Home Drug Guide Vilazodone Hydrochloride

Drug Guide

Generic Name

Vilazodone Hydrochloride

Brand Names Viibryd

Classification

Therapeutic: Antidepressant

Pharmacological: Selective Serotonin Reuptake Inhibitor (SSRI) and Serotonin 1A Receptor Partial Agonist

FDA Approved Indications

  • Major depressive disorder (MDD)

Mechanism of Action

Vilazodone acts as a selective serotonin reuptake inhibitor and a partial agonist at the 5-HT1A receptor, resulting in increased serotonin levels in the synaptic cleft and modulation of serotonergic activity.

Dosage and Administration

Adult: Starting dose: 10 mg once daily for 7 days, then increase to 20 mg once daily. Dose can be adjusted based on response and tolerability.

Pediatric: Not approved for pediatric use.

Geriatric: Dose adjustments not specifically required, but caution advised due to potential increased sensitivity.

Renal Impairment: Use caution; no specific adjustment recommended but monitor closely.

Hepatic Impairment: Use with caution; consider starting at lower doses due to impaired hepatic metabolism.

Pharmacokinetics

Absorption: Well absorbed; food increases absorption.

Distribution: Bound to plasma proteins (approximately 96%).

Metabolism: Primarily hepatic via CYP3A4; some metabolism via CYP2C19 and CYP2D6.

Excretion: Metabolites excreted mainly in urine; some fecal excretion.

Half Life: Approximately 25 hours.

Contraindications

  • Concurrent use with monoamine oxidase inhibitors (MAOIs) or history of hypersensitivity.

Precautions

  • Risk of serotonin syndrome, especially with other serotonergic agents.
  • Use with caution in patients with bleeding disorders or on anticoagulants.
  • Monitor for worsening depression or suicidality, especially early in treatment.

Adverse Reactions - Common

  • Gastrointestinal upset (nausea, diarrhea) (Common)
  • Dry mouth (Common)
  • Insomnia (Common)
  • Dizziness (Common)

Adverse Reactions - Serious

  • Serotonin syndrome (rare) (Serious)
  • Hyponatremia, especially in elderly (Serious)
  • Suicidal thoughts and behaviors (Serious)

Drug-Drug Interactions

  • CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin) may increase vilazodone levels.
  • CYP3A4 inducers (e.g., rifampin, carbamazepine) may decrease efficacy.

Drug-Food Interactions

  • Food increases absorption, so take with food as directed.

Drug-Herb Interactions

  • St. John’s Wort may increase the risk of serotonin syndrome.

Nursing Implications

Assessment: Monitor for mood changes, suicidal ideation, response to medication, and adverse effects.

Diagnoses:

  • Risk for suicide, Monitor for adverse drug reactions.

Implementation: Administer with food to enhance absorption; start with recommended dose and titrate based on response.

Evaluation: Assess improvement in depressive symptoms and monitor for adverse effects.

Patient/Family Teaching

  • Take exactly as prescribed.
  • Report any signs of serotonin syndrome (confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, coordination problems, stomach cramp, persistent nausea/vomiting/diarrhea).
  • Do not abruptly stop medication.
  • Limit alcohol and avoid other serotonergic drugs unless approved by a healthcare provider.

Special Considerations

Black Box Warnings:

  • Increased risk of suicidal thinking and behavior in children, adolescents, and young adults.

Genetic Factors: No specific genetic testing required.

Lab Test Interference: May cause false elevation of blood glucose or urinary 5-Hydroxyindoleacetic acid (5-HIAA) levels.

Overdose Management

Signs/Symptoms: Nausea, vomiting, tremor, somnolence, seizures, serotonin syndrome symptoms.

Treatment: Supportive care, activated charcoal if ingestion is recent, and monitoring in a medical setting. No specific antidote.

Storage and Handling

Storage: Store at room temperature, 20°C to 25°C (68°F to 77°F).

Stability: Stable under recommended storage conditions.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.