Generic Name and Formulations:
Vortioxetine 5mg, 10mg, 20mg; tabs.
Takeda and Lundbeck
Indications for TRINTELLIX:
Major depressive disorder (MDD).
Initially 10mg once daily; then, increase to 20mg/day, as tolerated. May consider 5mg/day if unable to tolerate. Discontinuing treatment: may reduce to 10mg/day for one week before full discontinuation of 15mg/day or 20mg/day. CYP2D6 poor metabolizers: max 10mg/day. Concomitant strong CYP2D6 inhibitors: reduce vortioxetine dose by ½; increase to original dose when inhibitor is discontinued. Concomitant strong CYP inducers for >14 days: consider increasing vortioxetine dose up to max 3x original dose; reduce to original dose within 14 days when inducer is discontinued.
<18yrs: not established.
During or within 14 days of MAOIs; do not start an MAOI during or within 21 days of vortioxetine. Concomitant linezolid or IV methylene blue.
Suicidal thoughts and behaviors.
Increased risk of suicidal thoughts and behavior in children, adolescents, and young adults; monitor for clinical worsening or behavior changes in all patients. Monitor for serotonin syndrome; discontinue if occurs. History of mania/hypomania. Screen for bipolar disorder prior to starting. Angle-closure glaucoma. Volume depletion. Elderly. Pregnancy (see full labeling for effects on neonates in 3rd trimester exposure). Nursing mothers.
Serotonergic agonist and antagonist.
See Contraindications. Increased risk of serotonin syndrome with other serotonergic drugs (eg, triptans, TCAs, fentanyl, lithium, tramadol, tryptophan, buspirone, amphetamines, St. John's Wort) or with drugs that impair serotonin metabolism (eg, MAOIs, linezolid, IV methylene blue). If linezolid or IV methylene blue necessary, discontinue vortioxetine before starting; monitor for serotonin syndrome for 21 days or until 24hrs after last dose of linezolid or IV methylene blue, whichever comes first. Increased risk of bleeding with NSAIDs, aspirin, warfarin, others that affect coagulation. May be affected by strong CYP2D6 inhibitors (eg, bupropion, fluoxetine, paroxetine, quinidine) or strong CYP inducers (eg, rifampin, carbamazepine, phenytoin); adjust doses (see Adults). May potentiate protein-bound drugs.
Nausea, constipation, vomiting, dizziness; hyponatremia (esp. elderly), mania/hypomania, sexual dysfunction.
Formerly known as Brintellix.
Tabs—30, 90, 500