viloxazine

N06AX09

Forms & Strengths

Adult Dosing

Not formally evaluated or approved for adult ADHD in clinical practice guidelines
Pediatric dosing titration schema sometimes adapted for older adolescents up to a max of 400 mg daily if indicated

Pediatric Dosing

Initial: 100 mg orally once daily for pediatric patients 6 to 17 years
Titration: Increase by 50 mg to 100 mg weekly based on efficacy and tolerability
Maximum recommended dose: 200 mg once daily for ages 6-11; 400 mg once daily for ages 12-17
Administer with or without food; capsules should not be crushed, chewed, or opened

Indications

Treatment of Attention Deficit Hyperactivity Disorder (ADHD) in pediatric patients aged 6 to 17 years

Mechanism of Action

Selective norepinephrine reuptake inhibitor (SNRI)
Inhibits the reuptake of norepinephrine and modulates serotonin receptors (5-HT2B antagonist and 5-HT2C agonist)

Contraindications

Concomitant use with monoamine oxidase inhibitors (MAOIs), or within 14 days of discontinuing an MAOI
Concomitant use with sensitive CYP1A2 substrates (e.g., alosetron, duloxetine, ramelteon, tizanidine) due to risk of severe toxicity
Known hypersensitivity to viloxazine or any of its inactive ingredients

Adverse Reactions

Drug Interactions

CYP1A2 inhibitors (e.g., fluvoxamine): May increase viloxazine exposure; use with caution or adjust dose
CYP1A2 substrates (e.g., caffeine, duloxetine, tizanidine): Viloxazine is a strong CYP1A2 inhibitor and weak CYP2D6/CYP3A4 inducer; increases plasma concentrations of these substrates
CNS depressants (e.g., alcohol, sedatives): May potentiate somnolence and sedation
Antihypertensives: Potential for diminished hypotensive effect or increased risk of tachycardia and blood pressure elevation

Curated Content: Needs Vetting Before Put to Clinical Use