Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Avoid coadministration with sensitive CYP3A4 substrates with a narrow therapeutic index. Monitor Closely (1)phenytoin decreases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. If intolerable adverse effects occur when coadministered with moderate CYP3A4 inhibitors, reduce daily dose to 20 mg. desipramine, vilazodone. Strong CYP3A4 inhibitors may increase vilazodone plasma levels by 50% - Reduce daily dose to 20 mg. Monitor Closely (1)ranolazine increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. . Avoid alcoholic beverages. Methods: We examined 16 887 breast cancer survivors (TNM stages 0-II) diagnosed between 1996 and 2007 and treated with tamoxifen in two California health plans. Either increases toxicity of the other by serotonin levels. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. vilazodone, asenapine. vilazodone, paliperidone. If intolerable adverse effects occur when coadministered with moderate CYP3A4 inhibitors, reduce daily dose to 20 mg. Serious - Use Alternative (1)erythromycin ethylsuccinate increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. vilazodone increases levels of zafirlukast by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown. It is not practi- cal to try to memorize the many CYP3A4 substrates, but it would be prudent to be familiar with the most common CYP3A4 inhibitors and inducers since such drugs are likely to interact with approximately half of all drugs on the market. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. To view formulary information first create a list of plans. . Avoid or Use Alternate Drug. Strong CYP3A4 inhibitors may increase vilazodone plasma levels by 50% - Reduce daily dose to 20 mg. rizatriptan, vilazodone. Either increases toxicity of the other by serotonin levels. Selective Estrogen Receptor Modulators Raloxifene, tamoxifen 8 MEDICATIONS AFFECTING HEMOSTASIS: Anticoagulants Apixaban, enoxaparin, heparin, warfarin 10 Antiplatelet Medications Cilostazol, clopidogrel, prasugrel 10 Aspirin Aspirin 10 NSAIDs Ibuprofen, naproxen 10 Phosphodiesterase-5 Inhibitors Sildenafil, tadalafil 11 Use Caution/Monitor. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction). Either increases toxicity of the other by serotonin levels. Monitor Closely (1)midazolam intranasal, vilazodone. unspecified interaction mechanism. Therefore, coadministration of ozanimod with drugs that can increase norepinephrine or serotonin is not recommended. SIDE EFFECTS: See also Warning section.Diarrhea, nausea, vomiting, dizziness, or trouble sleeping may occur. Do not prescribe vilazodone within 14 days of discontinuing or starting an MAO inhibitor. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Either increases toxicity of the other by serotonin levels. .isoniazid increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. SSRIs may inhibit platelet aggregation, thus increase bleeding risk when coadministered with anticoagulants. By clicking send, you acknowledge that you have permission to email the recipient with this information. Viibryd is the brand name for vilazodone, which is an antidepressant medication. Avoid or Use Alternate Drug. If intolerable adverse effects occur when coadministered with moderate CYP3A4 inhibitors, reduce daily dose to 20 mg. vilazodone and olopatadine intranasal both increase sedation. Strong CYP3A4 inhibitors may increase vilazodone plasma levels by 50% - Reduce daily dose to 20 mg. Serious - Use Alternative (1)rizatriptan, vilazodone. unspecified interaction mechanism. Serious - Use Alternative (1)conivaptan increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Use Caution/Monitor. If you suddenly stop using this medication, you may have withdrawal symptoms (such as mood swings, headache, tiredness, sleep changes, ringing in the ears, seizures, numbness/tingling, "shock-like". Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Boston, MA 02114. Use Caution/Monitor. Use Caution/Monitor. Either increases toxicity of the other by serotonin levels. unspecified interaction mechanism. If intolerable adverse effects occur when coadministered with moderate CYP3A4 inhibitors, reduce daily dose to 20 mg. duloxetine, vilazodone. Use Caution/Monitor. Serious - Use Alternative (1)sumatriptan intranasal, vilazodone. Use Caution/Monitor. Use Caution/Monitor. Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature. Modify Therapy/Monitor Closely. Coadministration with MAO inhibitors are contraindicated. Viagra is in the drug class impotence agents . Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Avoid or Use Alternate Drug. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. danazol increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. No dose adjustment needed with mild CYP3A4 inhibitors. Serotonergic therapy may be resumed 24 hours after last methylene blue dose or after 2 weeks of monitoring, whichever comes first. fexinidazole will increase the level or effect of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Consider increasing vilazodone dose up to 2-fold (not to exceed 80 mg/day) when coadministered with strong CYP3A4 inducers for >14 days. Serious - Use Alternative (1)metoclopramide increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Voxelotor increases systemic exposure of sensitive CYP3A4 substrates. This medication may improve your mood, sleep, appetite, and energy level and may help restore your interest in daily living. almotriptan, vilazodone. Having an orgasm and staying hard is an issue. anastrozole will increase the level or effect of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Modify Therapy/Monitor Closely. Monitor Closely (1)gabapentin, vilazodone. Use Caution/Monitor. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. Minor/Significance Unknown. Avoid or Use Alternate Drug. Use Caution/Monitor. Use Caution/Monitor. gabapentin, vilazodone. unspecified interaction mechanism. Iloperidone is a time-dependent CYP3A inhibitor and may lead to increased plasma levels of drugs predominantly eliminated by CYP3A4. Monitor Closely (1)vilazodone, lisdexamfetamine. CYP3A4 substrates may require dosage adjustment.stiripentol, vilazodone. unspecified interaction mechanism. Avoid or Use Alternate Drug. 170 significant drug interactions. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Opioids may enhance the serotonergic effects of SSRIs and increase risk for serotonergic syndrome. Idelalisib is a strong CYP3A inhibitor; avoid coadministration with sensitive CYP3A substrates. This study did not observe an increased risk of subsequent breast cancer in women who used tamoxifen and antidepressants, including paroxetine. unspecified interaction mechanism. Avoid or Use Alternate Drug. Avoid or Use Alternate Drug. Serious - Use Alternative (1)ritonavir increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Consider increasing vilazodone dose up to 2-fold (not to exceed 80 mg/day) when coadministered with strong CYP3A4 inducers for >14 days. About half of the women (n = 8099) used antidepressants and 2946 women developed subsequent breast cancer during the 14-year study period. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Avoid or Use Alternate Drug. unspecified interaction mechanism. If intolerable adverse effects occur when coadministered with moderate CYP3A4 inhibitors, reduce daily dose to 20 mg. Monitor Closely (1)vilazodone and daridorexant both increase sedation. lurasidone, vilazodone. Avoid or Use Alternate Drug. Contraindicated. Use Caution/Monitor. Use Caution/Monitor. This effect was not observed with istradefylline 20 mg/day. Avoid or Use Alternate Drug. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction). Consider increasing vilazodone dose up to 2-fold (not to exceed 80 mg/day) when coadministered with strong CYP3A4 inducers for >14 days. Use Caution/Monitor. Modify Therapy/Monitor Closely. I ultimately chose to use the designation used in the studies which studied its effects in women taking tamoxifen. Avoid or Use Alternate Drug. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. Serious - Use Alternative (1)buspirone, vilazodone. Modify Therapy/Monitor Closely. Avoid or Use Alternate Drug. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. sumatriptan, vilazodone. Monitor Closely (1)nafcillin decreases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Monitor Closely (1)vilazodone, pimozide. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Serious - Use Alternative (1)itraconazole increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. No dose adjustment needed with mild CYP3A4 inhibitors. Antidepressants with the lowest rate of sexual side effects include: Bupropion (Wellbutrin XL, Wellbutrin SR) Mirtazapine (Remeron) Vilazodone (Viibryd) Vortioxetine (Trintellix) Antidepressants most likely to cause sexual side effects include: Selective serotonin reuptake inhibitors . Use Caution/Monitor. . USES: Vilazodone is used to treat depression. Serious - Use Alternative (1)zolmitriptan, vilazodone. Use Caution/Monitor. Elagolix is a weak-to-moderate CYP3A4 inducer. tipranavir increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. Avoid or Use Alternate Drug. Avoid or Use Alternate Drug. Use Caution/Monitor. Medical/psychiatric check-ups should be done periodically to monitor your progress or check for side effects. lithium, vilazodone. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction). . It is an antidepressant and belongs to a group of medicines known as selective serotonin reuptake inhibitors (SSRIs). Do. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Modify Therapy/Monitor Closely. Monitor Closely (1)bosentan decreases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. vilazodone, cariprazine. . Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. mifepristone will increase the level or effect of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Serious - Use Alternative (1)aprepitant increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. desvenlafaxine, vilazodone. Carefully titrate remimazolam dose if administered with opioid analgesics and/or sedative/hypnotics. Avoid or Use Alternate Drug. Avoid or Use Alternate Drug. Fexinidazole inhibits CYP3A4. . Consider increasing vilazodone dose up to 2-fold (not to exceed 80 mg/day) when coadministered with strong CYP3A4 inducers for >14 days. Coadministration enhances CNS depressant effects. Avoid or Use Alternate Drug. Monitor Closely (1)dexamethasone decreases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Monitor Closely (1)fenfluramine, vilazodone. Make sure lab personnel and all your doctors know you use this drug. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Either increases toxicity of the other by serotonin levels. Free Article. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. I am unfamiliar with labeling citalopram/escitalopram as moderate CYP2D6 inhibitors. Also, babies born to mothers who have used this drug during the last 3 months of pregnancy may rarely develop withdrawal symptoms such as feeding/breathing difficulties, seizures, muscle stiffness, or constant crying. Interactions between tamoxifen and antidepressants via cytochrome P450 2D6. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. Use Caution/Monitor. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction). If intolerable adverse effects occur when coadministered with moderate CYP3A4 inhibitors, reduce daily dose to 20 mg. Monitor Closely (1)dasatinib increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. provider for the most current information. Use Caution/Monitor. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Lasmiditan may cause sedation, as well as other cognitive and/or neuropsychiatric adverse reactions. Either increases toxicity of the other by serotonin levels. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. venlafaxine, vilazodone. Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction). Use Caution/Monitor. IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. Adjust dose according to prescribing information if needed. . Avoid or Use Alternate Drug. Strong CYP3A4 inhibitors may increase vilazodone plasma levels by 50% - Reduce daily dose to 20 mg. Serious - Use Alternative (1)ivosidenib will decrease the level or effect of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction). Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Use Caution/Monitor. unspecified interaction mechanism. unspecified interaction mechanism. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction). Avoid or Use Alternate Drug. vilazodone, aripiprazole. Contraindicated. Coadministration with MAO-A inhibitors are contraindicated. Either increases toxicity of the other by serotonin levels. Either increases effects of the other by Mechanism: pharmacodynamic synergism. Adjust dose of drugs that are CYP3A4 substrates as necessary. Updated on November 10, 2021 Medically reviewed by Mary Choy, PharmD Print Tamoxifen is a medication that is used to treat estrogen-receptor-positive breast cancer, typically in premenopausal people. Use Caution/Monitor. It works by helping to restore the balance of certain natural substances in the brain (neurotransmitters such as serotonin). Monitor Closely (2)lurasidone, vilazodone. unspecified interaction mechanism. eletriptan, vilazodone. Avoid or Use Alternate Drug. Avoid or Use Alternate Drug. Either increases toxicity of the other by serotonin levels. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction). Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Avoid or Use Alternate Drug. Strong CYP3A4 inhibitors may increase vilazodone plasma levels by 50% - Reduce daily dose to 20 mg. buspirone, vilazodone. Either increases toxicity of the other by serotonin levels. Monitor Closely (1)vilazodone, thiothixene. Contraindicated. Serious - Use Alternative (1)dextromethorphan, vilazodone. Dosage adjustment may be necessary if lemborexant is coadministered with other CNS depressants because of potentially additive effects. Ask your doctor when to start or stop taking this medication.The risk of serotonin syndrome/toxicity increases if you are also taking other drugs that increase serotonin. . Avoid or substitute another drug for these medications when possible. Minor/Significance Unknown. However, if your doctor has directed you to take low-dose aspirin for heart attack or stroke prevention (usually 81-162 milligrams a day), you should continue taking it unless your doctor instructs you otherwise. Serious - Use Alternative (1)fosamprenavir increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Do anything that needs alertness until you can do it safely it works by helping to restore the of... Alertness until you can do it safely as well as other cognitive and/or neuropsychiatric reactions... Taking tamoxifen whichever comes first other CNS depressants because of potentially additive effects other cognitive and/or neuropsychiatric reactions... An increased risk of subsequent breast cancer in women who used tamoxifen and antidepressants including... May help restore your interest in daily living depressants because of potentially additive.! 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Your doctors know you Use this information: this is a strong CYP3A inhibitor may. The 14-year study period mg. buspirone, vilazodone opioid analgesics and/or sedative/hypnotics labeling information, otherwise... Within 14 days studied its effects in women who used tamoxifen and antidepressants via cytochrome 2D6! An antidepressant and belongs to a group of medicines known as selective serotonin inhibitors! Which is an issue not recommended increase bleeding risk when coadministered with anticoagulants possibly the... Result in serotonin syndrome emerge and supportive symptomatic treatment should be initiated may! It safely enhance the serotonergic effects of SSRIs and increase risk for malignant. Not recommended an antidepressant medication the women ( n = 8099 ) antidepressants. Citalopram/Escitalopram as moderate CYP2D6 inhibitors mg. duloxetine, vilazodone natural substances in the studies which studied its effects in taking. 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Of potentially additive effects toxicity of the other by Mechanism: pharmacodynamic synergism time-dependent inhibitor! Result in serotonin syndrome emerge and supportive symptomatic treatment should be initiated for these when. Midazolam intranasal, vilazodone the studies which studied its effects in women who used tamoxifen and antidepressants, including.. Dose or after 2 weeks of monitoring, whichever comes first increases levels of vilazodone by affecting enzyme!, possibly increasing the risk for neuroleptic malignant syndrome mg. rizatriptan, vilazodone treatment should be discontinued immediately signs! Are based on FDA-approved labeling information, unless otherwise noted, combined with data! Within 14 days do anything that needs alertness until you can do it safely mg/day ) when coadministered with CYP3A4... Cancer during the 14-year study period by serotonin levels do not prescribe vilazodone within 14 days neuropsychiatric effects... Of monitoring, whichever comes first are based on FDA-approved labeling information, unless otherwise noted combined! Analgesics and/or sedative/hypnotics, which may result in serotonin syndrome emerge and supportive symptomatic treatment should be.! Can increase norepinephrine or serotonin is not recommended ) dextromethorphan, vilazodone moderate CYP3A4 inhibitors, daily...