Intuniv vs. Qelbree

See how Intuniv and Qelbree compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Intuniv is approved only for children and adolescents with ADHD, while Qelbree is approved for both children and adults.

  • Both are non-stimulant, once-daily oral medications, but Intuniv can be added to stimulant treatment while Qelbree carries a boxed warning for suicidal thoughts in young people.

  • Intuniv reaches its maintenance dose in 4 weeks, while Qelbree's titration can take up to 5 weeks to reach its highest maintenance dose.

Intuniv vs. Qelbree Drug Summary

Intuniv

Intuniv (guanfacine) is a non-stimulant alpha2A-adrenergic agonist used to treat ADHD in children and adolescents ages 6 to 17. It comes as an extended-release tablet taken once daily, either alone or combined with a stimulant medication.

Qelbree

Qelbree (viloxazine) is a non-stimulant selective norepinephrine reuptake inhibitor used to treat ADHD in both children age 6 and up and adults. It comes as an extended-release capsule taken once daily, and its capsules can be opened and sprinkled on food.

Intuniv vs. Qelbree Side Effects

Intuniv

Most common
somnolence (up to 38%)
fatigue (up to 14%)
headache (up to 24%)
abdominal pain (up to 11%)

Qelbree

Most common
somnolence (up to 16%)
fatigue (up to 12%)
nausea (up to 5%)
decreased appetite (up to 5%)

Intuniv vs. Qelbree Dosage

Intuniv

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 1 mg once daily Week 1
Maximum dose 4 mg once daily Week 4 onward
Dose changes 3 increases Every week

Qelbree

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 100 mg once daily Week 1
Maximum dose 600 mg once daily Week 5 onward
Dose changes 4 increases Every week

Intuniv vs. Qelbree Indications

Intuniv

Intuniv is FDA-approved to treat ADHD in children and adolescents ages 6 to 17, either as a standalone medication or added to a stimulant regimen. It is sometimes prescribed off-label for adults with ADHD, though it has not been studied or approved for that group.

  • ADHD monotherapy in children and adolescents (6-17)

  • Add-on therapy alongside stimulant medications (6-17)

  • Off-label use in adults with ADHD (not FDA-approved)

Qelbree

Qelbree is FDA-approved to treat ADHD in both children ages 6 and older and adults, making it one of the few nonstimulant options approved across the full age range. It was approved in 2021 as the first new nonstimulant ADHD mechanism in over a decade.

  • ADHD treatment in children and adolescents (6 and up)

  • ADHD treatment in adults

  • Non-stimulant option for patients avoiding controlled substances

Intuniv vs. Qelbree Pros and Cons

Intuniv

Intuniv has a long safety record and can be layered onto stimulant treatment for added symptom control, but it is only approved for children and adolescents. Its most common side effects include sedation and a drop in blood pressure, so it needs to be tapered off rather than stopped abruptly.

Pros

  • Longer track record, FDA-approved since 2009

  • Can be added on top of stimulant medications for extra control

  • Titration reaches maintenance dose in just 4 weeks

  • No boxed warning for suicidal thoughts

Cons

  • Not FDA-approved for adults; adult use is off-label

  • Higher rates of somnolence, headache, and hypotension than Qelbree

  • Must be tapered gradually to avoid rebound high blood pressure

  • Cannot be combined with other guanfacine-containing products

Qelbree

Qelbree stands out as a nonstimulant approved for adults as well as children, with a flexible capsule that can be sprinkled on food. It carries a boxed warning for suicidal thoughts in younger patients and involves a longer titration period to reach its higher maintenance doses.

Pros

  • FDA-approved for both adults and children age 6 and up

  • Not a controlled substance

  • Capsule contents can be sprinkled on food for easier swallowing

  • Newer mechanism combining norepinephrine and serotonin modulation

Cons

  • Carries a boxed warning for suicidal thoughts in patients under 25

  • Longer titration schedule, up to 5 weeks to reach top dose

  • Interacts with MAOIs and certain CYP1A2 medications like theophylline

  • No generic version currently available, unlike older guanfacine

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