Can I continue taking L-tyrosine, Alpha (Alpha-Glyceryl Phosphoryl Choline) GPC, Mucuna pruriens, and moderate caffeine the day before starting Qelbree (Viloxazine)?

Supplement and Caffeine Use Before Starting Qelbree

You should discontinue L-tyrosine, Mucuna pruriens, and ideally taper caffeine at least 2 weeks before starting Qelbree, while Alpha-GPC can likely be continued but should be discussed with your prescriber given the lack of specific interaction data.

Rationale for Each Supplement

L-Tyrosine

• Discontinue 2 weeks before starting Qelbree. L-tyrosine is a precursor to dopamine and norepinephrine, the same neurotransmitters that viloxazine (Qelbree) modulates 1
• The combination could theoretically lead to excessive catecholaminergic stimulation, potentially causing hypertension, tachycardia, or other cardiovascular effects
• While no direct interaction studies exist, the mechanistic overlap warrants a conservative approach prioritizing safety

Mucuna Pruriens

• Discontinue 2 weeks before starting Qelbree. Mucuna pruriens contains 4-6% L-dopa, which converts to dopamine and has significant effects on catecholamine neurotransmission 2, 3
• This supplement has documented anti-inflammatory, antioxidant, and antiparkinsonian properties that directly affect dopaminergic pathways 4, 2
• The combination with viloxazine's norepinephrine reuptake inhibition could create unpredictable effects on blood pressure and heart rate
• Mucuna pruriens has known gastrointestinal side effects in 50% of users, which could complicate assessment of Qelbree's tolerability 5

Caffeine

• Taper and discontinue caffeine 2 weeks before starting Qelbree if possible. The Mayo Clinic recommends discontinuing caffeine supplements 2 weeks before any medication initiation that affects the central nervous system due to stimulant properties 1, 6
• Caffeine acts as a CNS stimulant and adenosine antagonist, increases blood pressure and heart rate, and increases susceptibility to cardiac arrhythmias 1
• Patients with cardiovascular concerns or taking certain medications should limit caffeine to <300 mg/day 6
• If complete cessation is not feasible, reduce to <200 mg/day (approximately 2 cups of coffee) and avoid energy drinks or caffeine supplements 6
• Important caveat: Abrupt caffeine cessation can cause withdrawal headaches, fatigue, and irritability. Taper gradually over 1-2 weeks rather than stopping suddenly

Alpha-GPC (Alpha-Glyceryl Phosphoryl Choline)

• Can likely continue, but discuss with prescriber. No specific evidence was found regarding interactions between Alpha-GPC and norepinephrine reuptake inhibitors
• Alpha-GPC is a choline compound that primarily affects acetylcholine neurotransmission, which operates through a different mechanism than viloxazine
• However, the lack of interaction data means this recommendation is based on mechanistic reasoning rather than clinical evidence

Clinical Approach

Timeline

• Begin tapering caffeine 2-3 weeks before starting Qelbree to avoid withdrawal symptoms
• Discontinue L-tyrosine and Mucuna pruriens at least 2 weeks before the first Qelbree dose
• This washout period allows these supplements to clear your system and provides a clean baseline for assessing Qelbree's effects and tolerability

Monitoring Considerations

• Once starting Qelbree, monitor for cardiovascular effects including blood pressure changes, heart rate elevation, or palpitations
• Be aware that any residual effects from these supplements could be misattributed to Qelbree during the first few weeks
• If you experience excessive stimulation, anxiety, or cardiovascular symptoms, contact your prescriber immediately

Common Pitfall to Avoid

• Do not restart these supplements shortly after beginning Qelbree without explicit approval from your prescriber, as the combination effects remain unknown and could compromise your safety or treatment efficacy