8 Viibryd Interactions to Watch Out For

Viibryd (vilazodone) is an antidepressant medication for adults. If you’re taking Viibryd, knowing what it interacts with can help you avoid unwanted side effects or other health issues. 

Viibryd is broken down by certain enzymes (proteins) in the liver. Medications that increase or decrease levels of this enzyme can affect how well Viibryd works or raise your risk of side effects.

Here, we’ll cover eight key Viibryd interactions you should be aware of. Keep in mind, this isn’t a complete list of all possible interactions. So be sure to review your medication list with your healthcare team before starting Viibryd to check for any others.

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1. Blood thinners

Viibryd can raise your risk of bleeding. This risk is higher if Viibryd is combined with other medications that raise your bleeding risk, such as blood thinners.

Blood thinners are medications that treat and prevent blood clots. They include anticoagulant and antiplatelet medications, such as:

• Apixaban (Eliquis)

• Rivaroxaban (Xarelto)

• Warfarin (Coumadin, Jantoven)

• Low-dose aspirin

• Clopidogrel (Plavix)

Let your prescriber know if you take a blood thinner before starting Viibryd (or vice versa). In most cases, it’s safe to take these medications together as long as your prescriber OKs it. But you’ll need to keep an eye out for signs of bleeding, such as nosebleeds or bleeding gums when you brush your teeth. Let your healthcare team know if these symptoms occur.

Signs of serious bleeding, such as blood in your urine or stool, bruising that doesn’t heal, or coughing up blood, require emergency medical care.

2. NSAIDs

Nonsteroidal anti-inflammatory drugs (NSAIDs) are medications that reduce pain, fever, and swelling. Popular over-the-counter (OTC) NSAIDs include ibuprofen (Advil, Motrin) and naproxen (Aleve). Like blood thinners, NSAIDs can raise your risk of bleeding. And taking them with Viibryd raises your bleeding risk even more.

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It may be fine to combine these medications every now and then. But high doses or taking NSAIDs regularly isn’t recommended. It’s best to check with a healthcare professional before taking an NSAID if you’re taking Viibryd. They can let you know if it’s OK or recommend a safer option, such as acetaminophen (Tylenol).

3. Other antidepressants

Viibryd is an antidepressant that works in part by boosting serotonin levels in your brain. Serotonin is a chemical messenger that plays a key role in regulating your mood and behavior. But too much serotonin can be toxic and lead to a condition called serotonin syndrome. 

Viibryd isn’t likely to cause serotonin syndrome by itself. But taking it with other medications that increase serotonin levels can raise your risk. This includes other antidepressants, such as:

• Selective serotonin reuptake inhibitors (SSRIs), such as sertraline (Zoloft)

• Tricyclic antidepressants, such as amitriptyline

• Serotonin and norepinephrine reuptake inhibitors (SNRIs), such as venlafaxine (Effexor)

• Monoamine oxidase inhibitors (MAOIs), such as selegiline (Emsam, Zelapar)

You should never combine Viibryd with an MAOI. In fact, you need to wait 14 days if you’re switching between these medications to ensure they aren’t in your system at the same time. 

But in some cases, your prescriber may recommend another type of antidepressant along with Viibryd. In this case, keep an eye out for signs of serotonin syndrome and seek medical care if they occur. This includes increased sweating, a fast heart rate, and tremors. Confusion, agitation, and seizures are also possible in severe cases.

4. St. John’s wort

St. John’s wort is an herbal supplement that’s thought to help with depression. However, it can interact with many medications, including Viibryd.

St. John’s wort can interact with Viibryd in two different ways:

• St John’s wort raises serotonin levels, which can raise the risk of serotonin syndrome if it’s taken with Viibryd.

• St. John’s wort can lower Viibryd levels in the body, which may make it less effective.

It’s recommended to avoid taking St. John’s wort with Viibryd. You should check with your pharmacist before taking any OTC supplements with Viibryd to make sure they’re safe.

5. Digoxin

Digoxin (Lanoxin) is a medication that treats certain heart-related conditions. It has a narrow therapeutic index, meaning there’s a fine line between safe and toxic levels in the body.

Viibryd can increase digoxin levels in your body if they’re taken together. This can lead to side effects such as blurry vision, upset stomach, or even digoxin toxicity.

If you take both Viibryd and digoxin, your healthcare team will likely keep a close eye on your digoxin levels and adjust your dose if needed to keep them within a safe range. So keeping your appointments is crucial for your safety.

6. Some oral antifungals

Some oral antifungal medications can also interact with Viibryd. Examples include itraconazole (Sporanox) and voriconazole (Vfend). They can raise the levels of Viibryd in your body, making side effects more likely.

You may need a lower Viibryd dosage while you’re taking an oral antifungal. Your prescriber will let you know if you need to make any changes. Just be sure they’re aware of your current medications.

7. Certain antibiotics

Some antibiotics can also cause Viibryd interactions. Examples are clarithromycin (Biaxin XL), erythromycin, and rifampin (Rifadin).

Rifampin can lower Viibryd levels, which may make it less effective. You may need a higher Viibryd dosage if you need to take rifampin for more than 2 weeks.

Clarithromycin and erythromycin have the opposite effect. They can increase Viibryd levels in your body, raising the risk of side effects.

If you need antibiotics for a bacterial infection, make sure your healthcare team knows you’re taking Viibryd. They may want to choose an option that doesn’t interact. Or they may adjust your Viibryd dosage if needed. Be sure to follow their directions carefully.

8. Grapefruit

Grapefruit and grapefruit juice can interact with many medications, including Viibryd. This interaction can increase Viibryd levels and raise your risk of side effects.

It’s best to avoid grapefruit products while you’re taking Viibryd. But if they’re part of your regular diet, talk to your prescriber. They may want to switch you to an antidepressant that’s less likely to interact with it.

Can you drink alcohol while taking Viibryd?

It’s best to avoid alcohol while you’re taking Viibryd or other antidepressants. Alcohol can worsen dizziness and drowsiness caused by Viibryd. It can also make side effects like nausea and headache more likely. What’s more, alcohol can worsen depression symptoms, so it may work against Viibryd’s effects on your mental health.

If you’re not OK with avoiding alcohol while taking Viibryd, let your prescriber know. They can talk to you about other options and provide support to help you reduce your drinking, if needed.

Is it OK to have caffeine while taking Viibryd?

Caffeine can interact with tricyclic antidepressants and some antipsychotic medications. But that doesn’t seem to be the case with Viibryd, so the combination is likely safe.

Keep in mind that Viibryd can cause nausea and diarrhea, especially when you first start taking it. And caffeine may worsen these side effects. So you may want to cut back on coffee or separate Viibryd from caffeine by a few hours to avoid this.

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Written by:

Patricia Weiser, PharmD

Patricia has 16 years of pharmacist experience. She previously held positions as a community pharmacist, pharmacy manager, and hospital pharmacist.

Edited by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

Reviewed by:

Renad Abu-Sawwa, PharmD, BCPPS

Renad Abu-Sawwa, PharmD, BCPPS, is an associate professor and associate discipline director of clinical pharmacology at Rush Medical College with a practice site as a clinical pharmacy specialist practitioner at RUSH Children's Hospital in the Pediatric Epilepsy Clinic.

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