Vilazodone hydrochloride
Pronunciation: pronunciation varies by local usage.
- Generic name
- vilazodone hydrochloride
- Brand names
- VIIBRYD
- Drug class
- Serotonin reuptake inhibitor and 5-HT1A receptor partial agonist
- Form
- Tablet
- Route
- Oral
- Legal status
- Prescription-only antidepressant medicine
Availability and supply rules vary by country
Trade names by country: United States
Australia: · Full directory
What vilazodone hydrochloride is and how it works
Vilazodone is an oral prescription antidepressant medicine indicated for the treatment of major depressive disorder (MDD) in adults. It is a serotonin reuptake inhibitor and 5-HT1A receptor partial agonist. (1)
The medicine must be taken with food to ensure adequate absorption. It is prescription-only and not approved for use in pediatric patients.
Mechanism of action: how vilazodone hydrochloride works
Vilazodone is a combined serotonin reuptake inhibitor and 5-HT1A receptor partial agonist; its therapeutic action in depression is thought to be mediated through serotonergic activity. (1)
What vilazodone hydrochloride is used for
Major depressive disorder
Vilazodone is indicated for the treatment of major depressive disorder (MDD) in adults. (1)
Before taking vilazodone hydrochloride
Do not take / not appropriate for
- Vilazodone is contraindicated with concurrent use, or use within 14 days, of a monoamine oxidase inhibitor (MAOI), including linezolid or intravenous methylene blue, due to the risk of serotonin syndrome. If you are taking, or have recently taken, an MAOI, contact the prescriber or urgent medical services for advice before taking vilazodone. (all products) (1)
- Vilazodone is not approved for use in pediatric patients; safety and effectiveness have not been established in this population. (all products) (1)
- Abrupt cessation of vilazodone can cause discontinuation symptoms; the prescriber should advise on any tapering schedule or other treatment change. (all products) (1)
Tell your clinician about
- If you have a personal or family history of bipolar disorder, mania, or hypomania.
- If you have a history of seizures.
- If you are pregnant, planning to become pregnant, or breastfeeding.
- If you are taking any other medications, especially MAOIs, triptans, tricyclic antidepressants, lithium, tramadol, buspirone, St. John's wort, NSAIDs, aspirin, warfarin, or other anticoagulants.
- If you are taking digoxin.
- If you are taking strong CYP3A4 inhibitors (e.g., itraconazole, clarithromycin, voriconazole) or inducers (e.g., carbamazepine, phenytoin, rifampin).
- If you are elderly, take diuretics, or are volume-depleted (increased risk of low sodium).
How to take vilazodone hydrochloride
- Take vilazodone exactly as prescribed by your healthcare provider. It must be taken with food once daily.
- The typical starting dose is 10 mg once daily with food for 7 days, then increased to 20 mg once daily with food for 7 days, then may be increased to 40 mg once daily based on response.
- Any dose change or treatment stop is a prescriber-directed decision. If discontinuation is planned, the prescriber may direct a gradual taper (e.g., from 40 mg to 20 mg for 4 days, then 20 mg to 10 mg for 3 days) to reduce the risk of discontinuation symptoms.
- Avoid taking vilazodone without food, as food is required for adequate absorption.
Procedures and treatment changes
Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1)
Missed dose
Gap/
Overdose
Seek emergency medical attention immediately if an overdose is suspected.
Side effects
Common adverse reactions include diarrhea, nausea, insomnia, and vomiting.
Diarrhea
What to notice: Loose or frequent stools; incidence 20 mg: 26%, 40 mg: 29% vs placebo 10%.
What to do: Contact the prescriber if severe or persistent, as it may require dose adjustment or discontinuation. (1)
Nausea
What to notice: Feeling sick; 20 mg: 22%, 40 mg: 24% vs placebo 7%.
What to do: Contact prescriber if severe. (1)
Insomnia
What to notice: Difficulty sleeping; 20 mg: 7%, 40 mg: 6% vs placebo 2%.
What to do: Contact prescriber if bothersome. (1)
Vomiting
What to notice: Vomiting; 20 mg: 4%, 40 mg: 5% vs placebo 2%.
What to do: Contact prescriber if persistent. (1)
Sexual dysfunction
What to notice: Decreased libido, abnormal orgasm, erectile dysfunction; 20 mg: abnormal orgasm 1%, decreased libido 2%; 40 mg: abnormal orgasm 2%, erectile dysfunction 3%, decreased libido 4%.
What to do: Discuss with prescriber if these effects are concerning. (1)
Serotonin syndrome
What to notice: Agitation, hallucinations, autonomic instability, and seizures.
What to do: Seek immediate medical attention. Any combination with MAOIs or other serotonergic drugs must be directed by the prescriber. (1)
Suicidal thoughts and behaviors
What to notice: New or worsening depression, anxiety, restlessness, trouble sleeping, panic attacks, or thoughts of self-harm.
What to do: Monitor closely, especially at the start of treatment or when the dose changes. Contact a healthcare provider immediately if symptoms appear. (1)
Discontinuation syndrome
What to notice: Nausea, mood changes, dizziness, tingling/numbness, anxiety, confusion, headache, and seizures if stopped abruptly.
What to do: Abrupt cessation can cause these symptoms; the prescriber should advise on any tapering plan or other treatment change. (1)
Bleeding risk
What to notice: Unusual bruising, bleeding gums, or prolonged bleeding.
What to do: Tell the prescriber if taking blood thinners or NSAIDs. (1)
Activation of mania/hypomania
What to notice: Unusual excitement, elation, racing thoughts, decreased need for sleep, or reckless behavior.
What to do: Report to prescriber immediately, especially if you have a history of bipolar disorder. (1)
Hyponatremia (low sodium)
What to notice: Confusion, seizures, or in severe cases respiratory arrest.
What to do: Seek prompt medical assessment. (1)
Seizures
What to notice: Convulsions or fits.
What to do: Use with caution if you have a seizure disorder. Report any seizure to the prescriber. (1)
Angle-closure glaucoma
What to notice: The label identifies angle-closure glaucoma as a risk associated with vilazodone.
What to do: Seek prompt ophthalmologic evaluation if any eye symptoms occur. (1)
Serious warnings
Suicidal thoughts and behaviors — boxed_warning
Symptoms: New or worsening depression, anxiety, restlessness, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia, or suicidal thoughts or actions. Short-term studies found this increased risk specifically in pediatric and young-adult patients.
Action: Monitor closely; patients and caregivers should watch for these symptoms and report immediately to a healthcare provider. Seek emergency care if there is imminent risk of self-harm. (1)
Serotonin syndrome — emergency
Symptoms: Agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, diarrhea, and confusion.
Action: Seek immediate medical attention. If you are taking, or are considering taking, vilazodone with MAOIs or other serotonergic agents, contact the prescriber promptly so the prescriber can assess and advise on the combination and any treatment change. (1)
Discontinuation syndrome (if abruptly stopped) — high
Symptoms: Nausea, mood changes, dizziness, paresthesia, anxiety, confusion, headache, and seizures.
Action: Contact the prescriber about any planned or unplanned interruption in treatment; the prescriber will advise on tapering or whether to continue treatment. (1)
Bleeding — moderate
Symptoms: Unusual bruising, bleeding gums, or prolonged bleeding.
Action: Notify prescriber; seek emergency care if severe or uncontrolled bleeding. (1)
Hyponatremia — moderate
Symptoms: Confusion, headache, weakness, seizures.
Action: Seek medical evaluation. (1)
Interactions
| Medicine or test | Effect | Action |
|---|---|---|
| Monoamine oxidase inhibitors (MAOIs) | Risk of serotonin syndrome; contraindicated within 14 days of vilazodone use. | Contact the prescriber for advice; MAOI timing and contraindication management require clinician guidance. (1) |
| Other serotonergic agents (e.g., triptans, tricyclic antidepressants, lithium, tramadol, buspirone, St. John's wort) | Increased risk of serotonin syndrome. | Monitor closely if coadministration is necessary. (1) |
| Strong CYP3A4 inhibitors (e.g., itraconazole, clarithromycin, voriconazole) | Increases vilazodone blood levels; maximum vilazodone dose should be reduced to 20 mg/day. | The prescriber will determine any dose adjustment; do not change your own dose. (1) |
| Strong CYP3A4 inducers (e.g., carbamazepine, phenytoin, rifampin) | Decreases vilazodone blood levels; dose increase up to 80 mg/day may be considered by the prescriber, titrated over 1-2 weeks, when the inducer is used for more than 14 days. | The prescriber will determine any dose adjustment and titration schedule; do not change your own dose. (1) |
| Digoxin | Vilazodone may increase digoxin concentrations. | The prescriber or clinical team will monitor digoxin levels and watch for signs of toxicity. (1) |
| Antiplatelet agents and anticoagulants (e.g., NSAIDs, aspirin, warfarin) | Increased risk of bleeding. | The prescriber or clinical team will monitor INR in patients on warfarin; watch for signs of bleeding and report them. (1) |
Pregnancy, breastfeeding, kidney/liver function, age
Pregnancy
Third-trimester exposure associated with risk of postpartum hemorrhage and potential risk of persistent pulmonary hypertension of the newborn (PPHN); no teratogenicity in animal studies. A pregnancy registry exists (1-844-405-6185). Weigh risks and benefits. (1)
Breastfeeding
No human data; vilazodone is excreted in rat milk. Consider benefits of breastfeeding against potential infant exposure. (1)
Pediatric use
Not approved for pediatric patients; safety and effectiveness not established. (1)
Geriatric use
No age-based dosage adjustment required; conservative dosing recommended due to increased hyponatremia risk. (1)
Renal impairment
No dosage adjustment necessary for mild to severe renal impairment (glomerular filtration rate 15-90 mL/min). (1)
Hepatic impairment
No dosage adjustment necessary for mild to severe hepatic impairment (Child-Pugh score 5-15). (1)
Monitoring
Before starting
- Prescriber confirms diagnosis of major depressive disorder before initiating treatment.
- Screen for personal or family history of bipolar disorder, seizure disorder, bleeding risk, and other medications.
- Ensure no MAOI use within the last 14 days.
- Assess hyponatremia risk factors (elderly, diuretic use, volume depletion).
During treatment
- Monitor for clinical worsening and emergence of suicidal thoughts/behaviors, especially at initiation and dose changes.
- Watch for signs of serotonin syndrome, bleeding, manic activation, seizures, and hyponatremia.
- The prescriber or clinical team monitors digoxin levels if coadministered, and INR if on warfarin.
Storage
Gap/
Professional information
Clinician-facing context only. Use the current local indication, dosing table, formulation/device instructions, and applicable guidelines.
United States (FDA labeling)
Indication: Major depressive disorder
Dose summary: Prescriber-managed titration: initial 10 mg once daily with food for 7 days, then 20 mg once daily for 7 days, then may increase to 40 mg once daily — dose selection and any change must be made by the prescriber, not implemented independently by the patient. With strong CYP3A4 inhibitors, maximum 20 mg/day; with strong CYP3A4 inducers used for more than 14 days, the prescriber may consider an increase up to 80 mg/day, titrated over 1-2 weeks. Discontinuation taper (prescriber-directed): 40 mg to 20 mg for 4 days, then 20 mg to 10 mg for 3 days.
Renal context: No dosage adjustment for renal impairment (GFR 15-90 mL/min). (1)
Hepatic guidance
No dose adjustment needed for mild to severe hepatic impairment (Child-Pugh score 5-15).
Frequently asked questions
Can I stop taking vilazodone suddenly?
Abrupt discontinuation can cause withdrawal (discontinuation) symptoms including nausea, dizziness, and seizures. The prescriber should advise on any tapering schedule or other treatment change. (1)
Why must vilazodone be taken with food?
Food is necessary for adequate absorption of the medicine into your bloodstream. (1)
What should I do if I think I'm having serotonin syndrome?
Seek immediate emergency medical attention. Symptoms include agitation, hallucinations, fever, and muscle stiffness. (1)
Is vilazodone safe for children?
No, it is not approved for pediatric use. (1)
Can I take vilazodone with other antidepressants?
Combining vilazodone with MAOIs is contraindicated. Using it with other serotonergic drugs requires close monitoring by your doctor due to the risk of serotonin syndrome. (1)
What is the mechanism of action of vilazodone hydrochloride?
Vilazodone is a combined serotonin reuptake inhibitor and 5-HT1A receptor partial agonist; its therapeutic action in depression is thought to be mediated through serotonergic activity. (1)
What is the generic name of Vilazodone hydrochloride?
The generic name is vilazodone hydrochloride. It is sold under brand names including VIIBRYD. (1)
What class of drug is vilazodone hydrochloride?
Vilazodone hydrochloride is classed as: Serotonin reuptake inhibitor and 5-HT1A receptor partial agonist. (1)
References
- VIIBRYD (vilazodone hydrochloride) tablet, film coated / kitU.S. Food and Drug Administration (DailyMed) · United States · dated 2026 · accessed 2026-08-05 · source 1
- Vilazodone — patient drug information (MedlinePlus)U.S. National Library of Medicine (MedlinePlus) · US · accessed 2026-08-14 · source 2
- VILAZODONE HYDROCHLORIDE — FDA approval record (Drugs@FDA ANDA208202)U.S. Food and Drug Administration · US · accessed 2026-08-14 · source 3
- vilazodone — RxNorm normalized drug concept (RXCUI 1086768)U.S. National Library of Medicine (RxNorm) · US · accessed 2026-08-14 · source 4
Brand names by country
Single-ingredient vilazodone hydrochloride names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.
Priority countries
United States
- VIIBRYD10 mg, 20 mg, 40 mg · allergan, inc.