greater risk of suicidal thinking or behavior (suicidality) occurred during the first few months of antidepressant treatment compared with placebo in children and adolescents with major depressive disorder, obsessive-compulsive disorder (OCD), or other psychiatric disorders based on pooled analyses of 24 short-term, placebo-controlled trials of 9 antidepressant drugs (SSRIs and others).^{1 8} However, a more recent meta-analysis of 27 placebo-controlled trials of 9 antidepressants (SSRIs and others) in patients <19 years of age with major depressive disorder, OCD, or non-OCD anxiety disorders suggests that the benefits of antidepressant therapy in treating these conditions may outweigh the risks of suicidal behavior or suicidal ideation.¹⁸ No suicides occurred in these pediatric trials.^{1 8 18}

Carefully consider these findings when assessing potential benefits and risks of desvenlafaxine in a child or adolescent for any clinical use.^{1 8 9 18} (See Suicidality in the Boxed Warning and see Worsening of Depression and Suicidality Risk under Cautions.)

Geriatric Use

No overall differences in safety or efficacy observed relative to younger adults, but increased sensitivity cannot be ruled out.¹ Consider possible reduced renal clearance of the drug in geriatric patients.¹ (See Dosage and Administration: Special Populations and see Absorption: Special Populations, under Pharmacokinetics.)

Higher incidence of systolic orthostatic hypotension reported in patients ≥65 years of age.¹

Clinically important hyponatremia reported in geriatric patients.¹ (See Hyponatremia/SIADH under Cautions.)

In pooled data analyses, a reduced risk of suicidality was observed in adults ≥65 years of age with antidepressant therapy compared with placebo.^{1 7 8} (See Suicidality in the Boxed Warning and see Worsening of Depression and Suicidality Risk under Cautions.)

Hepatic Impairment

Increased mean elimination half-life in patients with moderate and severe hepatic impairment compared with healthy individuals and patients with mild hepatic impairment.¹ (See Hepatic Impairment under Dosage and Administration and see Elimination: Special Populations, under Pharmacokinetics.)

Renal Impairment

Decreased clearance in patients with moderate or severe renal impairment or end-stage renal disease; adjust dosage.¹ (See Renal Impairment under Dosage and Administration and see Elimination: Special Populations, under Pharmacokinetics.)

Common Adverse Effects

Nausea, dizziness, insomnia, hyperhidrosis, constipation, somnolence, decreased appetite, anxiety, and sexual function disorders in males (e.g., anorgasmia, decreased libido, abnormal orgasm, delayed ejaculation, erectile dysfunction, ejaculation disorder, ejaculation failure).^{1 3 4 5 19}

Interactions for Desvenlafaxine Succinate

Principally metabolized via conjugation by UGT isoenzymes; oxidation via CYP3A4 isoenzyme is a minor metabolic pathway.^{1 6} Minimally inhibits CYP2D6; does not inhibit CYP 1A2, 2A6, 2C8, 2C9, or 2C19 isoenzymes; did not inhibit or induce CYP3A4 in vitro (see Drugs Metabolized by Hepatic Microsomal Enzymes under Interactions).^{1 6 22}

Desvenlafaxine is not a substrate or an inhibitor of the P-glycoprotein transporter in vitro.¹

Drugs Metabolized by Hepatic Microsomal Enzymes

Drugs metabolized by CYP2D6: Potential pharmacokinetic interaction (increased CYP2D6 substrate plasma concentrations).^{1 22}

Drugs metabolized by CYP3A4: Potential pharmacokinetic interaction (reduced exposure to CYP3A4 substrate).¹ Although no inhibition or induction of CYP3A4 observed in vitro, AUC and peak plasma concentrations of CYP3A4 substrate decreased with concomitant administration of desvenlafaxine in one study.¹

Drugs metabolized by CYP1A2, 2A6, 2C8, 2C9, or 2C19 isoenzymes: Pharmacokinetic interaction unlikely.¹

Drugs Affecting Hepatic Microsomal Enzymes

Potent CYP3A4 inhibitors: Potential pharmacokinetic interaction (increased plasma desvenlafaxine concentrations).^{1 6}

Inhibitors of CYP isoenzymes 1A1, 1A2, 2A6, 2C8, 2C9, 2C19, 2D6, and 2E1: Clinically important pharmacokinetic interaction is unlikely.¹

Drugs Associated with Serotonin Syndrome

Potential pharmacologic interaction (potentially serious, sometimes fatal serotonin syndrome or NMS-like reactions) with serotonergic drugs.¹ Avoid concomitant use or exercise caution.¹ If serotonin syndrome or NMS occurs, immediately discontinue desvenlafaxine and any concurrently administered antidopaminergic or serotonergic agents and initiate supportive and symptomatic treatment.¹ (See Specific Drugs under Interactions and see Serotonin Syndrome or Neuroleptic Malignant Syndrome [NMS]-like Reactions under Cautions.)

Drugs Affecting Hemostasis

Potential pharmacologic interaction (increased risk of bleeding) if used concurrently with drugs that affect coagulation or bleeding; use with caution.^{1 23} (See Abnormal Bleeding under Cautions.)

Drugs that are Substrates or Inhibitors of P-glycoprotein Transport System

Pharmacokinetic interaction unlikely.¹

CNS-active Drugs

Potential interactions not systematically evaluated to date; use with caution.¹

Electroconvulsive Therapy

Risks and/or benefits of combined use of electroconvulsive therapy and desvenlafaxine not evaluated.¹

Specific Drugs

Drug	Interaction	Comments
Alcohol	Desvenlafaxine did not increase alcohol-induced impairment of mental and motor skills in a clinical study1	Manufacturer recommends avoiding concomitant alcohol consumption during desvenlafaxine therapy1
Anticoagulants (e.g., warfarin)	Potential pharmacologic interaction (increased risk of bleeding)1 23	Carefully monitor patients receiving warfarin during initiation and discontinuance of desvenlafaxine1
Antipsychotic agents	Potential pharmacologic interaction (potentially serious, sometimes fatal serotonin syndrome or NMS-like reactions)1	If serotonin syndrome or NMS occurs, immediately discontinue desvenlafaxine and any concurrently administered antidopaminergic or serotonergic agents and initiate supportive and symptomatic treatment1
Desipramine	Increased peak plasma concentrations and AUCs of desipramine 1 22
Diuretics	Consider risk of hyponatremia1
Dopamine antagonists	Potential pharmacologic interaction (potentially serious, sometimes fatal serotonin syndrome or NMS-like reactions)1	If serotonin syndrome or NMS occurs, immediately discontinue desvenlafaxine and any concurrently administered antidopaminergic or serotonergic agents and initiate supportive and symptomatic treatment1
5-HT1 receptor agonists (“triptans”) (e.g., almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, zolmitriptan)	Potential pharmacologic interaction (potentially serious, sometimes fatal serotonin syndrome or NMS-like reactions)1 24	If concurrent therapy is clinically warranted, carefully observe patient, particularly during initiation or dosage increase or when initiating another serotonergic agent1 24 If serotonin syndrome or NMS occurs, immediately discontinue desvenlafaxine and any concurrently administered antidopaminergic or serotonergic agents and initiate supportive and symptomatic treatment1
Ketoconazole	Increased AUC and peak plasma concentrations of desvenlafaxine1 6
Lithium	Potential pharmacologic interaction (potentially serious, sometimes fatal serotonin syndrome or NMS-like reactions)1	Use concomitantly with caution1 If serotonin syndrome or NMS occurs, immediately discontinue desvenlafaxine and any concurrently administered antidopaminergic or serotonergic agents and initiate supportive and symptomatic treatment1
MAO inhibitors (e.g., antidepressants, linezolid)	Risk of serious, sometimes fatal serotonin syndrome or NMS-like reactions1	Concomitant use with MAO inhibitors contraindicated1 Do not use desvenlafaxine within 14 days of stopping an MAO inhibitor; allow ≥7 days between discontinuance of desvenlafaxine and initiation of MAO inhibitor1 If serotonin syndrome or NMS occurs, immediately discontinue desvenlafaxine and any concurrently administered antidopaminergic or serotonergic agents and initiate supportive and symptomatic treatment1
Midazolam	Decreased AUC and peak plasma concentrations of midazolam1
NSAIAs (e.g., aspirin)	Potential pharmacologic interaction (increased risk of bleeding)1 23	Use concomitantly with caution1
Sibutramine	Potential pharmacologic interaction (potentially serious, sometimes fatal serotonin syndrome or NMS-like reactions)1	Use concomitantly with caution1 If serotonin syndrome or NMS occurs, immediately discontinue desvenlafaxine and any concurrently administered antidopaminergic or serotonergic agents and initiate supportive and symptomatic treatment1
SNRIs or SSRIs	Potential pharmacologic interaction (potentially serious, sometimes fatal serotonin syndrome or NMS-like reactions)1	If serotonin syndrome or NMS occurs, immediately discontinue desvenlafaxine and any concurrently administered antidopaminergic or serotonergic agents and initiate supportive and symptomatic treatment1
St. John’s wort (Hypericum perforatum)	Potential pharmacologic interaction (potentially serious, sometimes fatal serotonin syndrome or NMS-like reactions)1	Use concomitantly with caution1 If serotonin syndrome or NMS occurs, immediately discontinue desvenlafaxine and any concurrently administered antidopaminergic or serotonergic agents and initiate supportive and symptomatic treatment1
Tramadol	Potential pharmacologic interaction (potentially serious, sometimes fatal serotonin syndrome or NMS-like reactions)1	Use concomitantly with caution1 If serotonin syndrome or NMS occurs, immediately discontinue desvenlafaxine and any concurrently administered antidopaminergic or serotonergic agents and initiate supportive and symptomatic treatment1
Tryptophan and other serotonin precursors	Potential pharmacologic interaction (potentially serious, sometimes fatal serotonin syndrome or NMS-like reactions)1	Concomitant use not recommended1 If serotonin syndrome or NMS occurs, immediately discontinue desvenlafaxine and any concurrently administered antidopaminergic or serotonergic agents and initiate supportive and symptomatic treatment.1
Venlafaxine	Desvenlafaxine is the major active metabolite of venlafaxine1	Do not use desvenlafaxine and venlafaxine concomitantly1

Desvenlafaxine Succinate Pharmacokinetics

Absorption

Bioavailability

Absolute oral bioavailability is about 80%.¹

Peak plasma concentrations achieved about 7.5 hours after oral administration.¹

In women, peak plasma concentrations and AUC were approximately 25 and 10% higher, respectively, than age-matched men, but no dosage adjustment needed.¹

Food

Peak plasma concentration was increased about 16% in the fed state compared with fasting, but AUCs were similar; difference not clinically important.¹

Special Populations

In healthy geriatric individuals 65–75 years of age, there was no change in peak plasma concentrations, but AUC was increased approximately 32% compared with subjects 18–45 years of age.¹ In geriatric individuals >75 years of age, peak plasma concentrations increased approximately 32%, and AUC increased 55% compared with subjects 18–45 years of age.¹

Distribution

Extent

Distributed into milk.¹

Plasma Protein Binding

30%; plasma protein binding of desvenlafaxine is independent of plasma concentrations.^{1 6}

Elimination

Metabolism

Principally metabolized via conjugation by UGT isoenzymes; oxidation via CYP3A4 isoenzyme is a minor metabolic pathway.^{1 6}

Elimination Route

Approximately 45% of a single oral dose is eliminated unchanged in urine at 72 hours; approximately 19% of the dose is excreted as the glucuronide metabolite and less than 5% is excreted as the oxidative metabolite (N,O-didesmethylvenlafaxine) in urine.^{1 6}

Half-life

Mean elimination half-life is approximately 11 hours.^{1 6}

Special Populations

In patients with moderate (Child-Pugh class B) and severe (Child-Pugh class C) hepatic impairment, average AUC was increased by approximately 31 and 35%, respectively compared with healthy individuals; in patients with mild hepatic impairment (Child-Pugh class A), average AUC values were similar to those in healthy subjects (<5% difference).¹ In patients with moderate and severe hepatic impairment, systemic clearance was decreased by approximately 20 and 36%, respectively, compared with healthy individuals.¹ In patients with mild hepatic impairment, systemic clearance was comparable to that in healthy individuals.¹ Half-life was 13 and 14 hours in patients with moderate and severe hepatic impairment, respectively; half-life in patients with mild hepatic impairment was similar to that in healthy individuals.¹

In patients with renal impairment, elimination was correlated with Cl_cr.¹ AUC was increased about 42% in mild renal impairment (24-hour Cl_cr: 50–80 mL/minute), about 56% in moderate renal impairment (24-hour Cl_cr: 30–50 mL/minute), about 108% in severe renal impairment (24-hour Cl_cr: ≤30 mL/minute), and about 116% in end-stage renal disease subjects, compared with healthy, age-matched control subjects.^a The mean terminal half-life was prolonged from 11.1 hours in the control subjects to approximately 13.5, 15.5, 17.6, and 22.8 hours in mild, moderate, and severe renal impairment, and end-stage renal disease subjects, respectively.¹ Less than 5% of the drug in the body was cleared during a standard 4-hour hemodialysis procedure.¹

Stability

Storage

Oral

Extended-release Tablets

20–25°C (may be exposed to 15–30°C).¹

ActionsActions

• 
  

  Desvenlafaxine is the principal active metabolite of venlafaxine and is pharmacologically related to duloxetine, another SNRI.^{1 3 4 5 20}

  
  


• 
  

  Exact mechanism of antidepressant action has not been fully elucidated but appears to be associated with potentiation of serotonergic and noradrenergic activity in the CNS.^{1 4 5 6}

  
  


• 
  

  Desvenlafaxine is a potent inhibitor of neuronal serotonin and norepinephrine reuptake; however, inhibition of dopamine reuptake at concentrations that inhibit serotonin and norepinephrine reuptake appears unlikely in most patients.^{1 2 3 4 5 20}

  
  


• 
  

  Desvenlafaxine does not inhibit MAO and has not demonstrated substantial affinity for muscarinic cholinergic, H₁-histaminergic, α₁-adrenergic, dopaminergic, GABA, glutamate, and opiate receptors in vitro.^{1 3 4 5 6}

  
  

Advice to Patients

• 
  

  Risk of suicidality; importance of patients, family, and caregivers being alert to and immediately reporting emergence of suicidality, worsening depression, or unusual changes in behavior, especially during the first few months of therapy or during periods of dosage adjustment.^{1 7 8 9} FDA recommends providing written patient information (medication guide) explaining risks of suicidality each time the drug is dispensed.^{1 7 8 9}

  
  


• 
  

  Importance of informing patients of potential risk of serotonin syndrome and neuroleptic malignant syndrome (NMS)-like reactions, particularly with concurrent use of desvenlafaxine and 5-HT₁ receptor agonists (also called triptans), tramadol, tryptophan, other serotonergic agents, or antipsychotic agents.¹ Importance of immediately contacting clinician if signs and symptoms of these syndromes develop (e.g., restlessness, hallucinations, loss of coordination, fast heart beat, increased body temperature, muscle stiffness, increased BP, diarrhea, coma, nausea, vomiting, confusion).¹

  
  


• 
  

  Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs or herbal supplements, as well as any concomitant illnesses (e.g., cardiovascular, cerebrovascular, or lipid metabolism disorders; glaucoma) or personal or family history of suicidality or bipolar disorder.¹

  
  


• 
  

  Importance of advising patients about the risk of bleeding associated with concomitant use of desvenlafaxine with aspirin or other NSAIAs, warfarin, or other drugs that affect coagulation.¹

  
  


• 
  

  Importance of advising patients not to concurrently take other products containing desvenlafaxine or venlafaxine.¹

  
  


• 
  

  Importance of instructing patients not to take desvenlafaxine with an MAO inhibitor or within 14 days of stopping the drug, and to allow 7 days after stopping desvenlafaxine before starting therapy with an MAO inhibitor.¹

  
  


• 
  

  Importance of advising patients that they should have regular BP monitoring while taking desvenlafaxine.¹

  
  


• 
  

  Importance of advising patients with raised IOP or at risk of acute narrow-angle glaucoma (angle-closure glaucoma) that mydriasis has been reported with desvenlafaxine and that they should be monitored.¹

  
  


• 
  

  Importance of advising patients, their families, and caregivers to observe desvenlafaxine-treated patients for signs of activation of mania/hypomania.¹

  
  


• 
  

  Importance of advising patients that elevations in total cholesterol, LDL, and triglycerides may occur; measurement of lipid concentrations may be considered.¹

  
  


• 
  

  Importance of advising patients to notify their clinician if they develop any allergic signs or symptoms during therapy (e.g., rash, hives, swelling, difficulty breathing).¹

  
  


• 
  

  Risk of cognitive and motor impairment; importance of exercising caution while operating hazardous machinery, including automobile driving, until patients are reasonably certain that desvenlafaxine therapy does not adversely affect their ability to engage in such activities.¹

  
  


• 
  

  Importance of avoiding alcohol during desvenlafaxine therapy.¹

  
  


• 
  

  Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.¹

  
  


• 
  

  Importance of advising patients that it usually takes several weeks of antidepressant therapy before they will start to feel better.¹ Advise patients not to stop taking the drug if they do not feel the results right away.¹

  
  


• 
  

  Importance of advising patients not to stop taking desvenlafaxine without first talking with their clinician.¹ Importance of patients being aware that discontinuance effects may occur when stopping desvenlafaxine or when switching from another antidepressant to desvenlafaxine.^{1 a}

  
  


• 
  

  Importance of informing patients to swallow desvenlafaxine extended-release tablets whole, and not to crush, cut, chew, or dissolve the tablets.¹

  
  


• 
  

  Importance of informing patients that they may notice an inert matrix tablet passing in the stool or via colostomy, and that the active medication has already been absorbed by the time the patient sees the inert matrix tablet.¹

  
  


• 
  

  Importance of informing patients of other important precautionary information.¹ (See Cautions.)

  
  

Preparations

Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.

Desvenlafaxine Succinate

Routes	Dosage Forms	Strengths	Brand Names	Manufacturer
Oral	Tablet, extended-release, film-coated	50 mg (of desvenlafaxine)	Pristiq	Wyeth
		100 mg (of desvenlafaxine)	Pristiq	Wyeth

Comparative Pricing

This pricing information is subject to change at the sole discretion of DS Pharmacy. This pricing information was updated 03/2011. Actual costs to patients will vary depending on the use of specific retail or mail-order locations and health insurance copays.

Pristiq 100MG 24-hr Tablets (WYETH): 30/$146.99 or 90/$417.96

Pristiq 50MG 24-hr Tablets (WYETH): 30/$141.99 or 90/$406.97

Disclaimer

This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.

The American Society of Health-System Pharmacists, Inc. and Drugs.com represent that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. and Drugs.com make no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. and Drugs.com do not endorse or recommend the use of any drug. The information is not a substitute for medical care.

AHFS Drug Information. © Copyright, 1959-2011, Selected Revisions August 2010. American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland 20814.

References

1. Wyeth Laboratories Inc. Pristiq (desvenlafaxine succinate) extended-release tablets prescribing information. Philadelphia, PA; 2009 Feb.

2. Wyeth Laboratories. Effexor (venlafaxine hydrochloride) tablets prescribing information. Philadelphia, PA: 2008 Feb.

3. DeMartinis NA, Yeung PP, Entsuah R et al. A double-blind, placebo-controlled study of the efficacy and safety of desvenlafaxine succinate in the treatment of major depressive disorder. J Clin Psychiatry. 2007; 68:677-88. [PubMed 17503976]

4. Deecher DC, Beyer CE, Johnston G et al. Desvenlafaxine succinate: a new serotonin and norepinephrine reuptake inhibitor. J Pharmacol Exp Ther. 2006; 318:657-65. [PubMed 16675639]

5. Septien-Velez L, Pitrosky B, Padmanabhan SK et al. A randomized, double-blind, placebo-controlled trial of desvenlafaxine succinate in the treatment of major depressive disorder. Int Clin Psychopharmacol. 2007; 22:338-47.

6. Wyeth Laboratories, Philadelphia, PA: Personal communication.