Viloxazine

Viloxazine
Clinical data
Trade namesQelbree, others
Other namesICI-58834; SPN-812; SPN-809
License data
Routes of
administration		By mouth
Drug classNorepinephrine reuptake inhibitor
ATC code
Legal status
Legal status
Pharmacokinetic data
Protein binding76–82%[1]
MetabolismHydroxylation (CYP2D6), glucuronidation (UGT1A9, UGT2B15)[1]
Metabolites5-Hydroxyviloxazine glucuronide[1]
Elimination half-lifeIR: 2–5 hours[2]
ER: 7.02 ± 4.74 hours[1]
ExcretionUrine (~90%), feces (<1%)[1][3]
Identifiers
IUPAC name
  • (RS)-2-[(2-ethoxyphenoxy)methyl]morpholine[4]
CAS Number
PubChem CID
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
CompTox Dashboard (EPA)
ECHA InfoCard100.051.148
Chemical and physical data
FormulaC13H19NO3
Molar mass237.299 g·mol−1
3D model (JSmol)
ChiralityRacemic mixture
SMILES
  • CCOC1=CC=CC=C1OCC1CNCCO1

  • HCl: Cl.CCOC1=CC=CC=C1OCC1CNCCO1
InChI
  • InChI=1S/C13H19NO3/c1-2-15-12-5-3-4-6-13(12)17-10-11-9-14-7-8-16-11/h3-6,11,14H,2,7-10H2,1H3 Y
  • Key:YWPHCCPCQOJSGZ-UHFFFAOYSA-N Y

  • HCl: InChI=1S/C13H19NO3.ClH/c1-2-15-12-5-3-4-6-13(12)17-10-11-9-14-7-8-16-11;/h3-6,11,14H,2,7-10H2,1H3;1H
  • Key:HJOCKFVCMLCPTP-UHFFFAOYSA-N
 NY (what is this?)  (verify)

Viloxazine, sold under the brand name Qelbree among others, is a selective norepinephrine reuptake inhibitor medication that is indicated in the treatment of attention deficit hyperactivity disorder (ADHD) in children and adults.[1][5] It was marketed for almost 30 years as an antidepressant for the treatment of depression before being discontinued and subsequently repurposed as a treatment for ADHD.[6][5][1] Viloxazine is taken orally.[1] It was used as an antidepressant in an immediate-release form and is used in ADHD in an extended-release form,[6][1] although current evidence indicates that it is significantly less effective at reducing ADHD symptoms compared to stimulant medications like methylphenidate.[7][8]

Side effects of viloxazine include insomnia, headache, somnolence, fatigue, nausea, vomiting, decreased appetite, dry mouth, constipation, irritability, increased heart rate, and increased blood pressure.[1] Rarely, the medication may cause suicidal thoughts and behaviors.[1] It can also activate mania or hypomania in people with bipolar disorder.[1] Viloxazine acts as a selective norepinephrine reuptake inhibitor (sNRI).[6][1][5] The immediate-release form has an elimination half-life of 2.5 hours[6][2] while the half-life of the extended-release form is 7 hours.[1]

Viloxazine was first described by 1972[9] and was marketed as an antidepressant in Europe in 1974.[6][10] It was not marketed in the United States at this time.[11] The medication was discontinued in 2002 for commercial reasons.[6][12][13] However, it was repurposed for the treatment of ADHD and was reintroduced, in the United States, in April 2021.[6][14][15] Viloxazine is a non-stimulant medication; it has no known misuse liability and is not a controlled substance.[1]

  1. ^ a b c d e f g h i j k l m n o p "Qelbree- viloxazine hydrochloride capsule, extended release". DailyMed. Archived from the original on 28 October 2022. Retrieved 3 May 2022.
  2. ^ a b Pinder RM, Brogden RN, Speight TM, Avery GS (June 1977). "Viloxazine: a review of its pharmacological properties and therapeutic efficacy in depressive illness". Drugs. 13 (6): 401–421. doi:10.2165/00003495-197713060-00001. PMID 324751. S2CID 44804763.
  3. ^ Case DE, Reeves PR (February 1975). "The disposition and metabolism of I.C.I. 58,834 (viloxazine) in humans". Xenobiotica; the Fate of Foreign Compounds in Biological Systems. 5 (2): 113–129. doi:10.3109/00498257509056097. PMID 1154799.
  4. ^ "SID 180462". PubChem Substance Summary. U.S. National Library of Medicine. Archived from the original on 14 June 2013. Retrieved 5 November 2005.
  5. ^ a b c Cutler AJ, Mattingly GW, Jain R, O'Neal W (April 2022). "Current and future nonstimulants in the treatment of pediatric ADHD: monoamine reuptake inhibitors, receptor modulators, and multimodal agents". CNS Spectrums. 27 (2): 199–207. doi:10.1017/S1092852920001984. PMID 33121553.
  6. ^ a b c d e f g Findling RL, Candler SA, Nasser AF, Schwabe S, Yu C, Garcia-Olivares J, et al. (June 2021). "Viloxazine in the Management of CNS Disorders: A Historical Overview and Current Status". CNS Drugs. 35 (6): 643–653. doi:10.1007/s40263-021-00825-w. PMC 8219567. PMID 34003459.{{cite journal}}: CS1 maint: overridden setting (link)
  7. ^ Schein J, Cloutier M, Gauthier-Loiselle M, Catillon M, Xu C, Chan D, et al. (June 2024). "Assessment of centanafadine in adults with attention-deficit/hyperactivity disorder: A matching-adjusted indirect comparison vs lisdexamfetamine dimesylate, atomoxetine hydrochloride, and viloxazine extended-release". Journal of Managed Care & Specialty Pharmacy. 30 (6): 528–540. doi:10.18553/jmcp.2024.30.6.528. PMC 11145007. PMID 38824626.
  8. ^ Cite error: The named reference Faraone_2021 was invoked but never defined (see the help page).
  9. ^ Cite error: The named reference pmid4558457 was invoked but never defined (see the help page).
  10. ^ Cite error: The named reference OlivierSoudijn2000 was invoked but never defined (see the help page).
  11. ^ Cite error: The named reference Dahmen was invoked but never defined (see the help page).
  12. ^ Cite error: The named reference Williams was invoked but never defined (see the help page).
  13. ^ Cite error: The named reference Cochrane2008 was invoked but never defined (see the help page).
  14. ^ "Qelbree: FDA-Approved Drugs". U.S. Food and Drug Administration (FDA). Archived from the original on 2 April 2021. Retrieved 2 April 2021.
  15. ^ "Supernus Announces FDA Approval of Qelbree (SPN-812) for the Treatment of ADHD". Supernus Pharmaceuticals (Press release). 2 April 2021. Archived from the original on 6 April 2021. Retrieved 3 April 2021.
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