Should Vilazodone Be Broken in Half?
No, vilazodone tablets should not be broken in half. Vilazodone must be taken as whole tablets with food to ensure adequate plasma concentrations and proper absorption, and the medication requires incremental dose titration to minimize gastrointestinal side effects 1.
Key Administration Requirements
- Vilazodone must be taken with food to ensure adequate plasma concentrations and bioavailability 1
- Tablets should be swallowed whole without crushing, breaking, or chewing to maintain proper pharmacokinetic properties
- Dose titration is essential - vilazodone needs to be incrementally adjusted to the therapeutic dose of 40 mg/day to minimize gastrointestinal symptoms 1
Why Splitting Is Not Recommended
- Altered absorption: Breaking tablets may compromise the drug's absorption profile, which is already dependent on food intake for adequate plasma levels 1
- Dose accuracy concerns: Splitting tablets does not guarantee equal distribution of active drug, potentially leading to subtherapeutic or excessive dosing
- Gastrointestinal tolerability: The medication requires gradual dose escalation specifically to minimize nausea, diarrhea, and vomiting - splitting tablets interferes with this careful titration strategy 1
Dosing Strategy
- Standard therapeutic dose: 40 mg once daily with food 1
- Dose reduction scenarios: When dose adjustment is needed (such as with strong CYP3A4 inhibitors like ketoconazole), reduce to 20 mg - this should be achieved using the appropriate tablet strength, not by splitting 1
- Titration approach: Start at lower doses and incrementally increase to minimize adverse gastrointestinal effects 1
Clinical Pitfall to Avoid
The most common error is attempting to split vilazodone tablets to achieve lower doses or reduce costs. This practice compromises the medication's carefully designed pharmacokinetic profile and may lead to treatment failure or increased side effects. If dose adjustment is needed, prescribe the appropriate tablet strength rather than instructing patients to split tablets 1.