Trintellix

The recommended dose of Trintellix (Vortioxetine) for adults less than 65 years of age is 10 mg taken once daily. For adults 65 years of age or older the starting dose is 5 mg taken once daily. Depending on how well it works for you and the level of side effects you experience, your doctor may suggest that you increase the dose to a maximum of 20 mg daily.

Trintellix (Vortioxetine) may be taken with or without food.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take Trintellix (Vortioxetine) exactly as prescribed by your doctor.

If you miss a dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store Trintellix (Vortioxetine) at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

In addition to its desired action, this medication may cause some adverse effects, notably: it may cause dryness of the mouth; it may cause diarrhea or constipation, depending on the person; it may cause dizziness - use caution when getting up from a lying or sitting position and use caution if driving; it may cause nausea and vomiting. Each person may react differently to a treatment. If you think this medication may be causing adverse effects (including those described here, or others), talk to your health care professional. He or she can help you to determine whether or not the medication is the source of the problem.

5 mg
Each pink, almond-shaped, biconvex film-coated tablet engraved with "TL" on one side and "5" on the other side contains 6.355 mg of Trintellix (Vortioxetine) hydrobromide equivalent to 5 mg of Trintellix (Vortioxetine). Nonmedicinal ingredients: hydroxypropylcellulose, hypromellose, iron oxide red, Macrogol 400, magnesium stearate, mannitol, microcrystalline cellulose, sodium starch glycolate (Type A), and titanium dioxide (E 171).

10 mg
Each yellow, almond-shaped, biconvex, film-coated tablet engraved with "TL" on one side and "10" on the other side contains 12.71 mg of Trintellix (Vortioxetine) hydrobromide equivalent to 10 mg of Trintellix (Vortioxetine). Nonmedicinal ingredients: hydroxypropylcellulose, hypromellose, iron oxide yellow, Macrogol 400, magnesium stearate, mannitol, microcrystalline cellulose, sodium starch glycolate (Type A), and titanium dioxide (E 171).

15 mg
Each orange, almond-shaped, biconvex, film-coated tablet engraved with "TL" on one side and "15" on the other side contains 19.065 mg of Trintellix (Vortioxetine) hydrobromide equivalent to 15 mg of Trintellix (Vortioxetine). Nonmedicinal ingredients: hydroxypropylcellulose, hypromellose, iron oxide red, iron oxide yellow, Macrogol 400, magnesium stearate, mannitol, microcrystalline cellulose, sodium starch glycolate (Type A), and titanium dioxide (E 171).

20 mg
Each red, almond-shaped, biconvex, film-coated tablet engraved with "TL" on one side and "20" on the other side contains 25.42 mg of Trintellix (Vortioxetine) hydrobromide equivalent to 20 mg of Trintellix (Vortioxetine). Nonmedicinal ingredients: hydroxypropylcellulose, hypromellose, iron oxide red, Macrogol 400, magnesium stearate, mannitol, microcrystalline cellulose, sodium starch glycolate (Type A), and titanium dioxide (E 171).

Do not take Trintellix (Vortioxetine) if you:

• are allergic to Trintellix (Vortioxetine) or any ingredients of the medication
• are taking an MAO inhibitor (e.g., Phenelzine, Tranylcypromine, Moclobemide) or have taken an MAO inhibitor within the past 2 weeks (do not start treatment with an MAO inhibitor until at least 3 weeks after stopping Trintellix (Vortioxetine) treatment)

There may be an interaction between Trintellix (Vortioxetine) and any of the following:

• Abiraterone
• acetylsalicylic acid (ASA)
• alcohol
• Amiodarone
• amphetamines (e.g., Dextroamphetamine, Lisdexamfetamine)
• antihistamines (e.g., cetirizine, doxylamine, Diphenhydramine, Hydroxyzine, Loratadine)
• anti-psychotics (e.g., Chlorpromazine, Clozapine, Haloperidol, Olanzapine, Quetiapine, Risperidone)
• Apalutamide
• Apixaban
• asunaprevir
• barbiturates (e.g., butalbital, pentobarbital, Phenobarbital)
• benzodiazepines (e.g., Alprazolam, Diazepam, Lorazepam)
• beta-adrenergic blockers (e.g., Atenolol, Propranolol, Sotalol)
• Bosentan
• Bromocriptine
• Bupropion
• Buspirone
• Cabergoline
• Celecoxib
• chloral hydrate
• chloroquine
• Cimetidine
• Cinacalcet
• clopidogrel
• Cobicistat
• cocaine
• dabigatran
• Darifenacin
• Deferasirox
• Desmopressin
• Dexamethasone
• Dextromethorphan
• Diabetes medications (e.g., chlorpropamide, Glyburide, insulin, Metformin, Rosiglitazone)
• dipyridamole
• Disopyramide
• Dronedarone
• Edoxaban
• Enzalutamide
• ergot alkaloids (e.g., ergotamine, Dihydroergotamine)
• Galantamine
• glucosamine
• Heparin
• HIV non-nucleoside reverse transcriptase inhibitors (NNRTIs; e.g., delavirdine, efavirenz, etravirine, nevirapine)
• HIV protease inhibitors (e.g., atazanavir, indinavir, ritonavir, saquinavir)
• isoniazid
• ketoconazole
• Lanreotide
• Linezolid
• lithium
• low molecular weight heparins (e.g., Dalteparin, Enoxaparin, Tinzaparin)
• macrolide antibiotics (e.g., clarithromycin, erythromycin)
• Methylphenidate
• Metoclopramide
• Methadone
• Mexiletine
• mifepristone
• Mirabegron
• Mirtazapine
• Mitotane
• Modafinil
• monoamine oxidase inhibitors (M.O.S. e.g., moclobemide, phenelzine, Rasagiline, Selegiline, tranylcypromine)
• muscle relaxants (e.g., Baclofen, Cyclobenzaprine, methocarbamol, orphenadrine, Tizanidine)
• narcotic pain relievers (e.g., Codeine, Fentanyl, Morphine, Oxycodone)
• non-steroidal anti-inflammatory medications (NSAIDs; e.g., Diclofenac, ibuprofen, naproxen)
• Obinutuzumab
• Octreotide
• Olopatadine
• omega-3 fatty acids
• Pasireotide
• pentamidine
• Pentoxifylline
• Pimozide
• Prasugrel
• quinidine
• quinine
• rifabutin
• rifampin
• Rivaroxaban
• St. John's wort
• scopolamine
• seizure medications (e.g., Carbamazepine, Clobazam, Levetiracetam, phenobarbital, Phenytoin, primidone, Topiramate, Valproic acid, zonisamide)
• selective serotonin reuptake inhibitors (SSRIs; e.g., Citalopram, Fluoxetine, Paroxetine, Sertraline)
• serotonin antagonists (anti-emetic medications; e.g., Granisetron, Ondansetron)
• serotonin/norepinephrine reuptake inhibitors (SNRIs; e.g., Desvenlafaxine, Duloxetine, Venlafaxine)
• sulfonamide antibiotics ("sulfas"; e.g., sulfisoxazole, sulfamethoxazole)
• Tapentadol
• terbinafine
• thiazide diuretics (water pills; e.g., Hydrochlorothiazide, Indapamide, Metolazone)
• Thyroid replacements (e.g., desiccated thyroid, Levothyroxine)
• Ticagrelor
• Ticlopidine
• Tocilizumab
• Tramadol
• Trazodone
• tricyclic antidepressants (e.g., Amitriptyline, Clomipramine, Desipramine, Trimipramine)
• "triptan" migraine medications (e.g., Eletriptan, Sumatriptan)
• Tryptophan
• certain tyrosine kinase inhibitors (e.g., Dabrafenib, imatinib, Nilotinib)
• vitamin E
• warfarin
• Zolpidem
• Zopiclone

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Trintellix (Vortioxetine). Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Trintellix (Vortioxetine).

Abnormal bleeding: Trintellix (Vortioxetine), like other similar medications, may cause abnormal bleeding, including bleeding in the stomach or intestines. People who have or have had a history of bleeding disorders should discuss with their doctor how Trintellix (Vortioxetine) may affect their medical condition, how their medical condition may affect the dosing and effectiveness of Trintellix (Vortioxetine), and whether any special monitoring is needed.

Report any unusual bruising or bleeding to your doctor, especially if you are taking other medications that affect blood clotting. These medications include acetylsalicylic acid (Asa), Clopidogrel, Dipyridamole, nonsteroidal anti-inflammatory drugs (NSAIDs; e.g., Ibuprofen or Naproxen), other anticoagulant medications (e.g., Warfarin), and certain antipsychotic medications.

Bone health: Like other similar medications, Trintellix (Vortioxetine) may increase the risk of bone fracture, especially if you are a senior or have Osteoporosis or other major risk factors for breaking a bone. Your doctor may monitor your bones while you are taking Trintellix (Vortioxetine).

Drowsiness/reduced alertness: Although Trintellix (Vortioxetine) is not known to cause drowsiness, avoid driving, operating machinery, or performing other hazardous tasks until you have determined how Trintellix (Vortioxetine) affects you.

Glaucoma: Trintellix (Vortioxetine) can cause an increase in the pressure in the eye, making symptoms of glaucoma worse. If you have narrow-angle glaucoma, discuss with your doctor how Trintellix (Vortioxetine) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Trintellix (Vortioxetine), and whether any special monitoring is needed.

Liver function: Liver disease or reduced liver function may cause Trintellix (Vortioxetine) to build up in the body, causing side effects. If you have liver problems, discuss with your doctor how Trintellix (Vortioxetine) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Trintellix (Vortioxetine), and whether any special monitoring is needed. Your doctor may want to test your liver function regularly with blood tests while you are taking Trintellix (Vortioxetine).

Trintellix (Vortioxetine) is not recommended for people with severe liver disease.

If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.

Mania: Trintellix (Vortioxetine) may cause symptoms of mania to worsen or return. If you have a history of mania or bipolar disorder, discuss with your doctor how Trintellix (Vortioxetine) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Trintellix (Vortioxetine), and whether any special monitoring is needed.

Seizures: Medications to treat depression may cause an increased risk of seizures. If you have a history of seizures, discuss with your doctor how Trintellix (Vortioxetine) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Trintellix (Vortioxetine), and whether any special monitoring is needed. Anyone who develops seizures should seek immediate medical attention.

Serotonin syndrome: Severe reactions are possible when Trintellix (Vortioxetine) is combined with other medications that act on serotonin, such as tricyclic antidepressants, "triptan" medications for migraine, and some medications to treat nausea due to chemotherapy. These combinations should be avoided. Symptoms of a reaction may include muscle rigidity and spasms, difficulty moving, and changes in mental state including delirium and agitation. Coma and death are possible.

If you are taking other medications that affect serotonin, discuss with your doctor how Trintellix (Vortioxetine) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Trintellix (Vortioxetine), and whether any special monitoring is needed.

Stopping the medication: Stopping Trintellix (Vortioxetine) suddenly may lead to side effects such as dizziness, abnormal dreams, numbness or tingling sensations, agitation, anxiety, nausea, vomiting, sweating, or other symptoms. If you are thinking of stopping the medication, check with your doctor first. Your doctor may want you to decrease the dose of the medication gradually when it is time to stop taking Trintellix (Vortioxetine).

Suicidal or agitated behaviour: People taking Trintellix (Vortioxetine) may feel agitated (restless, anxious, aggressive, emotional, and feeling not like themselves), or they may want to hurt themselves or others. These behavioural changes may be more likely to occur in children and adolescents, but they are possible for all age groups that use Trintellix (Vortioxetine). These symptoms may occur within several weeks after starting Trintellix (Vortioxetine). If you experience these side effects or notice them in a family member who is taking Trintellix (Vortioxetine), contact your doctor immediately. You should be closely monitored by your doctor for emotional and behaviour changes while taking Trintellix (Vortioxetine).

Pregnancy: Trintellix (Vortioxetine) should not be used during pregnancy unless the benefits outweigh the risks. It has also been reported that babies born to women who took medications similar to Trintellix (Vortioxetine) during the last trimester of their pregnancy may experience adverse effects (such as breathing problems, seizures, trouble feeding, vomiting, low blood sugar, shaking, jitteriness, irritability, and constant crying) that result in an increase in the length of hospital stay. If you become pregnant while taking Trintellix (Vortioxetine), contact your doctor immediately.

Breast-feeding: Trintellix (Vortioxetine) passes into breast milk. If you are a breast-feeding mother and are taking Trintellix (Vortioxetine), it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of Trintellix (Vortioxetine) for people less than 18 years of age have not been established. The use of Trintellix (Vortioxetine) by children and adolescents less than 18 years old may cause behavioural and emotional changes, such as suicidal thoughts and behaviour.

Seniors: There is limited information about the safety of seniors using Trintellix (Vortioxetine). If you are over 65 and using Trintellix (Vortioxetine), lower doses are recommended.

This medication is typically used only once a day. However, your pharmacist may have suggested a different schedule that is more appropriate for you. Important: Follow the instructions on the label. Do not use more of this product, or more often, than prescribed. It must be used regularly and continuously to maintain its beneficial effects. Be sure to keep an adequate supply on hand. It is not advisable to stop using this product suddenly, particularly if you have been on it for several weeks. If you are considering stopping the medication, talk to your pharmacist first. If you forget a dose, take it as soon as you remember -- unless it is almost time for your next dose. In that case, skip the missed dose. Do not double the next dose to catch up. This medication may be taken with or without food. Consuming alcohol may intensify the effect of this product. Limit alcohol consumption to occasional small quantities.