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Precautions and Warnings With Vilazodone

Taking vilazodone increases your risk of low blood sodium, intestinal bleeding, and (in rare cases) seizures. To help ensure your safety, talk to your healthcare provider about your medical history -- including your current medications -- before starting treatment with vilazodone. Precautions and warnings with this antidepressant also apply to women who are pregnant or breastfeeding.

What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking vilazodone (Viibryd™) if you have:
  • Kidney disease, such as kidney failure (renal failure)
  • Liver disease, such as hepatitis, cirrhosis, or liver failure
  • A history of seizures
  • Bipolar disorder (sometimes called manic depression) or mania
  • A history of suicide attempts or suicidal thoughts
  • Frequent alcohol intake
  • Low blood sodium levels
  • A history of bleeding problems
  • Any allergies, including to foods, dyes, or preservatives.
Also, let your healthcare provider know if you are:
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
Make sure to tell your healthcare provider about all other medications you are taking, including prescription and nonprescription medicines, vitamins, and herbal supplements.

Specific Vilazodone Precautions and Warnings

Some warnings and precautions to be aware of prior to taking vilazodone include the following:
  • All antidepressants may increase the risk of suicidal thinking or behavior in children, adolescents, and young adults. Anyone taking an antidepressant (including vilazodone) should be closely monitored for worsening depression, suicidal thoughts, and any unusual behavior, especially in the beginning of treatment and whenever the dose is increased (see Viibryd and Suicide for more information).
  • There is a concern that antidepressants may lead to mania in people with bipolar disorder who are not also taking a medication known as a "mood stabilizer." Make sure to tell your healthcare provider about your complete mental health history (and family history) before taking this medication. Your healthcare provider will determine if you may be at risk for bipolar disorder and mania.
  • Antidepressants may cause a rare but dangerous reaction known as serotonin syndrome. Taking vilazodone with other medications that affect serotonin can increase your risk for this reaction. Taking it with medications that affect dopamine (another brain chemical) may increase your risk for developing similar dangerous symptoms. Contact your healthcare provider immediately if you notice any possible symptoms of serotonin syndrome, including:
    • Confusion or disorientation
    • Seeing or hearing things that are not really there (hallucinations)
    • Fast heartbeat (tachycardia)
    • Fever
    • Overactive reflexes
    • Incoordination or difficulty walking
    • Sweating
    • Nausea and vomiting
    • Diarrhea
    • Muscle spasms
    • Stiff muscles that are difficult to move
    • Coma.
  • Antidepressant medications may increase the risk for seizures, although this is rare. People with a seizure disorder were not included in vilazodone clinical trials. Talk to your healthcare provider before taking vilazodone if you have a seizure disorder or have ever had a seizure.
  • Vilazodone may cause low blood sodium (hyponatremia). Older adults, people taking diuretics ("water pills"), and people who are dehydrated may be at an increased risk for hyponatremia with vilazodone use. If you develop symptoms of hyponatremia, contact your healthcare provider. Early symptoms may include:
    • Headache
    • Confusion
    • Problems concentrating
    • Memory problems
    • Weakness
    • Unsteadiness or falling down.
  • Suddenly stopping vilazodone may lead to uncomfortable withdrawal symptoms, such as anxiety, irritability, tremors, headache, and dizziness. Do not stop taking this medication without first talking to your healthcare provider. If you no longer need it, your healthcare provider can gradually reduce your dose to help reduce the chance that you will experience withdrawal symptoms.
  • Vilazodone may increase the risk of bleeding events, including serious stomach or intestinal bleeding. This risk is further increased in people taking certain medications, such as aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs). Contact your healthcare provider right away if you experience any symptoms of bleeding, which may include:
    • Unusual bruising
    • Bright-red blood coating the stool
    • Dark blood mixed with the stool
    • Black or tarry stool
    • Bright-red blood in vomit
    • Vomit that has the appearance of coffee grounds.
  • Vilazodone may affect your ability to perform complex tasks requiring mental and motor skills. Taking it with alcohol can increase this effect. To be safe, do not perform activities requiring mental or motor concentration (such as driving a car or operating machinery) until you know how this medication affects you.
  • Vilazodone is considered a pregnancy Category C medication. This means that it may not be safe for use during pregnancy. Talk to your healthcare provider about the risks and benefits of using this medication when pregnant (see Viibryd and Pregnancy for more information).
  • It is unknown if vilazodone passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider before beginning treatment (see Viibryd and Breastfeeding).
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