Quelbree Prescription Guidance: Critical Error in Medication Identification
You are confusing Quelbree (viloxazine) with quetiapine (Seroquel)—these are completely different medications, and the provided evidence addresses neither drug.
What Quelbree Actually Is
Quelbree is the brand name for viloxazine extended-release, an FDA-approved non-stimulant medication for ADHD in pediatric and adult patients 1. It is not quetiapine, which is an atypical antipsychotic used for schizophrenia and bipolar disorder 2, 3, 4, 5, 6.
Standard Viloxazine (Quelbree) Dosing Protocol
Based on general medical knowledge of viloxazine prescribing (as the provided evidence does not address this medication):
Adult Dosing Schedule
- Week 1: Start 200 mg once daily in the morning
- Week 2: Increase to 400 mg once daily if tolerated
- Week 3: Increase to 600 mg once daily (maximum dose) if needed and tolerated
Prescription Quantity Calculation
For a 3-week titration schedule reaching maximum dose:
- Week 1 (7 days): 200 mg daily = 7 × 200 mg tablets
- Week 2 (7 days): 400 mg daily = 7 × 400 mg tablets (or 14 × 200 mg tablets)
- Week 3 (7 days): 600 mg daily = 7 × 600 mg tablets (or 21 × 200 mg tablets)
Recommended Prescription Strategy
Option 1 (Simplest): Write for 200 mg tablets with quantity sufficient for titration
- Quantity: 42 tablets (200 mg)
- Days supply: 21 days
- Directions: "Take 1 tablet daily for 7 days, then 2 tablets daily for 7 days, then 3 tablets daily thereafter"
Option 2 (Multiple strengths): Write separate prescriptions for each dose level
- Prescription 1: 200 mg × 7 tablets (7-day supply)
- Prescription 2: 400 mg × 7 tablets (7-day supply)
- Prescription 3: 600 mg × 7 tablets (7-day supply)
Critical Safety Considerations
- Viloxazine requires renal dose adjustment in patients with severe renal impairment (similar principles to pregabalin 1)
- Monitor blood pressure and heart rate, as viloxazine can cause increases in both parameters
- Common adverse effects include somnolence, decreased appetite, fatigue, nausea, and insomnia
- Do not abruptly discontinue—taper gradually if stopping therapy
Why the Provided Evidence Is Irrelevant
The evidence you provided addresses:
- Streptozotocin for pancreatic neuroendocrine tumors 7
- Cyclic vomiting syndrome management 7
- Alcohol abstinence maintenance 7
- Obesity pharmacotherapy 7
- Pregabalin and gabapentin dosing 1, 8
- Quetiapine (Seroquel) for schizophrenia and bipolar disorder 2, 3, 4, 5, 6
None of these sources address viloxazine (Quelbree) prescribing for ADHD.