What Is Desvenlafaxine XR?

Desvenlafaxine XR is a prescription antidepressant in the serotonin-norepinephrine reuptake inhibitor (SNRI) class, FDA-approved to treat major depressive disorder (MDD) in adults.

It's the active metabolite of Venlafaxine (the active ingredient in Effexor XR), which means your body would naturally convert Venlafaxine into Desvenlafaxine anyway. By taking Desvenlafaxine directly, you skip that conversion step — which can mean more predictable blood levels and potentially fewer drug interactions.

Brand Names and Generics

Desvenlafaxine is available under several names:

• Pristiq — The original brand, made by Pfizer
• Khedezla — A brand-name version using the fumarate salt form
• Generic Desvenlafaxine ER — Available from multiple manufacturers as Desvenlafaxine Succinate ER or Desvenlafaxine Fumarate ER

All versions contain the same active ingredient and work the same way. The generic is significantly cheaper — typically $15 to $45 per month with a discount card compared to hundreds of dollars for brand-name Pristiq.

Drug Class and Schedule

Desvenlafaxine XR is an SNRI (serotonin-norepinephrine reuptake inhibitor). It is not a controlled substance, meaning there are no DEA restrictions on prescribing or refills. Any licensed prescriber can write a prescription for it.

What Is Desvenlafaxine XR Used For?

FDA-Approved Use

• Major Depressive Disorder (MDD) — This is the only FDA-approved indication for Desvenlafaxine XR.

Off-Label Uses

Doctors sometimes prescribe Desvenlafaxine XR for conditions not listed on the FDA label:

• Menopausal hot flashes (vasomotor symptoms) — This is one of the more common off-label uses, especially for women who can't take hormone replacement therapy.
• Generalized anxiety disorder
• Neuropathic pain
• Fibromyalgia

Off-label prescribing is legal and common when a doctor believes the medication may help based on clinical evidence.

How Is Desvenlafaxine XR Taken?

Here's what you need to know about taking Desvenlafaxine XR:

• Dose: The recommended dose is 50 mg once daily. Doses up to 400 mg/day have been studied, but research shows no additional benefit above 50 mg — and side effects increase at higher doses.
• Timing: Take it at the same time every day, with or without food.
• Swallow whole: Do not split, chew, crush, or dissolve the tablet. It's an extended-release formulation designed to release medication slowly throughout the day.
• Available strengths: 25 mg, 50 mg, and 100 mg tablets.
• Missed dose: Take it as soon as you remember, unless it's close to your next dose. Don't double up.

Who Should Not Take Desvenlafaxine XR?

Desvenlafaxine XR is not right for everyone. You should not take it if you:

• Are allergic to Desvenlafaxine, Venlafaxine, or any ingredient in the tablet
• Are currently taking an MAO inhibitor (like Phenelzine, Tranylcypromine, or Selegiline) or stopped one within the last 14 days
• Are taking Linezolid (an antibiotic) or IV methylene blue

Use caution and talk to your doctor if you:

• Have high blood pressure
• Have liver or kidney problems
• Have a history of seizures
• Have bipolar disorder or a history of mania
• Are pregnant or breastfeeding
• Are under 25 years old (increased risk of suicidal thoughts — see side effects guide)

How Much Does Desvenlafaxine XR Cost?

The cost varies widely depending on whether you get brand or generic, and whether you have insurance:

• Generic with discount card: $15 to $45 per month for 50 mg
• Generic retail (no discounts): $50 to $150 per month
• Brand-name Pristiq: $200 to $500+ per month

Generic Desvenlafaxine ER is covered by most insurance plans as a Tier 2 preferred generic. If you have insurance, your copay may be as low as $5 to $20.

For tips on reducing your cost, see our complete guide to saving money on Desvenlafaxine XR. If you're uninsured, Pfizer RxPathways (pfizerrxpathways.com) offers free or discounted medication for qualifying patients.

How Does It Compare to Similar Medications?

Desvenlafaxine XR belongs to the SNRI family, which includes several other medications. Here's a quick comparison:

• Venlafaxine XR (Effexor XR) — The parent compound. Approved for depression, anxiety, panic disorder, and social anxiety. Requires dose titration; Desvenlafaxine's 50 mg starting dose is also the therapeutic dose.
• Duloxetine (Cymbalta) — Another popular SNRI approved for depression, anxiety, chronic pain, and fibromyalgia.
• Levomilnacipran (Fetzima) — An SNRI with greater norepinephrine selectivity, used for depression.

For a deeper look at how Desvenlafaxine XR works in your body, read our mechanism of action guide.

Final Thoughts

Desvenlafaxine XR is a well-established antidepressant with a straightforward dosing schedule, a favorable side effect profile at 50 mg, and affordable generic options. Whether you're newly diagnosed with depression or considering switching from another antidepressant, it's worth discussing with your doctor.

If you need help finding Desvenlafaxine XR at a pharmacy near you, try Medfinder to check stock and compare prices. And if you need a doctor to prescribe it, see our guide on finding a prescriber near you.