Pristiq Drug Interactions

by on April 24, 2012

The following medications and substances have been shown to interact with Pristiq (Desvenlafaxine):

  • Diuretics like Furosemide
  • Linezolid
  • Metoclopramide (Reglan)
  • Midazolam
  • St. John’s Wort and other over-the-counter medications that act as sedatives, including Melatonin
  • Tryptophan, except for that which is naturally occurring in small amounts in foods
  • Certain antibiotics including Clarithromycin, Erythromycin and Telithromycin
  • Antifungals like Clotrimazole, Itraconazole, Ketoconazole and Voriconazole
  • Certain medications for the heart and blood pressure including Diltiazem, Nifedipine and Verapamil
  • HIV and AIDS medications like Fosamprenavir, Indinavir and Ritonavir
  • ‘Triptan’ family medications for migraine headaches
  • Other antidepressants including SSRIs, SRNIs and MAOI inhibitors such as Cymbalta, Lexapro, Prozac, and Zoloft.

Patients who take any of these medications or supplements should disclose this information with their physicians and pharmacists in order to avoid any serious complications that can arise, including a life-threatening condition known as Serotonin Syndrome.

Drugs that Boost the Action of Pristiq

Certain drugs must not be taken with Pristiq because they have the tendency to heighten both the main and the side effects of this antidepressant to dangerous levels. These drugs include:

  • Alcohol - Alcohol is a drug that boosts certain side effects of Pristiq such as drowsiness, dizziness and confusion which can be dangerous when people need to be alert, such as when driving.
  • Anticoagulants - Examples are warfarin (Coumadin, Marevan) and heparin (Heparin Flush, Heparin Novo). Combining Pristiq and an anticoagulant can increase the patient’s risks for serious bleeding.
  • Tricyclic Antidepressants - Examples of TCA’s are amitriptyline (Adepril, ADT) and amoxapine (Demolox, Moxadil) which also raise the body’s serotonin levels, thus intensifying Pristiq’s side effects.

Drugs that Cause Serotonin Syndrome When Combined with Pristiq

Certain drugs intensify the effects of Pristiq so much that a patient develops a potentially fatal condition called serotonin syndrome. Some of these drugs with serious Pristiq drug interactions include:

  • Monoamine Oxidase Inhibitors or MAOIs - Examples are Enelzine (Nardil) and selegiline (Emsam) which block MAO (a chemical that breaks down serotonin), thus leading to abnormally high serotonin levels.
  • Lithium - The drug, which comes in brand names such as Eskalith and Lithobid, also works by increasing serotonin activity in the body, thus doubling the serotonin-raising effect of Pristiq.
  • Tramadol - Rybix, Ryzolt, Ultram are three popular brands of this drug which stimulates serotonin release, leading to unhealthily high levels of serotonin when combined with Pristiq.

Drugs that Reduce the Efficacy of Pristiq

Painkillers known as NSAID’s or non-steroidal anti-inflammatory drugs may reduce the efficacy of Pristiq by blocking the release of p11 proteins, which are responsible for activating receptors to which serotonin binds. Examples of NSAIDS include:

  • Aspirin (Advil, Motrin) - This NSAID is typically prescribed for minor pains such as headaches and toothaches, as well as rheumatic fever and chronic pain from conditions such as cancer.
  • Naproxen (Naposin, Aleve) - Naproxen is often given for managing pain from rheumatism, ankylosing spondylitis, gout seizures, soft tissue rheumatism, dysmenorrhea and migraine.
  • Diclofenac (Voltaren, Cataflam)- The drug is indicated for muscle pain, chronic pain associated with rheumatoid arthritis and osteoarthritis, as well as post-traumatic and post-operative pain.

The complete list of drugs that can possibly interact with Pristiq is longer, and there are more types of interactions that a person needs to be aware of during medication. If you are taking Pristiq and need to take another drug for any reason, make sure that you consult your doctor beforehand as the possibility of serious Pristiq drug interactions is high, even with seemingly harmless over-the-counter drugs.