Adult Dosing
Major depressive disorder (MDD)
- 40 mg PO qd
- Start 10 mg PO qd x1 wk; then 20 mg PO qd x1 wk; then 40 mg PO qd
- Notes:
- Administer required doses with food
- Taper dose gradually for discontinuation of treatment
Pediatric Dosing
- Safety and effectiveness in pediatrics have not been established
[Outline]
See Supplemental Patient Information
- Worsening of depression and/or the emergence of suicidal ideation and behavior (suicidality) or unusual changes in behavior may occur in patients with major depressive disorder (MDD); risk may persist until significant remission occurs
- Short-term studies of antidepressants vs, placebo did not reveal an increase in the risk of suicidality in adults >24 yrs of age; risk with antidepressants compared to placebo reduced in adults
65 yrs of age (US Black Box Warning) - Monitor and closely observe patients for clinical worsening, suicidality, or unusual changes in behavior specially during the initial few months of a course of drug therapy, or at times of dose modifications
- Anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia (psychomotor restlessness), hypomania, and mania, have occurred in adult and pediatric patients; such symptoms may represent as precursors to emerging suicidality
- Consider changing the therapeutic regimen or discontinuing therapy on persistent worsening of depression, or on experiencing emergent suicidality, or on abrupt onset of severe symptoms suggesting worsening of depression or suicidality especially if these symptoms are severe, abrupt in onset, and were not part of the patient’s presenting symptoms
- When discontinuing treatment, taper medication as rapidly as feasible, but recognize that abrupt discontinuation can be associated with certain symptoms
- Alert families and caregivers of patients being treated with antidepressants for major depressive disorder or other indications (both psychiatric and nonpsychiatric), about the need to monitor patients for the emergence of agitation, irritability, unusual changes in behavior, and the other symptoms, and also for the emergence of suicidality, and to report such symptoms immediately to health care providers
- Prescribe smallest quantity of capsules to reduce the risk of overdose
- Unapproved for use in treating any indications in the pediatric population [US Black Box Warning]
- Prior to initiating treatment, screen patients with depressive symptoms to determine if they are at risk for bipolar disorder. Consider detailed psychiatric history, including a family history of suicide, bipolar disorder, and depression. Closely monitor patients for the development of symptoms of mania/hypomania during therapy. This drug is not approved for treating bipolar depression
- A potentially fatal symptom complex sometimes referred to as neuroleptic malignant syndrome (NMS) has occurred in association with administration of antipsychotic drugs. Manifestations of NMS are hyperpyrexia, muscle rigidity, altered mental status, and evidence of autonomic instability. Additional signs including elevated creatinine phosphokinase, myoglobinuria (rhabdomyolysis), and acute renal failure have occurred
- Serotonin syndrome or neuroleptic malignant syndrome (NMS) like reactions has occurred. Discontinue therapy and provide appropriate supportive therapy. Monitor patients for the emergence of serotonin syndrome or NMS-like signs and symptoms
- Concomitant use of this drug with MAOIs is contraindicated
- If concomitant treatment of this drug with a 5-hydroxytryptamine receptor agonist (triptan) is of utmost importance carefully observe patients particularly during initiation of therapy and dose escalations
- Concurrent use of this drug with serotonin precursors (such as tryptophan) is not recommended
- Immediately discontinue therapy with this drug and any other concomitant serotonin norepinephrine reuptake inhibitor or antidopaminergic drugs including antipsychotics on development of serotonin syndrome or neuroleptic malignant syndrome like reactions and institute supportive symptomatic treatment
- Avoid concomitant use with drugs that lower the seizure threshold
- Increases the risk of bleeding. Using with NSAIDs, aspirin, warfarin, or drugs that affect coagulation potentiates the risk of GI or other bleeding
- Monitor patients for symptoms occurring following discontinuation of treatment
- Geriatrics are more prone to risk for developing hyponatremia due to syndrome of inappropriate antidiuretic hormone secretion. Patients taking diuretics or who are otherwise volume depleted are at higher risk. Consider discontinuation of therapy in patients with symptomatic hyponatremia and institute appropriate medical intervention
Cautions: Use cautiously in
- Severe hepatic impairment
- Patients <25 yrs
- Geriatrics
- Pregnancy >20 wk gestation
- Hyponatremia
- Volume depleted patients
- Seizure disorder
- Bipolar disorder
- Hypomania
- Mania
- Risk of bleeding
- Suicidal ideation
Supplemental Patient Information
- Advise patients to avoid engaging in activities requiring mental alertness such as operating a hazardous machinery or driving an automobile
Pregnancy Category:C
Breastfeeding: Safety unknown; Prefer an alternate drug especially while nursing a newborn or preterm infant as there is no published experience with vilazodone during breastfeeding. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 4 August 2011). Consider breast feeding in women treated with this drug only if the potential benefit outweighs the potential risk to the child.
Pricing data from www.DrugStore.com in U.S.A.
- Viibryd 20 MG TABS [Bottle] (FOREST)
30 mg = $135.99
90 mg = $389.96 - Viibryd 40 MG TABS [Bottle] (FOREST)
30 mg = $135.99
90 mg = $389.96 - Viibryd 10 MG TABS [Bottle] (FOREST)
30 mg = $135.99
90 mg = $389.96
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
