Systemic total exposure (AUC) of Caffeine w/ ADHD Meds

Medical Q&A [Moderated]
1

Howdy Docs,

I was recently prescribed Qelbree (Viloxazine) for ADHD (sNRI extended-release) yesterday, and typically consume ~400-600mg of caffeine from coffee per day.

After finding these two publications listed below from this year, and knowing little to none about the medical terminology used… my understanding is that the duration of caffeine is extended five-fold and therefore potentially contributes to the insomnia side-effects of the Qelbree medication. If this is the case, I’m wondering how important it would be to limit caffeine or cut it out entirely (ideally limit, as I love my coffee and its stimulant effects). I’m only on day 2 of medication after a very poor night’s sleep, and I’m hesitant to drink my normal dose of caffeine moving forward: typically 200mg twice within first 3 hours of waking, and frequently (4-5x weekly) a 2:30pm cup for 200mg. Am I understanding this correctly?

  1. Evaluating the Impact of Caffeine on the Incidence of Adverse Events During Treatment with Viloxazine Extended-Release (Qelbree®) in Adults with ADHD | CNS Spectrums | Cambridge Core

  2. Page 13, Figure 3: https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/211964s000lbl.pdf

2

As a strong 1A2 inhibitor, it would be expected to reduce the metabolism of caffeine (and thus increase the duration of exposure).

However, regardless of all these scientific data, if I were in your situation I would worry a bit less about these papers and simply experiment with my own intake to see how I respond as an individual (rather than as a research group average).

3

Noted. And fair enough, that seems a reasonable approach. Greatly appreciate your time and response!