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{{MedTemplate
{{MedTemplate
| generic            = Viloxazine
| brand           = Qelbree
| brand             = Qelbree
| classes         = Selective norepinephrine reuptake inhibitor (NRI) with 5HT1A partial agonism, non-stimulant ADHD agent
| structure          =
| 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           = NRI, ADHD medicine
| uses           = ADHD in children (6+), adolescents, and adults (FDA-approved 2021 for pediatric, 2022 for adult)
| mechanism         = Selective norepinephrine reuptake inhibitor
| 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 Originally developed as an antidepressant in Europe in the 1970s (withdrawn for commercial reasons), it was repurposed for ADHD.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.
| pharmacokinetics  =
| 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).
| indications        =
| interactions     = <pharmaInteractions/>
| dosing            =  
| effects           =
| contraindications  =  
| interactions       =
| pregnancy_details  =
| monitoring        =
| counseling        =
| anecdotes          =
| seealso            =
| references        =  
}}
}}


[[Category:Psychostimulants]]
[[Category:Norepinephrine Reuptake Inhibitors (NRIs)]]
[[Category:Antidepressants]]
[[Category:Non-stimulant ADHD Medicines]]

Latest revision as of 17:02, 21 May 2026

Selective norepinephrine reuptake inhibitor (NRI) with 5HT1A partial agonism, non-stimulant ADHD agent
Viloxazine
Qelbree
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. Useful when stimulants are contraindicated, undesirable, or insufficient. Can be combined with stimulants.

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Problems

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Titration strategies

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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).

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Pharmacodynamics

Selective NET inhibition (Ki ~155 nM). 5HT1A partial agonism, 5HT2B antagonism, 5HT2C inverse agonism, 5HT7 antagonism. Minimal DAT activity (key differentiator from stimulants).

Interactions

Fluoxetine via Category:Antidepressants👤 exp n/a/5 outcome n/a (n=1)⚕️ exp 1.0/5 outcome +33.0 (n=1)

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Summary
Classes
Selective norepinephrine reuptake inhibitor (NRI) with 5HT1A partial agonism, non-stimulant ADHD agent
Common uses
ADHD in children (6+), adolescents, and adults (FDA-approved 2021 for pediatric, 2022 for adult)
Pharmacy
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.
Preparations
100 mg, 150 mg, 200 mg extended-release capsules (can be sprinkled on food)
US FDA Max
400 mg/d (pediatric); 600 mg/d (adult)
Pharmacology
Routes
Oral
Onset
ADHD symptom improvement reported within 1-2 weeks (faster than atomoxetine which takes 4-6 weeks)
Duration
Daily dosing
Half-life
~7 hours
Bioavailability
Adequate oral bioavailability with extended-release formulation
Pregnancy
Limited data
Legal status
Rx, not a controlled substance (no DEA scheduling)
Purported 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.
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