Usual Adult Dose for Depression

Initial dose: 10 mg orally once a day
Maintenance dose: 5 to 20 mg orally once a day
Maximum dose: 20 mg/day

Comments:

• Patients should be screened for bipolar disorder, mania, and hypomania prior to starting treatment.
• Patients who do not tolerate higher doses may be maintained on 5 mg orally once a day.

Usual Adult Dose for Major Depressive Disorder

Initial dose: 10 mg orally once a day
Maintenance dose: 5 to 20 mg orally once a day
Maximum dose: 20 mg/day

Comments:

• Patients should be screened for bipolar disorder, mania, and hypomania prior to starting treatment.
• Patients who do not tolerate higher doses may be maintained on 5 mg orally once a day.

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Dose Adjustments

Switching to/from an MAOI:

• From an MAOI used to treat psychiatric disorders: Allow at least 14 days before beginning this drug.
• To an MAOI used to treat psychiatric disorders: Allow at least 21 days after stopping this drug before beginning treatment with the MAOI.
• Use with linezolid or IV methylene blue: If treatment is absolutely necessary, promptly discontinue treatment with this drug and monitor the patient for symptoms of serotonin syndrome for 21 days OR until 24 hours after the last dose of linezolid/IV methylene blue, whichever comes first. Treatment may be resumed 24 hours after the last dose of linezolid/IV methylene blue.
• Serotonin syndrome associated with oral/local injection of methylene blue or IV doses of this drug lower than 1 mg/kg is unknown.

• The dose of this drug should be reduced by 50% with concomitant use of strong CYP450 2D6 inhibitors.
• CYP450 2D6 discontinuation: The dose of this drug should be increased to the original level.

• Coadministration for greater than 14 days: Increased doses of this drug should be considered; doses of this drug should not exceed 3 times the original dose.
• CYP450 2D6 discontinuation: The dose of this drug should be reduced to the original level within 14 days.

• This drug may be abruptly discontinued; however, headache and muscle tension occurred at doses of 15 to 20 mg/day.
• Adverse reactions may be avoided by decreasing the dose to 10 mg/day for 1 week, then completely discontinuing treatment.

Precautions

US BOXED WARNINGS:
SUICIDAL THOUGHTS AND BEHAVIORS:

• Antidepressants increased the risk of suicidal thoughts and behavior in pediatric and young adult patients in short-term studies.

• Closely monitor all antidepressant-treated patients for clinical worsening, and for emergence of suicidal thoughts and behaviors.
• This drug is not approved for use in pediatric patients.

• Hypersensitivity to the active component or to any of the ingredients
• Starting this drug in patients who are being treated with other MAOIs (e.g., IV methylene blue, linezolid)
• Use of this drug within 14 days of stopping an MAOI intended to treat psychiatric disorders
• Use of MAOIs to treat psychiatric disorders with this drug OR within 21 days of stopping treatment with this drug

Dialysis

Data not available

Other Comments

Administration advice:

• This drug may be taken without regard to meals.
• If a dose is missed, the next dose should be taken at the usual time; patients should not take a double dose to make up for a missed dose.

• Patients should be periodically assessed for usefulness of the drug.
• Efficacy was usually observed by week 2.

• Hematologic: Bleeding events
• Nervous system: Signs/symptoms of serotonin syndrome
• Psychiatric: Changes in mood/behavior, including depression and suicide

• Patients should be encouraged to tell their healthcare provider(s) about all of the medicines that they take, including prescription and non-prescription medicines.
• This medicine may increase the risk of suicidal thoughts and behavior. Patients should be alert for the emergence or worsening of symptoms of depression, any unusual changes in mood or behavior, or the emergence of suicidal thoughts, behavior, or thoughts about self-harm. Any behavior of concern should be reported as soon as possible.
• Patients should be advised to speak to a healthcare provider if they are pregnant, intend to become pregnant, or are breastfeeding.
• This medicine may cause dizziness, impaired judgment, thinking, or motor skills; patients should avoid driving a car or operating dangerous machinery until the full effects of this drug are known.

Frequently asked questions

• Does Trintellix (vortioxetine) cause weight gain or loss?
• How long does it take for Trintellix (vortioxetine) to start working?
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• Shall I take Trintellix (vortioxetine) in the night or morning?
• Can I take Cymbalta (duloxetine) and Trintellix (vortioxetine) together?
• Is Trintellix the same as Brintellix?