How to Decrease Qelbree 300 mg
Do not discontinue Qelbree (viloxazine) abruptly—work with your prescriber to implement a gradual dose reduction strategy, as abrupt cessation without medical guidance is specifically cautioned against. 1
Dose Reduction Strategy
The most appropriate approach is to reduce the dose rather than abruptly stop, as side effects are typically dose-dependent and reversible. 2 While specific tapering protocols for viloxazine are not established in the literature, the following approach is recommended based on general principles:
Step-by-Step Reduction Protocol
Reduce from 300 mg to 200 mg once daily as the initial step, maintaining this dose for at least 2-4 weeks to assess tolerance and symptom control 2, 3
Monitor closely during the first 2-4 weeks after any dose change, as therapeutic effects and side effect profiles often stabilize during this period 1, 2
If further reduction is needed, decrease to 100 mg once daily for an additional 2-4 weeks before considering complete discontinuation 4
Take viloxazine with food during the tapering process, as this may moderate absorption and reduce peak-related side effects 2
Clinical Monitoring During Tapering
Assess ADHD symptom control at each dose level using standardized rating scales, as symptom improvement patterns were sustained in long-term studies with dose adjustments 3, 4
Watch for withdrawal or rebound symptoms including return of ADHD symptoms (inattention, hyperactivity/impulsivity), mood changes, or agitation 5
Most patients in maintenance studies used doses ≥400 mg/day (73% of adults), suggesting that 300 mg represents a moderate therapeutic dose where careful monitoring during reduction is warranted 3
Common Pitfalls to Avoid
Do not rush the taper—viloxazine's norepinephrine reuptake inhibition mechanism requires time for neuroadaptation when reducing doses 6, 7
Avoid discontinuing due to early side effects without attempting dose reduction first, as 96% of patients preferred viloxazine over atomoxetine when properly dosed, and side effects are often dose-related 5
Ensure adequate follow-up is scheduled before initiating any dose reduction, as close monitoring during the first few weeks is specifically recommended for patients on noradrenergic medications 2