Qelbree (viloxazine) is a brand-name extended-release oral capsule prescribed for ADHD in adults and some children. Qelbree has interactions with alcohol, some other drugs, and certain supplements. Examples include monoamine oxidase inhibitors and certain other antidepressants.

An interaction occurs when one substance causes another substance to have a different effect than expected.

To learn more about Qelbree’s interactions, keep reading. For additional information about Qelbree, including details about its uses, see this article.

Note: Extended release means the drug is slowly released into your body over a long period of time.

Before you start treatment with Qelbree, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions. (To learn whether Qelbree interacts with supplements, herbs, or vitamins, see the “Qelbree and other interactions” section below.)

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Here’s a table of drugs that can interact with Qelbree. Keep in mind that this table doesn’t include all drugs that may interact with Qelbree. Some of these interactions are described in detail just below in “Drug interactions in depth.”

Drug class or drug nameDrug examplesInteraction result with Qelbree
monoamine oxidase inhibitors (MAOIs)*• linezolid (Zyvox)
• phenelzine (Nardil)
• rasagiline (Azilect)
• selegiline (Emsam, Zelapar)
• isocarboxazid (Marplan)
can increase the risk of very high blood pressure when Qelbree and MAOIs are taken together
certain calcium channel blockers (CCBs)• isradipine
• felodipine
• nimodipine (Nymalize)
can increase the risk of side effects of certain CCBs
certain opioidshydrocodone (Hysingla ER)
oxycodone (OxyContin, Xtampza ER, others)
fentanyl (Actiq, Fentora, Sublimaze)
can increase the risk of side effects of certain opioids
certain antidepressants• duloxetine (Cymbalta)*
• fluoxetine (Prozac)
paroxetine (Brisdelle, Paxil)
can increase the risk of side effects of certain antidepressants
certain antipsychoticsolanzapine (Zyprexa)
• aripiprazole (Abilify)
risperidone (Risperdal, Rykindo, others)
can increase the risk of side effects of certain antipsychotics
certain sleep aids• ramelteon (Rozerem)*
• tasimelteon (Hetlioz)*
• lemborexant (Dayvigo)
can increase the risk of side effects of certain sleep aids
certain benzodiazepines• midazolam (Nayzilam, Seizalam)
• alprazolam (Xanax, Xanax XR)
• triazolam (Halcion)
can increase the risk of side effects of certain benzodiazepines
alosetron (Lotronex)*can increase the risk of side effects of alosetron
tizanidine (Zanaflex)*can increase the risk of side effects of tizanidine
pirfenidone (Esbriet)can increase the risk of side effects of pirfenidone

* For details about this interaction, see the “When to avoid Qelbree” section below.
† For details about this interaction, see the “Drug interactions in depth” section below.
Melatonin, which is also used as a sleep aid, may interact with Qelbree. To learn more, see the “Qelbree and other interactions” section below.

In some cases, factors or conditions could prevent your doctor from prescribing Qelbree due to the risk of harm. These are known as contraindications. The contraindications of Qelbree include:

Taking certain medications broken down by the CYP1A2 enzyme

Doctors typically won’t prescribe Qelbree in combination with medications that are broken down by a specific enzyme. (An enzyme is a type of protein.) This enzyme is called cytochrome P450 1A2 (CYP1A2).

Qelbree slows down the activity of CYP1A2. As a result, Qelbree can cause certain medications to break down more slowly. This may lead to a high level of these medications in your body. Having a high level of these drugs may increase your risk of side effects from them.

Below are a few examples of drugs that are broken down by CYP1A2:

  • alosetron (Lotronex)
  • duloxetine (Cymbalta)
  • ramelteon (Rozerem)
  • tasimelteon (Hetlioz)
  • tizanidine (Zanaflex)

Before you start treatment with Qelbree, tell your doctor about other medications you take. They’ll tell you whether it’s safe to take them with Qelbree.

Taking a monoamine oxidase inhibitor

Doctors typically won’t prescribe Qelbree in combination with a monoamine oxidase inhibitor (MAOI). Among other conditions, MAOIs may be prescribed for depression and Parkinson’s disease.

Taking Qelbree with an MAOI can increase your risk of very high blood pressure, which can be life threatening. Symptoms may include confusion, dizziness, and severe headache.

Below are a few examples of MAOIs that can interact with Qelbree:

  • linezolid (Zyvox)
  • phenelzine (Nardil)
  • rasagiline (Azilect)
  • selegiline (Emsam, Zelapar)
  • isocarboxazid (Marplan)

Before you start treatment with Qelbree, it’s important to tell your doctor if you take an MAOI. They’ll likely have you stop taking the MAOI and wait at least 2 weeks to start Qelbree treatment. After you stop taking Qelbree, your doctor will typically have you wait at least 2 weeks before starting an MAOI.

Note: Before you start treatment with Qelbree, it’s important to tell your doctor if these contraindications apply to you. They can determine whether to prescribe Qelbree.

Your doctor may recommend that you limit or avoid alcohol while taking Qelbree. This is because consuming high concentrations of alcohol may reduce the level of Qelbree in your body. This could make Qelbree less effective for your condition.

If you drink alcohol and have concerns about limiting or avoiding it while you’re taking Qelbree, talk with your doctor before starting treatment.

Here’s a closer look at certain drug interactions of Qelbree.

Certain opioids

Opioids are prescribed to relieve pain.

Interaction result. Taking Qelbree with certain opioids could increase the risk of side effects from the opioids.

Interaction explained. Qelbree slows down the activity of specific enzymes that help your body break down certain opioids. (An enzyme is a type of protein.)

As a result, Qelbree can cause certain opioids to break down more slowly. This may lead to a high level of the opioid in your body. A high level of the opioid may increase your risk of side effects from the drug. Examples include respiratory depression and extreme sleepiness. Respiratory depression is a slower breathing rate than usual, which can be life threatening.

Examples of opioid drugs. Here are some opioids that may interact with Qelbree:

Steps you or your doctor may take. Before starting Qelbree treatment, be sure to tell your doctor if you take an opioid. They can recommend whether it’s safe to take these drugs together.

If your doctor prescribes Qelbree with certain opioids, they may give you a lower dosage of the opioid than is typical. Doing so can help reduce your risk of side effects from the drug.

Your doctor may also recommend keeping naloxone (Narcan, Kloxxado, others) on hand. Naloxone is an emergency treatment for opioid overdose. The drug reverses the effect of opioids, including respiratory depression. Your doctor or pharmacist can tell you more about how to use naloxone.

If you have other questions about Qelbree and opioids, talk with your doctor or pharmacist.

Certain antipsychotics

Antipsychotics are prescribed for certain mental health conditions, including schizophrenia.

Interaction result. Taking Qelbree with certain antipsychotics can increase the risk of side effects from the antipsychotic.

Interaction explained. Qelbree slows down the activity of specific enzymes that help your body break down certain antipsychotics. Taking Qelbree with certain antipsychotics can cause the antipsychotic to break down more slowly. A slower breakdown of the drug may lead to a high level of the antipsychotic in your body. And this may increase your risk of side effects from the antipsychotic.

Examples of antipsychotic drugs. Here are some antipsychotics that may interact with Qelbree:

Steps you or your doctor may take. Before taking Qelbree, tell your doctor about any antipsychotics you take. They can tell you whether it’s safe to take Qelbree with the drug.

If your doctor prescribes Qelbree, they may give you a lower dosage of the antipsychotic than usual. This can lower your risk of side effects from the drug.

If you have other questions about Qelbree and antipsychotics, talk with your doctor or pharmacist.

Certain benzodiazepines

Benzodiazepines may be prescribed to treat anxiety and seizures.

Interaction result. Taking Qelbree with certain benzodiazepines can increase the risk of side effects from the benzodiazepine.

Interaction explained. Certain benzodiazepines are broken down in your body by specific enzymes. Qelbree slows down the activity of these enzymes. As a result, taking Qelbree with certain benzodiazepines can lead to a high level of the benzodiazepine in your body. This could increase your risk of benzodiazepine side effects.

Examples of benzodiazepines. Here are some benzodiazepines that may interact with Qelbree:

  • midazolam (Nayzilam, Seizalam)
  • alprazolam (Xanax, Xanax XR)
  • triazolam (Halcion)

Steps you or your doctor may take. Before you begin Qelbree treatment, tell your doctor about any benzodiazepines you take. They’ll advise you on whether it’s safe to take Qelbree with the benzodiazepine.

If your doctor prescribes Qelbree with certain benzodiazepines, they may adjust your dosage. They may prescribe a lower dosage of the benzodiazepine than is typical. Doing so can lower your risk of side effects from the drug.

If you have other questions about Qelbree and benzodiazepines, talk with your doctor or pharmacist.

Qelbree may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below. Keep in mind that the following information doesn’t include all other possible interactions with Qelbree.

Qelbree interactions with supplements

Qelbree may interact with melatonin or caffeine supplements. Some people take melatonin to help with sleep or caffeine to help stay awake.

Qelbree may slow down the activity of an enzyme your body uses to break down melatonin and caffeine. (An enzyme is a type of protein.) By slowing down this enzyme, Qelbree can cause melatonin or caffeine to break down more slowly. And this may raise the level of melatonin or caffeine in your body. A high level of either substance may increase your risk of side effects from melatonin or caffeine.

If you take a melatonin or caffeine supplement, talk with your doctor before starting Qelbree treatment. They may advise you to take a lower dose of melatonin or caffeine than usual.

Before you start treatment with Qelbree, tell your doctor and pharmacist which supplements, herbs, and vitamins you take. By sharing this information with them, you may help prevent possible interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Qelbree and herbs

There are no specific reports of herbs interacting with Qelbree. However, that doesn’t mean herbal interactions won’t occur or be recognized in the future. Because of this, it’s important to check with your doctor or pharmacist before taking any of these products during Qelbree treatment.

Qelbree and vitamins

There are no specific reports of vitamins interacting with Qelbree. However, that doesn’t mean vitamin interactions won’t occur or be recognized in the future. Because of this, you should talk with your doctor or pharmacist before taking any vitamin product with Qelbree.

Qelbree interactions with food

Qelbree may interact with foods and beverages that contain caffeine.

This is because Qelbree may slow down the activity of an enzyme your body uses to break down caffeine. This may cause caffeine to break down more slowly, leading to a high caffeine level. As a result, consuming caffeine while taking Qelbree can increase the risk of side effects from caffeine.

Examples of foods and beverages that contain caffeine include:

Because of this interaction, your doctor will likely recommend limiting how much caffeine you consume during Qelbree treatment.

If you’d like to learn more about eating certain foods during treatment with Qelbree, talk with your doctor.

Qelbree and vaccines

There aren’t any known interactions between Qelbree and vaccines. Talk with your doctor or pharmacist to determine whether you’re due for any vaccines. They can tell you whether these vaccines are safe to receive during Qelbree treatment.

Qelbree and lab tests

Qelbree isn’t known to interact with any lab tests. If you have concerns about this medication interacting with lab tests, talk with your doctor. They can tell you whether Qelbree may affect these tests.

QELBREE AND CANNABIS OR CBD

Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have not been specifically reported to interact with Qelbree. However, as with any drug or supplement, talk with your doctor before using cannabis in combination with Qelbree. The impact of cannabis may affect how well you follow your Qelbree treatment plan.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Certain medical conditions and other factors may increase the risk of interactions with Qelbree. Before you take this drug, be sure to talk with your doctor about your health history. Qelbree may not be the right treatment option if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with Qelbree include:

Mental health conditions. Before starting Qelbree treatment, tell your doctor if you or a family member has a mental health condition. Examples include depression and bipolar disorder. Qelbree may increase the risk of mania or hypomania in people with certain mental health conditions. Your doctor can advise you on these risks and tell you whether Qelbree is a safe treatment option.

Problems with blood pressure or heart rate. Qelbree may increase your heart rate and blood pressure. If you already have difficulty with your blood pressure or heart rate, the drug could worsen your condition. Before taking Qelbree, tell your doctor if you have a blood pressure or heart rate condition. They can tell you whether Qelbree is safe for you to take.

Severe kidney problems. Before taking Qelbree, tell your doctor if you have a severe kidney condition such as kidney failure. Your kidneys help your body get rid of Qelbree. If your kidneys aren’t working well, Qelbree may build up in your system. This can raise your risk of side effects from the drug. Your doctor may give you a lower dose of Qelbree to help reduce this risk. To learn more about Qelbree’s dosage, see this article.

Allergic reaction. If you’ve had an allergic reaction to Qelbree or any of its ingredients, your doctor will likely not prescribe Qelbree. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.

Breastfeeding. It’s not known whether it’s safe to take Qelbree while breastfeeding. There isn’t enough information to determine whether the drug passes into breast milk or what effects Qelbree may have on a child who is breastfed. If you’re breastfeeding or planning to, talk with your doctor before taking Qelbree. They can talk with you about treatment options and ways to feed your child.

Pregnancy. There haven’t been enough clinical trials to determine whether Qelbree is safe to take while pregnant. Animal studies show that the drug may cause congenital anomalies (commonly known as birth defects). However, it’s important to note that animal studies don’t always indicate what may happen in humans. If you’re pregnant or planning to become pregnant, tell your doctor before starting Qelbree. They can advise you on the right treatment plan for you.

If your doctor prescribes Qelbree during pregnancy, consider enrolling in the drug’s pregnancy registry. The registry collects information about pregnancy issues related to Qelbree. To learn more, call 866-961-2388 or talk with your doctor.

Risk of suicidal thoughts and behaviors. Qelbree has a boxed warning about the risk of suicidal thoughts and behaviors. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). A boxed warning alerts doctors and patients about drug effects that may be dangerous. For details, see the boxed warning at the top of this article.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects if it’s safe to do so.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.

Find more links and local resources.

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You can take certain steps to help prevent interactions with Qelbree. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:

  • Let them know if you drink alcohol or use cannabis.
  • Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
  • Create a medication list, which your doctor and pharmacist can help you fill out.

It’s also important to read the Qelbree label and other paperwork that may come with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions.

If Qelbree doesn’t come with paperwork, you can ask your pharmacist to print a copy. If you need help reading or understanding this information, ask your doctor or pharmacist.

You can also help prevent interactions with Qelbree by taking it exactly as your doctor prescribes.

Besides learning about interactions, you may want to find out more about Qelbree. These resources might help:

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.