Pristiq is used for:

Treating depression. It may also be used for other conditions as determined by your doctor. Pristiq are a serotonin-norepinephrine reuptake inhibitor (SNRI). It works by restoring the balance of certain natural substances in the brain (serotonin and norepinephrine), which helps to improve certain mood problems.

Do NOT use Pristiq if:

• you are allergic to any ingredient in Pristiq or to venlafaxine
• you are taking or have taken a monoamine oxidase inhibitor (MAOI) (eg, phenelzine) or St. John's wort within the last 14 days
• you are taking a fenfluramine derivative (eg, dexfenfluramine), methylene blue, nefazodone, sibutramine, or tryptophan
• you are taking another medicine that contains venlafaxine or desvenlafaxine

Contact your doctor or health care provider right away if any of these apply to you.

Before using Pristiq:

Some medical conditions may interact with Pristiq . Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you or a family member has a history of bipolar disorder (manic-depression), other mental or mood problems, suicidal thoughts or attempts, or alcohol or substance abuse
• if you have a history of seizures, heart problems (eg, heart failure, irregular heartbeat), abnormal electrocardiogram, recent heart attack, stroke or bleeding in the brain, blood or bleeding problems, or high blood pressure
• if you have a history of high cholesterol, liver problems, lung problems, kidney problems, stomach or bowel bleeding, or increased eye pressure (eg, glaucoma)
• if you are dehydrated, have low blood sodium levels, or drink alcohol
• if you will be having electroconvulsive therapy (ECT)

Tell your health care provider if you are taking any other medicines, especially any of the following:

• Certain diet medicines (eg, fenfluramine, phentermine), linezolid, lithium, MAOIs (eg, phenelzine), methylene blue, metoclopramide, nefazodone, rasagiline, selective serotonin reuptake inhibitors (SSRIs) (eg, fluoxetine), selegiline, serotonin 5-HT1 receptor agonists (eg, sumatriptan), sibutramine, SNRIs (eg, duloxetine), St. John's wort, tramadol, trazodone, tricyclic antidepressants (eg, amitriptyline), or tryptophan because severe side effects, such as a reaction that may include fever, rigid muscles, blood pressure changes, mental changes, confusion, irritability, agitation, delirium, and coma, may occur
• Anticoagulants (eg, warfarin), aspirin, or nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen) because the risk of bleeding, including stomach bleeding, may be increased
• Diuretics (eg, furosemide, hydrochlorothiazide) because the risk of low blood sodium levels may be increased
• Azole antifungals (eg, ketoconazole) because they may increase the risk of Pristiq 's side effects
• Cyproheptadine because it may decrease Pristiq 's effectiveness
• Desipramine or midazolam because the risk of their side effects may be increased by Pristiq

This may not be a complete list of all interactions that may occur. Ask your health care provider if Pristiq may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Pristiq:

Use Pristiq as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Pristiq comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Pristiq refilled.
• Take Pristiq by mouth with or without food.
• Swallow Pristiq whole with fluid. Do not break, crush, chew, or dissolve before swallowing.
• Take Pristiq at about the same time each day.
• Continue to take Pristiq even if you feel well. Do not miss any doses.
• Do not suddenly stop taking Pristiq without checking with your doctor. Side effects may occur. They may include mental or mood changes, numbness or tingling of the skin, dizziness, drowsiness, confusion, headache, increased sweating, nausea, ringing in the ears, seizures, tremor, trouble sleeping, or unusual tiredness. You will be closely monitored when you start Pristiq and whenever a change in dose is made.
• If you miss a dose of Pristiq , take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Pristiq.

Important safety information:

• Pristiq may cause drowsiness, dizziness, or blurred vision. These effects may be worse if you take it with alcohol or certain medicines. Use Pristiq with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
• Do not drink alcohol while you are using Pristiq.
• Check with your doctor before you use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are taking Pristiq ; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.
• Several weeks may pass before your symptoms improve. Do NOT take more than the recommended dose or use for longer than prescribed without checking with your doctor.
• You may notice the tablet shell in your stool. This is normal and not a cause for concern.
• Children, teenagers, and young adults who take Pristiq may be at increased risk for suicidal thoughts or actions. Watch all patients who take Pristiq closely. Contact the doctor at once if new, worsened, or sudden symptoms such as depressed mood; anxious, restless, or irritable behavior; panic attacks; or any unusual change in mood or behavior occur. Contact the doctor right away if any signs of suicidal thoughts or actions occur.
• Serotonin syndrome is a possibly fatal syndrome that can be caused by Pristiq . Your risk may be greater if you take Pristiq with certain other medicines (eg, "triptans," MAOIs, SSRIs). Symptoms may include agitation; confusion; hallucinations; coma; fever; fast or irregular heartbeat; tremor; excessive sweating; and nausea, vomiting, or diarrhea. Contact your doctor at once if you have any of these symptoms.
• Neuroleptic malignant syndrome (NMS) is a possibly fatal syndrome that can be caused by Pristiq . Symptoms may include fever; stiff muscles; confusion; abnormal thinking; fast or irregular heartbeat; and sweating. Contact your doctor at once if you have any of these symptoms.
• If your doctor tells you to stop taking Pristiq , you will need to wait for a period of time before beginning to take certain other medicines (eg, MAOIs, nefazodone). Ask your doctor when you should start to take your new medicines after you have stopped taking Pristiq.
• Lab tests, including blood pressure and blood cholesterol levels, may be performed while you use Pristiq . These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
• Use Pristiq with caution in the ELDERLY; they may be more sensitive to its effects, especially low blood sodium levels.
• Caution is advised when using Pristiq in CHILDREN; they may be more sensitive to its effects, especially increased risk of suicidal thoughts or actions.
• Pristiq should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed.
• PREGNANCY and BREAST-FEEDING: Pristiq may cause harm to the fetus if it is used during the last 3 months of pregnancy. If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Pristiq while you are pregnant. Pristiq are found in breast milk. If you are or will be breast-feeding while you use Pristiq, check with your doctor. Discuss any possible risks to your baby.