Qelbree

Forms/Strengths

Age: ≥ 6 y/o
Duration: ~ 24 hours
Considerations: Bubblegum-flavored; may be taken with or without food. Shake bottle before administering. Store at room temperature.
Initial Dose:
- 6-11 y/o: 100 mg once daily
- 12+ y/o: 200 mg once daily
Titration:
- 6-11 y/o: 100 mg weekly
- 12+ y/o: 200 mg weekly
Max Dose:
- 6-17 y/o: 400 mg daily
- 17+ y/o: 600 mg daily

Non-stimulant; modulates norepinephrine (and possibly serotonin) to improve ADHD symptoms
Enhances focus, attention, and impulse control
Extended-release capsule for once-daily dosing
Unique alternative for patients intolerant of stimulants
Common side effects: decreased appetite, somnolence, fatigue, gastrointestinal discomfort, irritability

Take once daily at the same time each day.
Can be taken with or without food.
Swallow the capsule whole; do not crush, chew, or open.
If a dose is missed, take it as soon as possible unless it is close to the next dose—do not double up.
Do not abruptly stop taking; consult a healthcare provider before discontinuation.

Common: Somnolence, decreased appetite, fatigue, nausea, vomiting, insomnia, irritability
Serious: Suicidal thoughts and behaviors, blood pressure and heart rate increases, activation of mania or hypomania

Cardiovascular: Baseline and routine monitoring of heart rate and blood pressure.
Growth in Pediatrics: Regular monitoring of height and weight to detect growth suppression.
Psychiatric Symptoms: Observe for mood changes, anxiety, or psychosis.
Abuse Potential: Monitor for misuse or diversion.

When to Call the Doctor:
- Severe mood changes, aggression, or suicidal thoughts.
- Symptoms of serotonin syndrome (e.g., rapid heart rate, hallucinations, severe agitation, muscle rigidity, fever).
- Unusual bruising or bleeding.
- Signs of liver dysfunction (e.g., yellowing of the skin/eyes, dark urine, persistent nausea).
- Excessive drowsiness, fainting, or difficulty waking.
Safety Tips:
- Monitor blood pressure and heart rate, as Qelbree may cause changes in vital signs.
- Use caution in patients with history of depression, bipolar disorder, or suicidal thoughts.
- Avoid alcohol and sedatives, as they may increase drowsiness.
- Be cautious when driving or operating heavy machinery until the effects of the medication are known.
- Tapering may be needed if discontinuing after long-term use.
Parent Tips for Pediatric Patients:
- Monitor for behavioral changes, increased agitation, or suicidal thoughts, particularly in the first few weeks.
- May cause drowsiness or fatigue—observe how the child responds to the medication.
- Encourage hydration and balanced meals to minimize side effects.
- If taken for ADHD, track progress with teachers and caregivers to assess effectiveness.

Contraindications:
- Hypersensitivity to viloxazine or formulation components.
- Use within 14 days of MAOI therapy (risk of hypertensive crisis).
Pregnancy:
- Category Not Assigned; safety in pregnancy has not been fully established.
- Use only if the benefits outweigh the potential risks.
Lactation:
- Unknown if excreted in breast milk; use with caution.
Drug Interactions:
- CYP1A2 and CYP2D6 inhibitors (e.g., fluvoxamine, paroxetine) may increase viloxazine levels.
- Serotonergic drugs (e.g., SSRIs, SNRIs, MAOIs, St. John’s Wort) increase serotonin syndrome risk.
- CYP3A4 inducers (e.g., rifampin, carbamazepine) may reduce efficacy.
- May increase the effects of blood pressure medications, leading to hypotension.