Fluvoxamine

Generic name: fluvoxamine (floo VOX a meen)
Brand name: Luvox, Luvox CR
Dosage forms: oral capsule, extended release (100 mg; 150 mg); oral tablet (100 mg; 25 mg; 50 mg)
Drug class: Selective serotonin reuptake inhibitors

Fluvoxamine is a selective serotonin reuptake inhibitor (SSRI) antidepressant. Fluvoxamine affects chemicals in the brain that may be unbalanced in people with obsessive-compulsive symptoms.

Fluvoxamine is used to treat social anxiety disorder (social phobia), or obsessive-compulsive disorders involving recurring thoughts or actions.

Fluvoxamine may also be used for purposes not listed in this medication guide.

Warnings

You should not take fluvoxamine if you are also using alosetron, pimozide, ramelteon, thioridazine, or tizanidine.

Do not use fluvoxamine within 14 days before or 14 days after you have taken an MAO inhibitor, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, and tranylcypromine.

Some young people have thoughts about suicide when first taking an antidepressant. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor.

Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.

Do not stop using desvenlafaxine without first talking to your doctor.

Before taking this medicine

You should not take fluvoxamine if you are allergic to it, or if you are also using alosetron, pimozide, ramelteon, thioridazine, or tizanidine.

Do not use fluvoxamine within 14 days before or 14 days after you have taken an MAO inhibitor. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

To make sure fluvoxamine is safe for you, tell your doctor if you have ever had:

  • liver or kidney disease;
  • narrow-angle glaucoma;
  • heart disease, high blood pressure, or a stroke;
  • a bleeding or blood clotting disorder;
  • seizures or epilepsy;
  • bipolar disorder (manic depression); or
  • low levels or sodium in your blood (an electrolyte imbalance).

Some medicines can interact with fluvoxamine and cause a serious condition called serotonin syndrome. Be sure your doctor knows if you also take stimulant medicine, opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. Ask your doctor before making any changes in how or when you take your medications.

Some young people have thoughts about suicide when first taking an antidepressant. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Tell your doctor right away if you become pregnant while taking fluvoxamine. Fluvoxamine may cause serious lung problems or other complications in a newborn if you take the medication during late pregnancy. However, you may have a relapse of OCD symptoms if you stop taking fluvoxamine. Do not start or stop taking this medicine during pregnancy without your doctor's advice.

Fluvoxamine can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using fluvoxamine.

Do not give this medicine to anyone under 18 years old without medical advice.

How should I take fluvoxamine?

Fluvoxamine is usually taken at night. Follow all directions on your prescription label. Your doctor may occasionally change your dose. Do not take this medicine in larger or smaller amounts or for longer than recommended.

You may take fluvoxamine with or without food.

Do not crush, chew, break, or open an extended-release capsule. Swallow it whole.

You should not stop using fluvoxamine suddenly. Follow your doctor's instructions about tapering your dose.

Store at room temperature away from moisture and heat. Keep the bottle tightly closed when not in use.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking fluvoxamine?

Drinking alcohol can increase certain side effects of fluvoxamine.

Ask your doctor before taking a nonsteroidal anti-inflammatory drug (NSAID) for pain, arthritis, fever, or swelling. This includes aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib (Celebrex), diclofenac, indomethacin, meloxicam, and others. Using an NSAID with fluvoxamine may cause you to bruise or bleed easily.

Fluvoxamine may impair your thinking or reactions. Avoid driving or operating machinery until you know how fluvoxamine will affect you.

Fluvoxamine side effects

Get emergency medical help if you have signs of an allergic reaction: skin rash, blisters, or hives; fever, joint pain; difficult breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have;

  • anxiety, racing thoughts, risk-taking behavior, sleep problems (insomnia), feelings of extreme happiness or irritability;
  • blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights;
  • seizure (convulsions);
  • changes in weight or appetite;
  • easy bruising or unusual bleeding;
  • low levels of sodium in the body--headache, confusion, memory problems, severe weakness, loss of coordination, feeling unsteady; or
  • severe nervous system reaction--very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, feeling like you might pass out.

Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea

Common side effects may include:

  • drowsiness, dizziness;
  • shaking, feeling anxious;
  • depressed mood;
  • sleep problems (insomnia);
  • upset stomach, gas, loss of appetite;
  • nausea, vomiting, diarrhea;
  • dry mouth, yawning;
  • sore throat;
  • muscle pain;
  • sweating, rash;
  • heavy menstrual periods; or
  • decreased sex drive, abnormal ejaculation, trouble having an orgasm.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Fluvoxamine dosing information

Usual Adult Dose for Obsessive Compulsive Disorder:

Initial immediate-release tablet dose: 50 mg orally once a day at bedtime
Initial extended-release capsule dose: 100 mg orally once a day at bedtime
Maintenance dose: 100 to 300 mg orally per day
Maximum dose: 300 mg/day

Comments:
-The dose may be increased in 50 mg increments every 4 to 7 days, as tolerated, until maximum therapeutic benefit is achieved.
-A total daily dose of more than 100 mg should be given in two divided doses. If the doses are not equal, the larger dose should be given at bedtime.

Use: Treatment of obsessions and compulsions in patients with obsessive compulsive disorder (OCD), as defined in DSM-III-R or DSM-IV

Usual Pediatric Dose for Obsessive Compulsive Disorder:

8 to 11 years:
-Initial dose: 25 mg orally once a day at bedtime
-Maintenance dose: 25 to 200 mg orally per day
-Maximum dose: 200 mg/day

11 to 17 years:
-Initial dose: 25 mg orally once a day at bedtime
-Maintenance dose: 25 to 300 mg orally per day
-Maximum dose: 300 mg/day

Comments:
The dose may be increased in 25 mg increments every 4 to 7 days, as tolerated, up to a maximum daily dose.
-Total daily doses of more than 50 mg should be given in two divided doses. If the two divided doses are not equal, the larger dose should be given at bedtime.
-Lower doses may be effective in female versus male patients.

Use: Treatment of obsessions and compulsions in patients with OCD, as defined in DSM-III-R or DSM-IV