Viloxazine: Difference between revisions
From Pharmacopedia
More actions
| [checked revision] | [pending revision] |
MDElliottMD (talk | contribs) Pharmacopedia: add <pharmaInteractions/> |
MDElliottMD (talk | contribs) Remove Category:Psychostimulants tag (second pass after duplicate-tag situation) |
||
| (6 intermediate revisions by 3 users not shown) | |||
| Line 1: | Line 1: | ||
{{MedTemplate | {{MedTemplate | ||
| brand = Qelbree | |||
| brand | | classes = Selective norepinephrine reuptake inhibitor (NRI) with 5HT1A partial agonism, non-stimulant ADHD agent | ||
| mechanism = Selective NET inhibitor (no significant DAT activity — distinguishes from amphetamine/methylphenidate). Also: 5HT1A receptor partial agonism, 5HT2B and 5HT7 receptor antagonism. The serotonergic actions may underlie better tolerability and possibly different efficacy spectrum than atomoxetine. | |||
| classes | | uses = ADHD in children (6+), adolescents, and adults (FDA-approved 2021 for pediatric, 2022 for adult) | ||
| mechanism | | starting_dose = Pediatric 6-11: 100 mg PO daily, titrate weekly to max 400 mg. Adolescent 12-17: 200 mg, max 400 mg. Adult: 200 mg, max 600 mg. | ||
| uses | | preparations = 100 mg, 150 mg, 200 mg extended-release capsules (can be sprinkled on food) | ||
| starting_dose | | fda_max = 400 mg/d (pediatric); 600 mg/d (adult) | ||
| preparations | | routes = Oral | ||
| fda_max | | onset = ADHD symptom improvement reported within 1-2 weeks (faster than atomoxetine which takes 4-6 weeks) | ||
| routes | | duration = Daily dosing | ||
| onset | | halflife = ~7 hours | ||
| duration | | bioavailability = Adequate oral bioavailability with extended-release formulation | ||
| halflife | | pregnancy = Limited data | ||
| bioavailability | | legal = Rx — '''not a controlled substance''' (no DEA scheduling) | ||
| pregnancy | | intro = '''Viloxazine''' (brand name Qelbree) is an extended-release norepinephrine reuptake inhibitor FDA-approved in 2021 for ADHD in children 6 and older, and in 2022 for adults. Originally developed as an antidepressant in Europe in the 1970s (withdrawn for commercial reasons), it was repurposed for ADHD. Like atomoxetine, viloxazine is a non-stimulant alternative that is '''not a controlled substance'''. However, viloxazine has a more complex pharmacology than atomoxetine — beyond pure NET inhibition, it has 5HT1A partial agonism and 5HT2B/5HT7 antagonism, which may underlie faster onset (1-2 weeks vs atomoxetine's 4-6 weeks) and possibly different efficacy. | ||
| legal | |||
| intro | Useful when stimulants are contraindicated, undesirable, or insufficient. Can be combined with stimulants. | ||
| pharmacodynamics= Selective NET inhibition (Ki ~155 nM). 5HT1A partial agonism, 5HT2B antagonism, 5HT2C inverse agonism, 5HT7 antagonism. Minimal DAT activity (key differentiator from stimulants). | |||
| pharmacodynamics | | effects = Somnolence (most common), decreased appetite, headache, insomnia, fatigue, nausea, irritability. Generally good tolerability. Boxed warning: suicidal ideation in pediatric patients (class warning for SNRIs/antidepressants used in pediatric ADHD). | ||
| interactions = <pharmaInteractions/> | |||
| effects | |||
| interactions | |||
}} | }} | ||
[[Category: | [[Category:Norepinephrine Reuptake Inhibitors (NRIs)]] | ||
[[Category:Antidepressants]] | |||
[[Category:Non-stimulant ADHD Medicines]] | |||
[[Category:Norepinephrine Reuptake Inhibitors]] | |||