Details of the Drug

General Information of Drug (ID: DMHD4PE)

• Drug Name: Desvenlafaxine
• Synonyms: Norvenlafaxine; Desvenlafaxine (INN); Desvenlafaxine [INN:BAN]; O-Desmethylvenlafaxine; WY 45,233; O-DESMETHYLVENLAFAXINE (ODV); WY-45,233

Indication

Disease Entry	ICD 11	Status	REF
Major depressive disorder	6A70.3	Approved	[1]
Menopause symptom	GA30.0	Phase 3	[1]

• Drug Type: Small molecular drug
• #Ro5 Violations (Lipinski): 0:
  Molecular Weight (mw); 263.37
  Logarithm of the Partition Coefficient (xlogp); 2.6
  Rotatable Bond Count (rotbonds); 4
  Hydrogen Bond Donor Count (hbonddonor); 2
  Hydrogen Bond Acceptor Count (hbondacc); 3
• ADMET Property:
  Absorption Tmax: The time to maximum plasma concentration (Tmax) is 7.5 h [2]
  BDDCS Class: Biopharmaceutics Drug Disposition Classification System (BDDCS) Class 3: high solubility and low permeability [3]
  Bioavailability: The bioavailability of drug is 80% [2]
  Clearance: The drug present in the plasma can be removed from the body at the rate of 4.9 mL/min/kg [4]
  Elimination: 45% of the dose is unchanged in the urine, 19% is excreted as a glucuronide metabolite, and <5% is excreted as N,O-didesmethylvenlafaxine [5]
  Half-life: The concentration or amount of drug in body reduced by one-half in 11.1 hours [5]
  Metabolism: The drug is metabolized via the cytochrome P450 3A4 to a minor extent [5]
  MRTD: The Maximum Recommended Therapeutic Dose (MRTD) of drug that ensured maximising efficacy and moderate side effect is 5.424 micromolar/kg/day [6]
  Unbound Fraction: The unbound fraction of drug in plasma is 0.7% [4]
  Vd: The volume of distribution (Vd) of drug is 3.4 L/kg []
  Water Solubility: The ability of drug to dissolve in water is measured as 572 mg/mL [3]
• Chemical Identifiers:
  Formula: C16H25NO2
  IUPAC Name: 4-[2-(dimethylamino)-1-(1-hydroxycyclohexyl)ethyl]phenol
  Canonical SMILES: CN(C)CC(C1=CC=C(C=C1)O)C2(CCCCC2)O
  InChI: InChI=1S/C16H25NO2/c1-17(2)12-15(13-6-8-14(18)9-7-13)16(19)10-4-3-5-11-16/h6-9,15,18-19H,3-5,10-12H2,1-2H3
  InChIKey: KYYIDSXMWOZKMP-UHFFFAOYSA-N
• Cross-matching ID:
  PubChem CID: 125017
  ChEBI ID: CHEBI:83527
  CAS Number: 93413-62-8
  DrugBank ID: DB06700
  TTD ID: D0O3FG
  VARIDT ID: DR01008
  ACDINA ID: D00182
• Repurposed Drugs (RPD): Click to Jump to the Detailed RPD Information of This Drug

Molecular Interaction Atlas of This Drug

Drug Therapeutic Target (DTT)

DTT Name	DTT ID	UniProt ID	MOA	REF
Serotonin transporter (SERT)	TT3ROYC	SC6A4_HUMAN	Modulator	[7]

Molecular Expression Atlas of This Drug

• The Studied Disease: Major depressive disorder
• ICD Disease Classification: 6A70.3

Molecule Name	Molecule Type	Gene Name	p-value	Fold-Change	Z-score
Serotonin transporter (SERT)	DTT	SLC6A4	8.76E-01	7.18E-05	6.19E-04

Drug-Drug Interaction (DDI) Information of This Drug

Coadministration of a Drug Treating the Same Disease as Desvenlafaxine

DDI Drug Name	DDI Drug ID	Severity	Mechanism	Disease	REF
Vortioxetine	DM6F1PU	Major	Additive serotonergic effects by the combination of Desvenlafaxine and Vortioxetine.	Depression [6A70-6A7Z]	[8]

Coadministration of a Drug Treating the Disease Different from Desvenlafaxine (Comorbidity)

DDI Drug Name	DDI Drug ID	Severity	Mechanism	Comorbidity	REF
Methylene blue	DMJAPE7	Major	Additive serotonergic effects by the combination of Desvenlafaxine and Methylene blue.	Acquired methaemoglobinaemia [3A93]	[9]
Oliceridine	DM6MDCF	Moderate	Additive CNS depression effects by the combination of Desvenlafaxine and Oliceridine.	Acute pain [MG31]	[10]
Inotersen	DMJ93CT	Moderate	Increased risk of bleeding by the combination of Desvenlafaxine and Inotersen.	Amyloidosis [5D00]	[11]
Levalbuterol	DM5YBO1	Moderate	Increased risk of rapid heart rate by the combination of Desvenlafaxine and Levalbuterol.	Asthma [CA23]	[12]
Olodaterol	DM62B78	Moderate	Additive hypertensive effects by the combination of Desvenlafaxine and Olodaterol.	Chronic obstructive pulmonary disease [CA22]	[12]
Vilanterol	DMF5EK1	Moderate	Increased risk of rapid heart rate by the combination of Desvenlafaxine and Vilanterol.	Chronic obstructive pulmonary disease [CA22]	[12]
Levomilnacipran	DMV26S8	Major	Additive serotonergic effects by the combination of Desvenlafaxine and Levomilnacipran.	Chronic pain [MG30]	[8]
Regorafenib	DMHSY1I	Moderate	Increased risk of bleeding by the combination of Desvenlafaxine and Regorafenib.	Colorectal cancer [2B91]	[11]
Ardeparin	DMYRX8B	Moderate	Increased risk of bleeding by the combination of Desvenlafaxine and Ardeparin.	Coronary thrombosis [BA43]	[11]
Danaparoid	DM6CLBN	Moderate	Increased risk of bleeding by the combination of Desvenlafaxine and Danaparoid.	Deep vein thrombosis [BD71]	[11]
LEVONORDEFRIN	DMWDJ0H	Moderate	Increased risk of rapid heart rate by the combination of Desvenlafaxine and LEVONORDEFRIN.	Discovery agent [N.A.]	[12]
Eslicarbazepine	DMZREFQ	Moderate	Increased risk of hyponatremia by the combination of Desvenlafaxine and Eslicarbazepine.	Epilepsy/seizure [8A61-8A6Z]	[13]
Tazemetostat	DMWP1BH	Moderate	Increased risk of bleeding by the combination of Desvenlafaxine and Tazemetostat.	Follicular lymphoma [2A80]	[11]
Avapritinib	DMK2GZX	Moderate	Increased risk of bleeding by the combination of Desvenlafaxine and Avapritinib.	Gastrointestinal stromal tumour [2B5B]	[11]
Tetrahydrozoline	DMT57WC	Moderate	Increased risk of rapid heart rate by the combination of Desvenlafaxine and Tetrahydrozoline.	Herpes simplex infection [1F00]	[12]
Polyethylene glycol	DM4I1JP	Moderate	Increased risk of lowers seizure threshold by the combination of Desvenlafaxine and Polyethylene glycol.	Irritable bowel syndrome [DD91]	[14]
Naphazoline	DMJFZDL	Moderate	Increased risk of rapid heart rate by the combination of Desvenlafaxine and Naphazoline.	Itching [1F28-1G07]	[12]
Acalabrutinib	DM7GCVW	Moderate	Increased risk of bleeding by the combination of Desvenlafaxine and Acalabrutinib.	Mature B-cell lymphoma [2A85]	[11]
Ponatinib	DMYGJQO	Moderate	Increased risk of bleeding by the combination of Desvenlafaxine and Ponatinib.	Mature B-cell lymphoma [2A85]	[11]
Allopregnanolone	DMNLHAC	Moderate	Additive CNS depression effects by the combination of Desvenlafaxine and Allopregnanolone.	Mental/behavioural/neurodevelopmental disorder [6E20-6E8Z]	[15]
Ozanimod	DMT6AM2	Major	Additive serotonergic effects by the combination of Desvenlafaxine and Ozanimod.	Multiple sclerosis [8A40]	[16]
Fedratinib	DM4ZBK6	Moderate	Increased risk of bleeding by the combination of Desvenlafaxine and Fedratinib.	Myeloproliferative neoplasm [2A20]	[17]
Ruxolitinib	DM7Q98D	Moderate	Increased risk of bleeding by the combination of Desvenlafaxine and Ruxolitinib.	Myeloproliferative neoplasm [2A20]	[11]
Vorapaxar	DMA16BR	Moderate	Increased risk of bleeding by the combination of Desvenlafaxine and Vorapaxar.	Myocardial infarction [BA41-BA43]	[11]
E-2007	DMJDYNQ	Moderate	Antagonize the effect of Desvenlafaxine when combined with E-2007.	Neuropathy [8C0Z]	[13]
Propylhexedrine	DMTBW2O	Moderate	Increased risk of rapid heart rate by the combination of Desvenlafaxine and Propylhexedrine.	Obesity [5B80-5B81]	[12]
Choline salicylate	DM8P137	Moderate	Increased risk of bleeding by the combination of Desvenlafaxine and Choline salicylate.	Postoperative inflammation [1A00-CA43]	[11]
Plicamycin	DM7C8YV	Moderate	Increased risk of bleeding by the combination of Desvenlafaxine and Plicamycin.	Testicular cancer [2C80]	[11]
Brilinta	DMBR01X	Moderate	Increased risk of bleeding by the combination of Desvenlafaxine and Brilinta.	Thrombosis [DB61-GB90]	[11]
Cabozantinib	DMIYDT4	Moderate	Increased risk of bleeding by the combination of Desvenlafaxine and Cabozantinib.	Thyroid cancer [2D10]	[11]
Betrixaban	DM2C4RF	Moderate	Increased risk of bleeding by the combination of Desvenlafaxine and Betrixaban.	Venous thromboembolism [BD72]	[11]

Drug Inactive Ingredient(s) (DIG) and Formulation(s) of This Drug

DIG

DIG Name	DIG ID	PubChem CID	Functional Classification
Sunset yellow FCF	E00255	17730	Colorant
Ammonia	E00007	222	Alkalizing agent
Butyl alcohol	E00011	263	Flavoring agent; Solvent
Citric acid monohydrate	E00271	22230	Acidulant; Antioxidant; Buffering agent; Complexing agent; Flavoring agent
Eisenoxyd	E00585	56841934	Colorant
Ferric hydroxide oxide yellow	E00539	23320441	Colorant
Ferrosoferric oxide	E00231	14789	Colorant
Magnesium stearate	E00208	11177	lubricant
Polyethylene glycol 6000	E00655	Not Available	Coating agent; Diluent; Ointment base; Plasticizing agent; Solvent; Suppository base; lubricant
Polyvinyl alcohol	E00666	Not Available	Coating agent; Emulsion stabilizing agent; Film/Membrane-forming agent
Propylene glycol	E00040	1030	Antimicrobial preservative; Humectant; Plasticizing agent; Solvent
Silicon dioxide	E00670	Not Available	Anticaking agent; Opacifying agent; Viscosity-controlling agent
Talc	E00520	16211421	Anticaking agent; Diluent; Glidant; lubricant
Titanium dioxide	E00322	26042	Coating agent; Colorant; Opacifying agent
Vinylpyrrolidone	E00668	Not Available	Binding agent; Coating agent; Disintegrant; Film/membrane-forming agent; Solubilizing agent; Suspending agent

Pharmaceutical Formulation

Formulation Name	Drug Dosage	Dosage Form	Route
Desvenlafaxine 100 mg tablet	100 mg	24 HR Extended Release Oral Tablet	Oral
Desvenlafaxine 50 mg tablet	50 mg	24 HR Extended Release Oral Tablet	Oral

Jump to Detail Pharmaceutical Formulation Page of This Drug

References

• [1] URL: http://www.guidetopharmacology.org Nucleic Acids Res. 2015 Oct 12. pii: gkv1037. The IUPHAR/BPS Guide to PHARMACOLOGY in 2016: towards curated quantitative interactions between 1300 protein targets and 6000 ligands. (Ligand id: 7158).
• [2] Reddy S, Kane C, Pitrosky B, Musgnung J, Ninan PT, Guico-Pabia CJ: Clinical utility of desvenlafaxine 50 mg/d for treating MDD: a review of two randomized placebo-controlled trials for the practicing physician. Curr Med Res Opin. 2010 Jan;26(1):139-50. doi: 10.1185/03007990903408678.
• [3] BDDCS applied to over 900 drugs
• [4] Trend Analysis of a Database of Intravenous Pharmacokinetic Parameters in Humans for 1352 Drug Compounds
• [5] Efficacy, safety, and tolerability of Desvenlafaxine 50 mg/d for the treatment of major depressive disorder:a systematic review of clinical trials. Prim Care Companion J Clin Psychiatry. 2010;12(3). pii: PCC.09r00845. doi: 10.4088/PCC.09r00845blu.
• [6] Estimating the safe starting dose in phase I clinical trials and no observed effect level based on QSAR modeling of the human maximum recommended daily dose
• [7] 2008 FDA drug approvals. Nat Rev Drug Discov. 2009 Feb;8(2):93-6.
• [8] Achamallah NS "Visual hallucinations after combining fluoxetine and dextromethorphan ." Am J Psychiatry 149 (1992): 1406. [PMID: 1530079]
• [9] Boyer EW, Shannon M "The serotonin syndrome." N Engl J Med 352 (2005): 1112-20. [PMID: 15784664]
• [10] Vizcaychipi MP, Walker S, Palazzo M "Serotonin syndrome triggered by tramadol." Br J Anaesth 99 (2007): 919. [PMID: 18006535]
• [11] Alderman CP, Moritz CK, Ben-Tovim DI "Abnormal platelet aggregation associated with fluoxetine therapy." Ann Pharmacother 26 (1992): 1517-9. [PMID: 1482806]
• [12] Product Information. Cymbalta (duloxetine). Lilly, Eli and Company, Indianapolis, IN.
• [13] Belcastro V, Costa C, Striano P "Levetiracetam-associated hyponatremia." Seizure 17 (2008): 389-90. [PMID: 18584781]
• [14] Product Information. Suprep Bowel Prep Kit (magnesium/potassium/sodium sulfates). Braintree Laboratories, Braintree, MA.
• [15] Product Information. Zulresso (brexanolone). Sage Therapeutics, Inc., Cambridge, MA.
• [16] Alvine G, Black DW, Tsuang D "Case of delirium secondary to phenelzine/L-tryptophan combination." J Clin Psychiatry 51 (1990): 311. [PMID: 2365671]
• [17] Bannister SJ, Houser VP, Hulse JD, Kisicki JC, Rasmussen JG "Evaluation of the potential for interactions of paroxetine with diazepam, cimetidine, warfarin, and digoxin." Acta Psychiatr Scand Suppl 350 (1989): 102-6. [PMID: 2530759]