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Viloxazine

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Viloxazine, Qelbree

  • See Also
  1. ADHD Medication
  • Indications
  1. Attention Deficit Hyperactivity Disorder
  • Background
  1. Released in 2021 in U.S.
  • Contraindications
  1. Bipolar Disorder
    1. Risk of provoking a manic episode
  2. Concurrent use of Monoamine Oxidase Inhibitor
  3. Pregnancy
    1. Animal studies suggest fetal and maternal toxicity
  • Mechanism
  1. Selective Norepinephrine Reuptake Inhibitor (SNRI)
  2. Morpholine Derivative
  1. Marginal efficacy at best (that may not be detected clinically)
  • Dosing
  1. Start: 100 mg orally daily
  • Advantages
  1. Once daily dosing
  2. No abuse potential (similar in this regard to the lower cost Atomoxetine)
  • Disadvantages
  1. Low efficacy
  2. Expensive: $300/month (3x the cost of generic Atomoxetine)
  • Adverse Effects
  1. Suicidal Ideation
  2. Increased Heart Rate or Sinus Tachycardia (20-30% of patients)
  3. Sleep and Constitutional Effects
    1. Insomnia (23% of patients)
    2. Somnolence (16% of children)
    3. Fatigue (6% of children)
  4. Gastrointestinal Effects
    1. Decreased Appetite (7% of children, 10% of adults)
    2. Nausea or Vomiting (4-5% of children, 12% of adults)
    3. Dry Mouth (10% of adults)
    4. Constipation (6% of adults)
  5. Neurologic Effects
    1. Headache (17% of adults)
  • Resources
  1. Viloxazine (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=aedf408d-0f84-418d-9416-7c39ddb0d29a
  • References
  1. (2021) Presc Lett 28(9): 54
  2. Goodell (2023) Am Fam Physician 107(3): 309-10 [PubMed]