Indications for: TRINTELLIX
Major depressive disorder (MDD).
Initially 10mg once daily; then, increase to 20mg/day, as tolerated. May consider 5mg/day if unable to tolerate. Discontinuing treatment: may reduce to 10mg/day for one week before full discontinuation of 15mg/day or 20mg/day. CYP2D6 poor metabolizers: max 10mg/day. Concomitant strong CYP2D6 inhibitors: reduce vortioxetine dose by ½; increase to original dose when inhibitor is discontinued. Concomitant strong CYP inducers for >14 days: consider increasing vortioxetine dose up to max 3× original dose; reduce to original dose within 14 days when inducer is discontinued.
<18yrs: not established.
During or within 14 days of MAOIs; do not start an MAOI during or within 21 days of vortioxetine. Concomitant linezolid or IV methylene blue.
Suicidal thoughts and behaviors.
Increased risk of suicidal thoughts and behavior in children, adolescents, and young adults; monitor closely for clinical worsening or behavior changes in all patients (esp. during the first few months and at times of dosage changes). Monitor for serotonin syndrome; discontinue if occurs. History of mania/hypomania. Screen for bipolar disorder prior to starting. Angle-closure glaucoma. Volume depletion. CYP2D6 poor metabolizers. Avoid abrupt cessation. Elderly. Pregnancy (see full labeling for effects on neonates in 3rd trimester exposure). Nursing mothers.
Serotonergic agonist and antagonist.
See Contraindications. Increased risk of serotonin syndrome with other serotonergic drugs (eg, other SNRIs, SSRIs, triptans, TCAs, fentanyl, lithium, tramadol, tryptophan, buspirone, amphetamines, St. John's Wort) or with drugs that impair serotonin metabolism (eg, MAOIs, linezolid, IV methylene blue). Potentiated by strong CYP2D6 inhibitors (eg, bupropion, fluoxetine, paroxetine, quinidine); see Adults. Antagonized by strong CYP inducers (eg, rifampin, carbamazepine, phenytoin); see Adults. Increased risk of bleeding with antiplatelets or anticoagulants (eg, NSAIDs, aspirin, clopidogrel, heparin, warfarin); monitor. May potentiate other highly protein bound drugs (eg, warfarin). May cause false (+) results in urine enzyme immunoassays for methadone; consider alternative chromatographic methods.
Nausea, constipation, vomiting, dizziness; hyponatremia (esp. elderly), mania/hypomania, sexual dysfunction.
Formerly known as Brintellix.
Generic Drug Availability:
Tabs—30, 90, 500