AdultPediatricDosage Forms & Strengths tablet, immediate-release 5mg 10mg 20mg NOTE: Former brand name Brintellix Major Depressive Disorder Indicated for major depressive disorder (MDD) in adults 10 mg PO qDay; dose should then be increased to 20 mg/day, as tolerated Consider decreasing dose to 5 mg/day if higher doses are not tolerated Efficacy and safety of doses >20 mg/day have not been evaluated Dosage Modifications CYP2D6 poor metabolizers: Not to exceed 10 mg/day CYP2D6 inhibitors Reduce vortioxetine by one-half when coadministered with CYP2D6 inhibitors (eg, bupropion, fluoxetine, paroxetine, quinidine) Increase dose to original dose when CYP2D6 inhibitor is discontinued CYP inducers Consider increasing vortioxetine dose when coadministered with strong CYP inducer (eg, rifampin, carbamazepine, phenytoin) for >14 days; not to exceed 3x the original dose Reduce to original dose within 14 days, when inducer is discontinued Renal or hepatic impairment No dosage adjustment necessary Dosing Considerations Before initiating treatment Screen for personal or family history of bipolar disorder, mania, or hypomania Discontinuing treatment May be abruptly discontinued; patients may experience transient adverse reactions (eg, headache, muscle tension) following abrupt discontinuation if dose is 15-20 mg/day To avoid these adverse reactions, decrease to 10 mg/day for 1 week before full discontinuation of 15-20 mg/day doses Switching to or from a monoamine oxidase inhibitor (MAOI) Discontinuation of MAOI and starting vortioxetine: Wait at least 14 days after discontinuation Discontinuation of vortioxetine and starting MAOI: Wait at least 21 days after discontinuation Safety and efficacy not establishedInteraction CheckerEnter a drug name and vortioxetineNo Results No Interactions Found Interactions FoundContraindicatedSerious - Use AlternativeSignificant - Monitor CloselyMinorAll Interactions Sort By: SeverityName Contraindicated (8)isocarboxazidisocarboxazid, vortioxetine. Either increases effects of the other by serotonin levels. Contraindicated.linezolidlinezolid increases toxicity of vortioxetine by serum potassium. Contraindicated. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be urgently administered, discontinue vortioxetine immediately and monitor for serotonin syndrome. Monitor for serotonin syndrome for 3 weeks or 24 hr after last linezolid dose, whichever comes first. Vortioxetine may be resumed 24 hr after last linezolid dose.methylene bluemethylene blue increases toxicity of vortioxetine by serotonin levels. Contraindicated. Methylene blue may increase serotonin as a result of MAO-A inhibition. If methylene blue must be urgently administered, discontinue vortioxetine immediately and monitor for serotonin syndrome. Monitor for serotonin syndrome for 3 weeks or 24 hr after last methylene blue dose, whichever comes first. Vortioxetine may be resumed 24 hr after last methylene blue dose.phenelzinephenelzine increases toxicity of vortioxetine by serotonin levels. Contraindicated.rasagilinerasagiline increases toxicity of vortioxetine by serotonin levels. Contraindicated.selegilineselegiline increases toxicity of vortioxetine by serotonin levels. Contraindicated.selegiline transdermalselegiline transdermal increases toxicity of vortioxetine by serotonin levels. Contraindicated.tranylcyprominetranylcypromine increases toxicity of vortioxetine by serotonin levels. Contraindicated.Serious - Use Alternative (80)abametapirabametapir will increase the level or effect of vortioxetine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. For 2 weeks after abametapir application, avoid taking drugs that are CYP3A4 substrates. If not feasible, avoid use of abametapir.alfentanilalfentanil, vortioxetine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.almotriptanalmotriptan, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.amitriptylineamitriptyline, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.amoxapineamoxapine, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.apalutamideapalutamide will decrease the level or effect of vortioxetine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of apalutamide, a strong CYP3A4 inducer, with drugs that are CYP3A4 substrates can result in lower exposure to these medications. Avoid or substitute another drug for these medications when possible. Evaluate for loss of therapeutic effect if medication must be coadministered. Adjust dose according to prescribing information if needed.bupropionbupropion, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.carbamazepinecarbamazepine will decrease the level or effect of vortioxetine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.chlorpromazinechlorpromazine increases levels of vortioxetine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Decrease vortioxetine dose by 50% when coadministered with strong CYP2D6 inhibitors.citalopramcitalopram, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.clomipramineclomipramine, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.cocaine topicalcocaine topical increases levels of vortioxetine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Decrease vortioxetine dose by 50% when coadministered with strong CYP2D6 inhibitors.cyclobenzaprinecyclobenzaprine, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.dabigatranvortioxetine and dabigatran both increase anticoagulation. Avoid or Use Alternate Drug.dacomitinibdacomitinib will increase the level or effect of vortioxetine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Avoid use with CYP2D6 substrates where minimal increases in concentration of the CYP2D6 substrate may lead to serious or life-threatening toxicities. dalteparinvortioxetine and dalteparin both increase anticoagulation. Avoid or Use Alternate Drug.desipraminedesipramine, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.desirudinvortioxetine and desirudin both increase anticoagulation. Avoid or Use Alternate Drug.desvenlafaxinedesvenlafaxine, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.dexmedetomidinedexmedetomidine increases levels of vortioxetine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Decrease vortioxetine dose by 50% when coadministered with strong CYP2D6 inhibitors.doxepindoxepin, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.duloxetineduloxetine, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.eletriptaneletriptan, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.enzalutamideenzalutamide will decrease the level or effect of vortioxetine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.escitalopramescitalopram, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.fentanylfentanyl, vortioxetine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.fentanyl intranasalfentanyl intranasal, vortioxetine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.fentanyl transdermalfentanyl transdermal, vortioxetine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.fentanyl transmucosalfentanyl transmucosal, vortioxetine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.fexinidazolefexinidazole will increase the level or effect of vortioxetine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Fexinidazole inhibits CYP3A4. Coadministration may increase risk for adverse effects of CYP3A4 substrates.fluoxetinefluoxetine, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.fluvoxaminefluvoxamine, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.fosphenytoinfosphenytoin will decrease the level or effect of vortioxetine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.frovatriptanfrovatriptan, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.givosirangivosiran will decrease the level or effect of vortioxetine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP2D6 substrates with givosiran. If unavoidable, decrease the CYP2D6 substrate dosage in accordance with approved product labeling.hydromorphonehydromorphone, vortioxetine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.idelalisibidelalisib will increase the level or effect of vortioxetine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Idelalisib is a strong CYP3A inhibitor; avoid coadministration with sensitive CYP3A substratesimipramineimipramine, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.ivosidenibivosidenib will decrease the level or effect of vortioxetine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP3A4 substrates with ivosidenib or replace with alternative therapies. If coadministration is unavoidable, monitor patients for loss of therapeutic effect of these drugs.levomilnacipranlevomilnacipran, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.lithiumlithium, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.lonafarniblonafarnib will increase the level or effect of vortioxetine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration with sensitive CYP3A substrates. If coadministration unavoidable, monitor for adverse reactions and reduce CYP3A substrate dose in accordance with product labeling.lopinavirlopinavir increases levels of vortioxetine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Decrease vortioxetine dose by 50% when coadministered with strong CYP2D6 inhibitors.lorcaserinlorcaserin increases levels of vortioxetine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Decrease vortioxetine dose by 50% when coadministered with strong CYP2D6 inhibitors.meperidinemeperidine, vortioxetine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.milnacipranmilnacipran, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.mirtazapinemirtazapine, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.morphinemorphine, vortioxetine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.naratriptannaratriptan, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.nefazodonenefazodone, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.nortriptylinenortriptyline, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.olopatadine intranasalvortioxetine and olopatadine intranasal both increase sedation. Avoid or Use Alternate Drug. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment. paroxetineparoxetine, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.phenobarbitalphenobarbital will decrease the level or effect of vortioxetine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.phenytoinphenytoin will decrease the level or effect of vortioxetine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.primidoneprimidone will decrease the level or effect of vortioxetine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.protriptylineprotriptyline, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.quinidinequinidine increases levels of vortioxetine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Decrease vortioxetine dose by 50% when coadministered with strong CYP2D6 inhibitors.quininequinine increases levels of vortioxetine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Decrease vortioxetine dose by 50% when coadministered with strong CYP2D6 inhibitors.remifentanilremifentanil, vortioxetine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.ritonavirritonavir increases levels of vortioxetine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Decrease vortioxetine dose by 50% when coadministered with strong CYP2D6 inhibitors.rizatriptanrizatriptan, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.secobarbitalsecobarbital will decrease the level or effect of vortioxetine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.sertralinesertraline, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.St John's WortSt John's Wort, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.sufentanilsufentanil, vortioxetine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.sufentanil SLsufentanil SL, vortioxetine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.sumatriptansumatriptan, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.sumatriptan intranasalsumatriptan intranasal, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.tedizolidtedizolid, vortioxetine. Either increases effects of the other by Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. both increase serotonin levels; increased risk of serotonin syndrome.tipranavirtipranavir will increase the level or effect of vortioxetine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.tramadoltramadol, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.trazodonetrazodone increases toxicity of vortioxetine by serotonin levels. Avoid or Use Alternate Drug.trimipraminetrimipramine, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.tucatinibtucatinib will increase the level or effect of vortioxetine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid concomitant use of tucatinib with CYP3A substrates, where minimal concentration changes may lead to serious or life-threatening toxicities. If unavoidable, reduce CYP3A substrate dose according to product labeling.venlafaxinevenlafaxine, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.verapamilverapamil, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.vilazodonevilazodone, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.voxelotorvoxelotor will increase the level or effect of vortioxetine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Voxelotor increases systemic exposure of sensitive CYP3A4 substrates. Avoid coadministration with sensitive CYP3A4