VILAZODONE (vil az′ oh done) Vibryd
Classifications: SELECTIVE SEROTONIN REUPTAKE INHIBITOR (SSRI); PSYCHOTHERAPEUTIC
AGENT; ANTIDEPRESSANT
Therapeutic: ANTIDEPRESSANT; SSRI
ACTION & THERAPEUTIC EFFECT
A selective serotonin reuptake inhibitor (SSRI).
Antidepressant effect is presumed to be linked to inhibition of CNS neuronal
uptake of the neurotransmitter, serotonin. Improves mood in those with major
depressive disorder.
Treatment of major depressive disorder.
Concomitant use of MAOIs or MAOIs within the
preceding 14 days; suicidal ideation.
History of suicidal thoughts; potential
precursors to suicidal impulses (e.g., anxiety, agitation, panic attacks,
insomnia, irritability, hostility, aggressiveness, impulsivity, psychomotor
restlessness, hypomania, mania); history of seizure disorder; concurrent use of
NSAIDs, aspirin, or other drugs that affect coagulation or bleeding; pregnancy (category
C); lactation. The safety and efficacy in children have not been established.
Major Depressive Disorder
Adult: PO Initial dose of 10 mg once daily for 7 days, increase to 20 mg
once daily for 7 days, then to 40 mg once daily
- Give with food to enhance absorption.
- Store at 15°–30° C (59°–86° F).
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| Nursing Implications for Vilazodone Viibryd |
ADVERSE EFFECTS (≥1%)
Body as a Whole: Arthralgia, decreased appetite, feeling jittery, increased
appetite. CNS: Abnormal dreams, akathisia, dizziness, fatigue,
insomnia, libido decreased, migraine, abnormal orgasm, paresthesia, restless leg
syndrome, restlessness, sedation, somnolence, tremor, suicidality. CV: Palpitations.
GI: Diarrhea, dry mouth, dyspepsia, flatulence, gastroenteritis, nausea,
vomiting. Skin: Hyperhidrosis, night sweats. Special Senses: Blurred
vision, dry eye. Urogenital: Delayed ejaculation, erectile dysfunction.
Drug: Inducers of CYP3A4
(e.g., phenytoin) may reduce the levels of vilazodone. Coadministration
or moderate (e.g., erythromycin) and strong (e.g., ketoconazole)
increase the levels of vilazodone and require a dosage reduction to 20 mg once
daily. MONOAMINE OXIDASE INHIBITORS increase the levels of vilazodone and
should not be used in combination with vilazodone. Coadministration of
serotonergic agents (e.g, busipirone, tramadol, thyptophan, SELECTIVE
SEROTONIN REUPTAKE INHIBITORS, SEROTONIN-NOREPINEPHRINE REUPTAKE INHIBITORS, TRIPTANS)
increase the risk of serotonin syndrome. Vilazodone can increase the risk of bleeding
if used in combination with aspirin or NSAIDs. Food: Ingestion of
food enhances the absorption of vilazodone.
Absorption: Bioavailability 72%.
Peak: 4–5 h. Distribution: 96–99% plasma protein bound. Metabolism:
Hepatic oxidative metabolism. Elimination: Renal and fecal. Half-Life:
25 h.
Vilazodone has been associated with increased
risk of suicidal thinking and behavior
Assessment & Drug Effects
- Monitor closely and report promptly any of the following: Worsening
of clinical symptoms; emergence of suicidal ideation; agitation, irritability,
or unusual changes in behavior; signs of serotonin syndrome or neuroleptic malignant
syndrome (see Appendix F).
- Supervise patients closely who are high suicide risks; be
especially vigilant for changes in behavior and suicidal ideation in children and
adolescents.
- Monitor those at risk for volume depletion (e.g., diuretics use)
for S&S of hyponatremia.
- Montior lab tests: Periodic serum sodium.
Patient & Family Education
- Report promptly worsening of condition, suicidal thoughts or thoughts
of self-harm.
- Do not abruptly stop taking this drug without consulting
prescriber.
- Notify prescriber if you become pregnant or intend to breast-feed.
- Do not drive or engage in other hazardous activities until
response to drug is known.
- Consult prescriber prior to using nonsteroidal anti-inflammatory drugs
(NSAIDs), aspirin, or other drugs that affect coagulation.
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