Indications for: QELBREE
Attention deficit hyperactivity disorder (ADHD).
<6yrs: not established. Swallow whole or sprinkle contents onto applesauce. 6–11yrs: initially 100mg once daily; may titrate in increments of 100mg at weekly intervals, based on response and tolerability; max 400mg once daily. 12–17yrs: initially 200mg once daily; after 1 week, may increase in increments of 200mg to a max dose of 400mg once daily, based on response and tolerability. Severe renal impairment (eGFR <30mL/min/1.73m2): initially 100mg once daily; may titrate in weekly increments of 50–100mg once daily; max 200mg once daily.
Concomitant MAOIs or within 14 days of discontinuing an MAOI (eg, selegiline, isocarboxazid, phenelzine, tranylcypromine, safinamide, rasagiline). Concomitant sensitive CYP1A2 substrates or CYP1A2 substrates with a narrow therapeutic range (eg, alosetron, duloxetine, ramelteon, tasimelteon, tizanidine, theophylline).
Suicidal thoughts and behaviors.
Increased risk of suicidal thoughts and behavior in children; monitor closely for clinical worsening and unusual behaviors (esp. during the first few months, at times of dosage changes). Screen for history of suicide, bipolar disorder, and depression prior to initiation. Assess HR and BP prior to initiation, after dose increases, and periodically during therapy. Monitor for weight changes. Reevaluate periodically. Severe renal impairment (eGFR <30mL/min/1.73m2): reduce dose (see Children). Hepatic impairment: not recommended. Pregnancy. Nursing mothers.
See Contraindications. Potentiates moderate sensitive CYP1A2 substrates (eg, clozapine, pirfenidone): not recommended. Potentiates CYP2D6 substrates (eg, atomoxetine, desipramine, dextromethorphan, nortriptyline, metoprolol, nebivolol, perphenazine, tolterodine, venlafaxine, risperidone) and CYP3A4 substrates (eg, alfentanil, avanafil, buspirone, conivaptan, darifenacin, darunavir, ebastine, everolimus, ibrutinib, lomitapide, lovastatin, midazolam, naloxegol, nisoldipine, saquinavir, simvastatin, sirolimus, tacrolimus, tipranavir, triazolam, vardenafil, lurasidone); monitor and adjust dose of substrates as clinically indicated.
Somnolence, decreased appetite, fatigue, nausea, vomiting, insomnia, irritability; mania/hypomania.
Generic Drug Availability:
Caps—30, 60, 90, 100