From the FDA Drug Label
In clinical studies, doses of 10 mg to 400 mg per day were studied. In clinical studies, doses of 50 mg to 400 mg per day were shown to be effective, although no additional benefit was demonstrated at doses greater than 50 mg per day and adverse reactions and discontinuations were more frequent at higher doses The highest daily dosage of Pristiq (desvenlafaxine) is 400 mg per day, as studied in clinical trials 1. However, it is essential to note that:
- No additional benefit was demonstrated at doses greater than 50 mg per day.
- Adverse reactions and discontinuations were more frequent at higher doses. Key points to consider:
- The recommended dose is 50 mg once daily.
- Doses above 50 mg per day should be used with caution, as they may increase the risk of adverse reactions.
From the Research
The maximum daily dose of Pristiq (desvenlafaxine) is 400 mg per day, as indicated in the study published in 2008 2. The typical recommended starting and maintenance dose is 50 mg once daily, with some patients potentially benefiting from doses up to 100 mg daily. Doses above 100 mg daily have not shown additional benefit in clinical trials for depression treatment, while potentially increasing side effects, as noted in the study published in 2010 3. Pristiq should be taken at approximately the same time each day, with or without food. The medication should not be crushed, chewed, or split as it has an extended-release formulation designed to release the medication gradually. Patients with severe renal impairment or end-stage renal disease should have their maximum dose limited to 50 mg daily. Pristiq works as a serotonin-norepinephrine reuptake inhibitor (SNRI), increasing the levels of these neurotransmitters in the brain to help improve mood and reduce anxiety. Abrupt discontinuation should be avoided; the dose should be gradually reduced to minimize withdrawal symptoms. It's worth noting that a more recent study published in 2022 4 compared the safety and efficacy of desvenlafaxine with sertraline in treating depression, but it did not provide new information on the maximum daily dose of Pristiq. However, the study published in 2008 2 remains the most relevant to the question of the maximum daily dose. Key points to consider when prescribing Pristiq include:
- Starting dose: 50 mg once daily
- Maximum dose: 400 mg per day
- Dose adjustment for renal impairment: maximum dose of 50 mg daily for patients with severe renal impairment or end-stage renal disease
- Administration: take at approximately the same time each day, with or without food, and do not crush, chew, or split the medication.