Maximum Dose of Qelbree
The maximum recommended dose of Qelbree is 400 mg once daily for children ages 6-11 years and adolescents ages 12-17 years, and 600 mg once daily for adults 18 years and older. 1
Age-Specific Dosing
Children (6-11 years)
- Starting dose: 100 mg once daily
- Titration: Increase by 100 mg weekly as needed
- Maximum dose: 400 mg once daily 1
Adolescents (12-17 years)
- Starting dose: 200 mg once daily
- Titration: May increase after 1 week by 200 mg increment
- Maximum dose: 400 mg once daily 1
Adults (18+ years)
- Starting dose: 200 mg once daily
- Titration: Increase by 200 mg weekly as needed
- Maximum dose: 600 mg once daily 1
Special Population Adjustments
Severe Renal Impairment
Critical dosing modification required: In patients with severe renal impairment, the maximum dose is substantially reduced to 200 mg once daily 1. This represents a 50-67% dose reduction compared to standard maximums.
- Starting dose: 100 mg once daily
- Titration: 50-100 mg weekly increments
- Maximum dose: 200 mg once daily 1
Important Clinical Considerations
Pharmacokinetic differences by age: Pediatric patients (both 6-11 and 12-17 years) demonstrate 60-250% higher drug exposure (Cmax and AUC) compared to adults at equivalent doses 1. This explains why children and adolescents share the same 400 mg maximum despite different starting doses, while adults can tolerate up to 600 mg.
No hepatic dose adjustment: Unlike renal impairment, hepatic impairment does not require maximum dose reduction based on available FDA labeling 1.
Steady-state kinetics: Viloxazine reaches steady state after only 2 days of once-daily dosing with no accumulation, and has a half-life of approximately 7 hours 1. This rapid pharmacokinetic profile supports the weekly titration schedule.