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.
Please do post your questions or comments below.
Dr. Harvinder Singh, M.D. (Admin)
Enroll in our online course to have access to all important clinically relevant psychiatry topics in one place.