Active ingredient: viloxazine extended-release · US-only · FDA-approved for adults in 2021
Qelbree is the newest non-stimulant ADHD medication on the US market, FDA-approved for adults in 2021. It combines selective norepinephrine reuptake inhibition with additional serotonergic activity. Provides around-the-clock coverage and reaches full effect in two to four weeks.
How Qelbree works in plain English.
Qelbree contains viloxazine, an extended-release formulation that combines two mechanisms: selective norepinephrine reuptake inhibition (similar to atomoxetine) and modulation of serotonergic activity. Both mechanisms contribute to its effect on attention and impulse control.
Viloxazine has been used as an antidepressant in some European markets for decades, but the extended-release ADHD formulation (Qelbree) was developed and approved relatively recently. FDA-approved for paediatric ADHD in 2021 and adult ADHD shortly after.
Qelbree reaches full therapeutic effect in two to four weeks, faster than atomoxetine, which typically takes four to six weeks. Once at steady state, it provides 24-hour coverage from a single daily dose. There is no daily peak to time around.
Drug interactions matter. Viloxazine inhibits CYP1A2, which means it can significantly affect the metabolism of other medications metabolised by that enzyme, including some antidepressants and caffeine. Tell your prescriber about all medications and supplements you take.
Qelbree's close relations.
Other non-stimulant ADHD medications. Different mechanisms, similar around-the-clock framing.
Finding your dose.
US Qelbree adult titration typically starts at 200mg daily and increases by 200mg per week to a target dose. Maximum US adult dose is 600mg per day.
Available US doses: 100mg, 150mg, 200mg.
Qelbree is once daily. Capsules can be taken with or without food, but should be swallowed whole. Do not chew or crush. Capsule contents can be sprinkled on apple sauce for adults who have difficulty swallowing capsules.
Qelbree reaches full therapeutic effect in two to four weeks. The first dose does not produce a clinically meaningful effect. Patient observation across the ramp-up window is what tells you and your prescriber whether it's working.
Viloxazine is a strong CYP1A2 inhibitor. This means it can affect the metabolism of caffeine, some antidepressants, theophylline and other medications. Always disclose your full medication list to your prescriber before starting Qelbree.
ADHDose does not model a daily concentration curve for Qelbree because there isn't one to track. The app focuses on daily focus, sleep, mood, energy and side effects across the ramp-up window. The Clinician Summary export pulls that history into a structured PDF for your prescriber.
Steady-state coverage, tracked daily.
Qelbree has no daily curve to model. What matters is daily focus, sleep, mood and side effects across the weeks it takes to reach full effect. ADHDose tracks all of that for you.
Qelbree reaches full effect in two to four weeks. Daily logging across that window is how you and your prescriber will know whether it's working. ADHDose makes the logging structured and the patterns visible.
Every figure here is taken straight from the prescribing information, with the source on each row.
| Parameter | What the label states | Source |
|---|---|---|
| Active molecule | Viloxazine itself is active; a selective norepinephrine reuptake inhibitor | FDA label |
| Tmax | Median approximately 5 hours (range 3 to 9 hours), after a 200 mg dose | FDA label |
| Half-life | Mean 7.02 hours, plus or minus 4.74 hours SD | FDA label |
| Typical adult dose | Start 200 mg daily, titrate by 200 mg weekly; max 600 mg daily | FDA label |
| Food effect | High-fat meal: Cmax down about 9%, AUC down about 8%, Tmax up about 2 hours | FDA label |
Viloxazine itself is the active moiety; the label reports only its half-life, not a separate metabolite figure, and does not say whether the major metabolite is active.
Not stated in the label: Duration of effect: the label does not state a clinical duration-of-effect figure for once-daily Qelbree dosing, so this row is omitted rather than estimated.
Common side effects.
Most people tolerate Viloxazine well, especially after the first few weeks. Here are the patterns worth noticing, and the ones that warrant a call to your prescriber.
Sleepiness and appetite changes are the most commonly reported early effects. Logging them daily helps you and your prescriber decide whether they are settling or sticking.
Not emergencies, but worth bringing up. ADHDose tags recurring patterns automatically in your daily logs.
Viloxazine carries a boxed warning for suicidal thoughts and behaviour, and it can raise blood pressure and heart rate. If you notice any of these, contact your prescriber rather than stopping on your own.
Titration, week by week.
The first weeks of Viloxazine have a recognisable shape. Knowing what is normal at each stage stops you reading too much into a single bad day.
Non-stimulants do not work like stimulants. The first dose does not produce a noticeable effect. The first week is mostly about managing initial side effects (mild nausea, fatigue, dry mouth) while your body adjusts.
Initial side effects typically settle by week two or three. Still no clinically meaningful effect on attention or impulse control yet; that is the nature of non-stimulants.
Most people start noticing real effect around the four-week mark, sometimes earlier with Qelbree, sometimes later with atomoxetine. The effect tends to feel less dramatic than stimulants and more like a gradual improvement in baseline function.
Most non-stimulants reach their full therapeutic effect by six to eight weeks. By this point you and your prescriber should have a clear sense of whether the medication is working for you.
Once at steady state, non-stimulants are typically reviewed at three to six month intervals. Daily logging across the first eight weeks gives the prescriber the evidence they need to confirm response.
ADHDose makes the milestone view concrete. Daily logs of focus, sleep, energy and side effects across the titration window show the trajectory clearly, to you, and to your prescriber when review day arrives.