Vilazodone (VIIBRYD): Four Clinical Facts

Vilazodone (VIIBRYD): Four Clinical Facts


Q.1: Does Food Affect Vilazodone Absorption?

  • YES: Vilazodone should be taken with food.
  • In Fasted State: Vilazodone blood concentrations (AUC) can be decreased by approximately 50% in fasted state compared to the fed state, and may result in diminished effectiveness in some patients.
  • With Food: The absolute bioavailability of vilazodone is 72% with food. Administration of Vilazodone with food (high fat or light meal) increases oral bioavailability (Cmax increased by approximately 147-160%, and AUC increased by approximately 64-85%).

Q.2: Does Co-Administration of Ethanol or Proton Pump Inhibitors affect Vilazodone Absorption?

  • No this does not affect the rate or extent of vilazodone absorption, Tmax or terminal elimination rate of vilazodone.

Q.3: Does Vilazodone Prolong the QTc interval?

  • Treatment with Vilazodone did not prolong the QTc interval.
  • The effect of vilazodone (20, 40, 60, and 80 mg) on the QTc interval was evaluated in a randomized, placebo, and active-controlled (moxifloxacin 400 mg), parallel-group, thorough QTc study in 157 healthy subjects. The upper bound of the 90% confidence interval for the largest placebo-adjusted, baseline-corrected QTc interval was below 10 msec, based on the individual correction method (QTcI). This is below the threshold for clinical concern.

Q.4: Which Cytochrome P450 enzyme is responsible for metabolism of Vilazodone?

  • Metabolism by CYP3A4 is a major elimination pathway for vilazodone.
  • Strong CYP3A4 inhibitors (e.g., ketoconazole) can increase vilazodone plasma concentrations by ~50%: Vilazodone dose should be reduced to 20 mg.
  • Moderate CYP3A4 inhibitors (e.g., erythromycin): Vilazodone dose should be reduced to 20 mg for patients with intolerable adverse events.
  • Mild CYP3A4 inhibitors (e.g., cimetidine): No dose adjustment is recommended.

Source: Vilazodone Package Insert.

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Dr. Harvinder Singh, M.D. (Admin)

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