Desfoxine Drug Interactions

Desvenlafaxine minimally inhibits the cytochrome P-450 (CYP) 2D6 isoenzyme. Concomitant use of Desvenlafaxine with a drug metabolized by CYP2D6 may result in higher concentrations of that drug and decreased concentrations of its CYP2D6 metabolites.
The concurrent use of Desvenlafaxine with a drug metabolized by CYP3A4 can result in lower exposures to that drug.
Desvenlafaxine does not inhibit CYP isoenzymes 1A2, 2A6, 2C8, 2C9, and 2C19 in vitro and is unlikely to affect the pharmacokinetics of drugs that are metabolized by these CYP isoenzymes.
CYP3A4 is a minor pathway for the metabolism of Desvenlafaxine. The concurrent use of Desvenlafaxine with other potent CYP3A4 inhibitors may result in higher plasma concentrations of Desvenlafaxine.
Desvenlafaxine (100 mg daily) does not have a clinically relevant effect on drug metabolized by a combination of both CYP2D6 and CYP3A4 enzymes.
Based on in vitro data, drugs that inhibit CYP isozymes 1A1, 1A2, 2A6, 2D6, 2C8, 2C9, 2C19 and 2E1 are not expected to have significant impact on the pharmacokinetic profile of Desvenlafaxine.
The risk of using Desvenlafaxine in combination with other CNS-active drugs has not been systematically evaluated. Consequently, caution is advised when Desvenlafaxine is taken in combination with other CNS-active drugs.
Concomitant use of monoamine oxidase (MAO) inhibitors with Desvenlafaxine is contraindicated.
As with other serotonergic agents, serotonin syndrome, a potentially life-threatening condition, may occur with Desvenlafaxine treatment, 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), with drugs that impair metabolism of serotonin (such as MAOIs, including linezolid [an antibiotic which is a reversible non-selective MAOI] and methylene blue), or with serotonin precursors (such as tryptophan supplements). If concomitant treatment with Desvenlafaxine and an SSRI, an SNRI or a 5-hydroxytryptamine receptor agonist (triptan) is clinically warranted, carefully observation of the patient is advised, particularly during treatment initiation and dose increases. The concomitant use of Desvenlafaxine with serotonin precursor (such as tryptophan supplements) is not recommended.
If serotonin syndrome signs and symptoms occur, immediately discontinue treatment with Desvenlafaxine and any concurrently administered serotonergic or antidopaminergic agents and initiate supportive and symptomatic treatment.
In vitro, Desvenlafaxine is not a substrate or an inhibitor for the P-glycoprotein transporter.
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.
False-positive urine immunoassay screening tests for phencyclidine (PCP) and amphetamine have been reported in patients taking Desvenlafaxine.
There are no clinical data establishing the risks and/or benefits of electroconvulsive therapy combined with Desvenlafaxine treatment for MDD.