Mood disorders:
Indications for: VIIBRYD
Major depressive disorder.
Adult Dosage:
Take with food. Initially 10mg once daily for 7 days, then 20mg once daily for 7 days, then increase to 40mg once daily. Concomitant strong CYP3A4 inhibitors: max 20mg once daily. Concomitant strong CYP3A4 inducers for >14 days: consider increasing dose up to 2-fold over 1–2 weeks; max 80mg daily. Readjust to original level when CYP3A4 inhibitors or inducers (in 14 days) are discontinued.
Children Dosage:
Not established.
VIIBRYD Contraindications:
During or within 14 days of MAOIs; do not start an MAOI during or within 14 days of vilazodone. Concomitant linezolid or IV methylene blue.
Boxed Warning:
Suicidal thoughts and behaviors.
VIIBRYD Warnings/Precautions:
Increased risk of suicidal thinking and behavior in children, adolescents, and young adults; monitor for clinical worsening or unusual changes. Screen for bipolar disorder. Monitor for serotonin syndrome; discontinue if occurs. Increased risk of bleeding. History of mania/hypomania. Seizure disorder. Angle-closure glaucoma. Volume depleted. Sexual dysfunction. Avoid abrupt disruption. Reevaluate periodically. Write ℞ for smallest practical amount. Elderly. Pregnancy: effects on neonates exposed in 3rd trimester (see full labeling). Nursing mothers.
VIIBRYD Classification:
Selective serotonin reuptake inhibitor + 5-HT1A receptor partial agonist.
VIIBRYD Interactions:
See Contraindications. Avoid alcohol. Increased risk of serotonin syndrome with other serotonergic drugs (eg, triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, tryptophan, buspirone, amphetamines, St. John's Wort) or with drugs that impair serotonin metabolism (eg, MAOIs, linezolid, IV methylene blue). Increased risk of bleeding with concomitant aspirin, NSAIDs, warfarin (monitor), other anticoagulants. Potentiated by strong CYP3A4 inhibitors (eg, itraconazole, clarithromycin, voriconazole); see Adult. Antagonized by strong CYP3A4 inducers (eg, carbamazepine, phenytoin, rifampin); see Adult. Monitor digoxin. Caution with other highly protein-bound drugs.
Adverse Reactions:
Diarrhea, nausea, vomiting, insomnia, headache; hyponatremia/SIADH (esp. in elderly).
Drug Elimination:
Renal. Fecal. Half-life: ~25 hours.
Generic Drug Availability:
YES
How Supplied:
Tabs—30; Patient Starter Kit (7×10mg tabs + 7×20mg tabs + 16×40mg tabs; 7×10mg tabs + 23×20mg tabs)—30
