When This Medicine Should Not Be Used:
This medicine is not right for everyone. Do not use it if you had an allergic reaction to desvenlafaxine or venlafaxine.

How to Use This Medicine:
Long Acting Tablet

• Take your medicine as directed. Your dose may need to be changed several times to find what works best for you. It is best to take this medicine at the same time each day.
• Swallow the tablet whole with water. Do not dissolve, crush, break, or chew the tablet.
• You may have to take this medicine for several weeks before you feel better. If you feel that the medicine is not working well, do not take more than your normal dose. Call your doctor for instructions.
• If you take the extended-release tablet, part of the tablet may pass into your stools. This is normal and is nothing to worry about.
• This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.
• Missed dose: Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.
• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Do not use this medicine together with an MAO inhibitor (MAOI) or if you have used an MAOI within the past 14 days. Do not take an MAOI for at least 7 days after you stop this medicine.
• Do not take any medicine that contains venlafaxine while you are using this medicine.
• Some medicines can affect how desvenlafaxine works. Tell your doctor if you are also using any of the following:
  
  • Atomoxetine, buspirone, dextromethorphan, fentanyl, ketoconazole, lithium, metoprolol, midazolam, nebivolol, perphenazine, St John's wort, tolterodine, tramadol, or a tryptophan supplement
  • Other medicine to treat depression, triptan medicine to treat migraine headaches, an NSAID pain or arthritis medicine (such as aspirin, diclofenac, ibuprofen, naproxen), a blood thinner (such as warfarin), or a diuretic (water pill)
• Do not drink alcohol while you are using this medicine.

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding, or if you have kidney disease, liver disease, bleeding problems, heart or blood vessel disease, glaucoma, high blood pressure, high cholesterol, or a history of mania, seizures, or stroke.
• For some children, teenagers, and young adults, this medicine may increase mental or emotional problems. This may lead to thoughts of suicide and violence. Talk with your doctor right away if you have any thoughts or behavior changes that concern you. Tell your doctor if you or anyone in your family has a history of bipolar disorder or suicide attempts.
• This medicine may cause the following problems:
  
  • Serotonin syndrome (may be life-threatening)
  • Increased risk of bleeding problems
  • Low sodium in the blood
• This medicine may make you dizzy or drowsy. Do not drive or do anything that could be dangerous until you know how this medicine affects you.
• Do not stop using this medicine suddenly. Your doctor will need to slowly decrease your dose before you stop it completely.
• Tell any doctor or dentist who treats you that you are using this medicine. This medicine may affect certain medical test results.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Anxiety, restlessness, fever, sweating, muscle spasms, nausea, vomiting, diarrhea, seeing or hearing things that are not there
• Blistering, peeling, or red skin rash
• Chest pain, cough, trouble breathing
• Confusion, weakness, muscle twitching, headache, trouble concentrating, unsteadiness
• Feeling more excited or energetic than usual, trouble sleeping
• Lightheadedness, fainting, fast or pounding heartbeat
• Seizures
• Thoughts of hurting yourself or others, unusual behavior
• Unusual bleeding or bruising

If you notice these less serious side effects, talk with your doctor:

• Decreased appetite, constipation, mild nausea
• Dizziness
• Dry mouth
• Eye pain, vision changes, seeing halos around lights
• Sexual problems
• Tiredness, sleepiness

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088