Qelbree Vs Strattera: How Do They Compare?

What Is Qelbree (Viloxazine)?

Qelbree (viloxazine) is a new medication, FDA-approved for use in 2021, to treat attention deficit hyperactivity disorder (ADHD) in patients ages six years and older. A medication approved by the Food and Drug Administration (FDA) means that the drug underwent rigorous testing to ensure it is a safe and effective treatment for a specific indication.

Qelbree is the brand name medication that includes the active ingredient viloxazine. This medication belongs to the selective norepinephrine reuptake inhibitor (SNRI) drug class. This class of medications works to increase the amount of a neurotransmitter in the brain known as norepinephrine.¹

Off-label indications are uses for medications that are not directly approved by the FDA. The practitioner may prescribe this medication for alternate conditions based on new research showing a proven benefit for the patient. Qelbree currently has no off-label uses.¹

What Is Strattera (Atomoxetine)?

Strattera (atomoxetine) is an FDA-approved medication to treat ADHD. Strattera is the original brand name product that contains the active ingredient atomoxetine. Several FDA-approved generic versions of Strattera have been available since 2017.³ A generic medication has the same active ingredient and clinical effectiveness as the brand product but cannot be produced under the original manufacturer’s brand name.

Strattera belongs to the same drug class as Qelbree, known as SNRIs. Strattera and Qelbree work in the same way to treat and improve ADHD symptoms and behaviors.² Strattera has off-label uses for adult treatment-resistant depression and neurogenic orthostatic hypotension (low blood pressure when changing positions from sitting to standing). Although it may be beneficial for these uses, more research is still needed to determine if Strattera is safe for these indications.^{2, 4}

What Are the Differences Between Qelbree & Strattera?

Qelbree and Strattera are approved medications used for the treatment of ADHD, but they have some differences, including how long the medication lasts in the body and dosing.

Here are the key differences between Qelbree versus Strattera:^{1, 2}

How Do Qelbree Vs. Strattera Work?

Both Qelbree and Strattera work by affecting the activity of a neurotransmitter known as norepinephrine, a brain chemical that is critical for communicating signals within the body. The exact mechanism of how these medications work to help ADHD is not known, but it is theorized that the increase of norepinephrine in the brain helps improve focus and helps control symptoms of ADHD.^{1, 2, 5}

How Effective Are Qelbree Vs Strattera at Treating ADHD?

Both Qelbree and Strattera are clinically proven to be effective treatments for ADHD when compared to placebo treatment.

Are Qelbree & Strattera the Same?

While similar, Qelbree and Strattera do not have the same active ingredient. However, they do work to treat ADHD in the same way. Both medications have similar effectiveness, side effects, and tolerability. The main differences between Qelbree and Strattera are the price and daily dosing.

Is Viloxazine Better Than Atomoxetine?

With limited data available, it is challenging to directly compare the two medications. A recent study provided some evidence for a better response with Qelbree compared to Strattera. This is especially true if the patient had a poor initial response to Strattera. As of now, we can not conclude which medication performs better, so it is important to consider which one is right for you when talking with your prescriber and pharmacist about treatment options.⁶

What Are Qelbree & Strattera Used to Treat?

Qelbree and Strattera are both FDA-approved treatments for ADHD. Currently, Qelbree has no off-label uses. However, Strattera does have a few off-label uses, such as adult treatment-resistant depression and neurogenic orthostatic hypotension. Although it may be beneficial for these uses, more research is still needed to determine if Strattera is safe for these off-label indications. Be sure to discuss with your prescriber and pharmacist if you’re interested in using Strattera for off-label use.

The table below compares the medical and mental health conditions Qelbree & Strattera are used to treat:^{1, 2, 4}

Which Is Better for ADHD, Qelbree or Strattera?

Both Qelbree and Strattera are non-stimulant ADHD medications proven to be effective in treating ADHD. In both pediatric and adult clinical research trials, Strattera proved to be effective in reducing symptoms and behaviors of ADHD when compared to placebo treatment. Similarly, Qelbree in both the pediatric and adult clinical trials also proved to be effective in reducing symptoms and behaviors of ADHD compared to placebo.

There is new research showing patients may be able to tolerate Qelbree better with fewer side effects than Strattera, but we cannot definitively draw conclusions due to minimal evidence. Overall, there is limited data comparing the efficacy of the two medications since both have the same mechanism for treating ADHD, and Qelbree is a relatively new treatment.^{1, 2, 6}

Qelbree Vs. Strattera Dosages

Starting Qelbree doses range from 100 mg to 200 mg once daily, depending on the age of the patient. Qelbree is dosed once daily. After a week of taking the starting dose, your prescriber may increase the daily dose to the maximum dose that is tolerable and effective for the patient. It is important to take the medication as directed by your prescriber and pharmacist in order to achieve the full intended effect.¹

Qelbree is available in the following forms and strengths:¹

• 100 milligrams (mg) oral capsule
• 150 mg oral capsule
• 200 mg oral capsule

Strattera is dosed once to twice daily. Starting Strattera dosages range from 0.5 mg/kg to 40 mg, depending on the weight and age of the patient. After at least three days of taking the initial dose, the provider may increase the daily dose to the maximum dose that is effective and tolerable for the patient. The daily dose can also be split into morning and evening dosing to help lengthen the amount of time the medicine is effective. It is important to take the medication as directed by your doctor and pharmacist.²

Strattera is available in the following forms and strengths:²

• 10 mg oral capsule
• 18 mg oral capsule
• 25 mg oral capsule
• 40 mg oral capsule
• 60 mg oral capsule
• 80 mg oral capsule
• 100 mg oral capsule

Side Effects of Qelbree Vs. Strattera

Side effects of Qelbree and Strattera are similar because both of their active drug ingredients belong to the same drug class. Common side effects that occur with both medications include decreased appetite, dry mouth, and fatigue. Most of the commonly experienced side effects are mild; however, some may need medical attention. Discuss with your doctor or pharmacist about any concerning or serious side effects that may occur.

Common side effects from taking Qelbree may include:*¹

• Insomnia
• Headache
• Decreased appetite
• Dry mouth
• Fatigue
• Irritability
• Weight loss

Serious side effects from taking Qelbree may include:*¹

• Increased blood pressure and heart rate
• Suicidal thoughts and behaviors
• Activation of mania or hypomania
• Somnolence and fatigue

Common side effects from taking Strattera may include:*²

• Abdominal pain
• Nausea/vomiting
• Dry mouth
• Decreased appetite
• Constipation
• Extreme drowsiness and fatigue
• Urinary hesitancy
• Sexual dysfunction

Serious side effects from taking Strattera may include:*²

• Severe liver injury
• Suicidal thoughts or behaviors
• Serious cardiovascular events
• Severe allergic reaction

*All medications, including Strattera and Qelbree, have a risk of side effects, including serious side effects. This is not a complete list of side effects. You should talk with your prescriber and pharmacist about the benefits and risks of any medication before starting treatment.

Warnings & Precautions for Qelbree & Strattera

While taking Qelbree or Strattera, it is important to be aware of severe reactions and conditions that can occur with use of the medication. While most of the conditions are rare, if you experience any symptoms, seek medical care immediately as many conditions are or could become life-threatening.

Risks to consider when taking Qelbree & Strattera include:^{1, 2}

• Suicidal thoughts and behaviors: Both medications have boxed warnings indicating the risk for increased suicidal thoughts and behaviors. It is important to monitor yourself or your child for these behaviors and seek medical attention if you or your child are experiencing any new or life-threatening thoughts or behaviors.
• Allergic reaction: A risk of mild to severe allergic reactions with Strattera (has been reported. During clinical testing of Qelbree, no reports of an allergic reaction occurred. Symptoms of an allergic reaction include itching, hives, rash, and swelling of the eyes, mouth, or throat. Seek immediate medical attention if you or your child experience any signs of a life-threatening anaphylaxis reaction like swelling of the mouth, tongue, or airway.
• Blood pressure and heart rate increases: Qelbree and Strattera have both shown possible effects of increasing blood pressure or heart rate. These medications should be used with caution in children and adults with underlying diseases that could worsen with increases in blood pressure or heart rate. Your doctor should evaluate you or your child for any heart issues before stating Qelbree or Strattera. Talk with your doctor if you experience any new or worsening heart issues while taking these medications.
• Screening for bipolar disorder: Before starting Qelbree or Strattera, your provider should screen you or your child for bipolar disorder. Both medications can cause an increased risk of developing mania or mixed episodes while taking.
• Drowsiness and fatigue: Qelbree has reported side effects causing sedation and lethargy (lack of energy and enthusiasm). Before knowing how the medication affects you or your child, activities that require mental alertness should be avoided, such as using or operating any motor vehicles or heavy machinery.
• Severe liver injury: While rare and not present in the original clinical trials for approval, post-market research has shown Strattera possibly being connected to cases of severe liver injury and failure. Patients who show signs of jaundice (yellowing of eyes or skin) or liver injury while taking Strattera should stop taking the medication and never restart Strattera in the future.

Potential Drug Interactions With Qelbree & Strattera

Both Qelbree and Strattera can have serious interactions with medications such as isocarboxazid, phenelzine, selegiline, and tranylcypromine. These medications are known as monoamine oxidase inhibitors (MAOIs). Taking these medications too close together can cause serious and sometimes fatal effects. These medications should be separated by at least two weeks to prevent any interactions. Make sure to discuss all medications you are currently taking with your prescriber and pharmacist.

Taking Strattera with known CYP2D6 inhibitors like paroxetine, fluoxetine, or quinidine can increase the amount of Strattera present in the blood. This could lead to higher than normal levels of Strattera, causing more side effects than usual. Similarly, Qelbree is a strong inhibitor of CYP1A2, which can cause interactions with other medications and supplements. It is important to let your prescriber and pharmacist know what medications and supplements you or your child are currently taking before starting Qelbree or Strattera.^{1, 2}

Disclaimer: Taking certain medications, herbs, or supplements alongside Qelbree & Strattera can change how these medications work in your body or increase the risk of serious side effects. This article does not consider all the possible interactions. Please let your doctor, psychiatrists, and pharmacists know about all the products you currently use, such as prescription medication, nonprescription drugs, and herbal supplements. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

Qelbree Vs. Strattera Cost

The cost of a one month supply of Qelbree without insurance is between $300 to $400 dollars. One month’s supply of generic Strattera without insurance will cost between $100 to $140 dollars. Strattera is an older medication that is available as a generic option, which means it can be manufactured by multiple companies without the brand name.

Having a generic version usually helps bring down the cost of the medication relative to the original brand name price. Generic drugs are also usually preferred and covered by most insurance policies. This means generic Strattera would most likely be the cheaper option of the two for those with and without insurance. There are also coupons and discount programs for both medications to help reduce costs.

Qelbree has discount programs for those with private prescription insurance. This discount program will help cover some of the costs if your insurance does not cover the medication or the medication is still too expensive. Be sure to discuss any cost issues with your prescriber or pharmacist when choosing or continuing a new treatment.^{7, 8}

Which Is Right for You: Qelbree or Strattera?

You may need to consider many factors when deciding whether Qelbree or Stratter is right for you or your child. While Qelbree and Strattera are very similar medications, there are big differences between cost, availability, and dosing.

Qelbree is new and only currently available as a brand-name product. Many health insurances will not cover the cost of brand name medications without prior authorization (additional steps needed from insurance companies), making it a more difficult and expensive option sometimes. It also may not be available at your local pharmacy due to availability and cost.

Strattera is an older medication that is available as a generic option which is usually covered by most insurances. Generic Strattera (atomoxetine) is a cheaper alternative for both those with or without insurance. However, Strattera is usually dosed twice daily to reduce the amount of the drug taken at one time. Splitting the daily dose into two doses helps reduce side effects. For some, Strattera may be well-suited as a treatment for adults with ADHD.

For some patients, like children, twice daily dosing is not convenient. Qelbree is a once-daily dose in the morning and may be a more suitable ADHD treatment for children. When discussing these options with your provider, it is important to consider which one is best for you based on cost and dosing preferences.

How to Get a Prescription for Qelbree & Strattera

Qelbree and Strattera are only available through prescription by a psychiatrist or primary care doctor. The doctor will evaluate you or your child for signs or symptoms of ADHD during an office visit or an online psychiatric visit. If the provider decides medication could be of benefit, a discussion will take place to decide which medication would be the best fit.

After beginning either Qelbree or Strattera, regular check-ins with your prescriber will be encouraged. These check-ins will help your prescriber evaluate how well the medication is working for you. If your prescriber is unable to see you regarding psychiatric evaluations and you are unable to see a practitioner at a psychiatric care facility, online psychiatry services are available and may be of help.

Questions to Ask Your Health Team About Qelbree Vs. Strattera

When deciding the best treatment for you or your child, it is important to be open with the provider about concerns you have about new treatment options. Talk with the provider about potential benefits, minor and severe side effects, and other options available. Being open with your provider about preferences and personal lifestyle choices will help them choose the best treatment for you or your child.

Questions to ask your prescriber about Qelbree & Strattera include:

• Is it safe to take Qelbree & Strattera with my other medications?
• Will Qelbree & Strattera be covered by my prescription insurance?
• Will Qelbree & Strattera discount cards work with my prescription insurance?
• Which one has the best results as a treatment for ADHD?
• Does my medical history increase my risk of side effects for either Qelbree or Strattera?
• Does Qelbree or Strattera have worse side effects?
• How long can I expect side effects to last for Qelbree or Strattera?
• How often should I see you for checkups while taking Qelbree & Strattera?
• What should I do if I am unsure whether stimulant or non-stimulant medications for ADHD are right for me?
• Can I take Qelbree or Strattera while pregnant or breastfeeding?
• Are there discounts or coupons for Qelbree to help me save money on my prescription?