INDICATION AND USES:
VIIBRYD is indicated for the treatment of major depressive disorder (MDD) in adults (1).
DOSAGE AND ADMINISTRATION
- Recommended target dosage: 20 mg to 40 mg once daily with food (2.1, 12.3)
- To titrate: start with initial dosage of 10 mg once daily for 7 days, followed by 20 mg once daily. The dose may be increased up to 40 mg once daily after a minimum of 7 days between dosage increases (2.1)
- Prior to initiating VIIBRYD, screen for bipolar disorder (2.2, 5.4)
- When discontinuing VIIBRYD, reduce dosage gradually (2.4, 5.5)
SIDE EFFECTS:
Most common adverse reactions (incidence ≥ 5% and at least twice the rate of placebo): diarrhea, nausea, vomiting, and insomnia (6).
CONTRAINDICATIONS:
Concomitant use of monoamine oxidase inhibitors (MAOIs), or use within 14 days of stopping MAOIs (4)
WARNINGS AND PRECAUTIONS:
- Serotonin Syndrome: Increased risk when co-administered with other serotonergic agents (e.g., SSRI, SNRI, triptans, amphetamines), but also when taken alone. If it occurs, discontinue VIIBRYD and initiate supportive treatment (5.2)
- Increased Risk of Bleeding: Concomitant use of aspirin, nonsteroidal antiinflammatory drugs (NSAIDs), other antiplatelet drugs, warfarin, and other anticoagulants may increase this risk (5.3)
- Activation of Mania/Hypomania: Screen patients for bipolar disorder (5.4).
- Seizures: Can occur with treatment. Use with caution in patients with a seizure disorder (5.6).
- Angle Closure Glaucoma: Avoid use of antidepressants, including VIIBRYD, in patients with untreated anatomically narrow angles. (5.7)
DRUG INTERACTIONS:
- CYP3A4 Inhibitors: The VIIBRYD dose should not exceed 20 mg once daily when co-administered with strong CYP3A4 inhibitors (2.4, 7).
- CYP3A4 Inducers: Consider increasing VIIBRYD dosage by 2-fold, up to 80 mg once-daily over 1 to 2 weeks when used concomitantly with strong CYP3A4 inducers for greater than 14 days (2.4, 7)
OVERDOSE:
There is limited clinical trial experience regarding human overdose with VIIBRYD. The adverse reactions associated with overdose of VIIBRYD at doses of 200-280 mg (5 to 7 times the recommended dosage) as observed in clinical trials included serotonin syndrome, lethargy, restlessness, hallucinations, and disorientation.
For current information on the management of poisoning or overdose, contact a poison control center at 1-800-222-1222. No specific antidotes for vilazodone are known. Removal of vilazodone by dialysis has not been studied; however, the high volume of distribution of vilazodone suggests that dialysis will not be effective in reducing vilazodone plasma concentrations.
- Uses
-
INDICATION AND USES:
VIIBRYD is indicated for the treatment of major depressive disorder (MDD) in adults (1).
DOSAGE AND ADMINISTRATION
- Recommended target dosage: 20 mg to 40 mg once daily with food (2.1, 12.3)
- To titrate: start with initial dosage of 10 mg once daily for 7 days, followed by 20 mg once daily. The dose may be increased up to 40 mg once daily after a minimum of 7 days between dosage increases (2.1)
- Prior to initiating VIIBRYD, screen for bipolar disorder (2.2, 5.4)
- When discontinuing VIIBRYD, reduce dosage gradually (2.4, 5.5)
- Side Effects
-
SIDE EFFECTS:
Most common adverse reactions (incidence ≥ 5% and at least twice the rate of placebo): diarrhea, nausea, vomiting, and insomnia (6).
- Precautions
-
CONTRAINDICATIONS:
Concomitant use of monoamine oxidase inhibitors (MAOIs), or use within 14 days of stopping MAOIs (4)
WARNINGS AND PRECAUTIONS:
- Serotonin Syndrome: Increased risk when co-administered with other serotonergic agents (e.g., SSRI, SNRI, triptans, amphetamines), but also when taken alone. If it occurs, discontinue VIIBRYD and initiate supportive treatment (5.2)
- Increased Risk of Bleeding: Concomitant use of aspirin, nonsteroidal antiinflammatory drugs (NSAIDs), other antiplatelet drugs, warfarin, and other anticoagulants may increase this risk (5.3)
- Activation of Mania/Hypomania: Screen patients for bipolar disorder (5.4).
- Seizures: Can occur with treatment. Use with caution in patients with a seizure disorder (5.6).
- Angle Closure Glaucoma: Avoid use of antidepressants, including VIIBRYD, in patients with untreated anatomically narrow angles. (5.7)
- Interactions
-
DRUG INTERACTIONS:
- CYP3A4 Inhibitors: The VIIBRYD dose should not exceed 20 mg once daily when co-administered with strong CYP3A4 inhibitors (2.4, 7).
- CYP3A4 Inducers: Consider increasing VIIBRYD dosage by 2-fold, up to 80 mg once-daily over 1 to 2 weeks when used concomitantly with strong CYP3A4 inducers for greater than 14 days (2.4, 7)
- Overdose
-
OVERDOSE:
There is limited clinical trial experience regarding human overdose with VIIBRYD. The adverse reactions associated with overdose of VIIBRYD at doses of 200-280 mg (5 to 7 times the recommended dosage) as observed in clinical trials included serotonin syndrome, lethargy, restlessness, hallucinations, and disorientation.
For current information on the management of poisoning or overdose, contact a poison control center at 1-800-222-1222. No specific antidotes for vilazodone are known. Removal of vilazodone by dialysis has not been studied; however, the high volume of distribution of vilazodone suggests that dialysis will not be effective in reducing vilazodone plasma concentrations.