Can you take Qelbree (viloxazine) at night?

Qelbree (Viloxazine) Administration Timing

Qelbree (viloxazine extended-release) should be administered once daily in the morning for optimal ADHD symptom management and to minimize adverse effects like insomnia. 1

Recommended Administration Schedule

• Viloxazine extended-release (Qelbree) is designed for once-daily dosing in the morning, providing "around-the-clock" symptom control throughout the day 1
• The American College of Pharmacology specifically recommends morning administration for non-stimulant ADHD medications like viloxazine 1
• Unlike some other non-stimulant medications, viloxazine does not have specific recommendations for evening dosing 1

Rationale for Morning Administration

• Insomnia is one of the most common adverse effects of viloxazine (13.8% incidence in clinical trials), making morning administration preferable to minimize sleep disruption 2
• Other common adverse effects that may be better tolerated with morning dosing include fatigue (10.1%), nausea (13.8%), and headache (10.7%) 2
• Taking viloxazine at the same time each day helps maintain stable blood levels, with morning administration being the standard approach in clinical trials 2, 3

Dosing Considerations

• The recommended starting dose is 200 mg taken orally once daily 1, 4
• Dosage can be increased by 200 mg increments at weekly intervals based on response and tolerability 4, 1
• The maximum daily dose is 600 mg/day 4, 1
• Clinical data shows that most adults (73%) require doses ≥400 mg/day during maintenance treatment, with 36% using the maximum dose of 600 mg/day 2

Important Caveats

• Treatment effects of non-stimulants like viloxazine are not usually observed until several weeks (2-4 weeks) after initiation 1
• If a patient experiences significant activation effects or insomnia, morning administration becomes even more important 1
• Viloxazine is a strong CYP1A2 inhibitor and a weak CYP2D6 and CYP3A4 inhibitor, which may affect the metabolism of other medications taken concurrently 5
• There is limited data on viloxazine's efficacy, safety, and tolerability in adults, and no published information on its safety during pregnancy or breastfeeding 4

Clinical Implications

• Patients should be advised to take viloxazine at approximately the same time each morning to maintain consistent blood levels 2
• Adverse effects like insomnia, which occurred in 14.8% of subjects in clinical trials, may worsen if the medication is taken later in the day 3
• In clinical trials, many treatment effects became significant by week 2, but full therapeutic benefits may take longer 3