FLUVOXAMINE

COMMON BRAND NAME(S): Luvox

GENERIC NAME(S): FLUVOXAMINE MALEATE

 

Description: Fluvoxamine is an selective serotonin receptor inhibitor that restores the balance of serotonin and helps to decrease obsessive or compulsive behavior.

Pharmacokinetics:

Absorption: Readily absorbed from the GI tract (oral).

Distribution: Protein-binding: 80%.

Metabolism: Extensively hepatic by oxidative demethylation and deamination to inactive metabolites.

Excretion: Urine; 15 hr (elimination half-life).

Fluvoxamine is used to treat obsessive-compulsive disorder (OCD). It helps decrease persistent/unwanted thoughts (obsessions) and urges to perform repeated tasks (compulsions such as hand-washing, counting, checking) that interfere with daily living.

 

OTHER USES:

This medication may also be used to treat anxiety disorders, depression, and post-traumatic stress disorder.

 

This is a prescription only drug.

 

How to use fluvoxamine

Read the Medication Guide and, if available, the Patient Information Leaflet provided by your pharmacist before you start taking fluvoxamine and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

 

Take this medication by mouth with or without food as directed by your doctor, usually once daily at bedtime, or twice daily (once in the morning and once at bedtime). If you are taking this medication twice daily and the doses are not equal, then the larger of the 2 doses should be taken at bedtime.

 

The dosage is based on your medical condition, response to treatment, age, and other medications you may be taking. Be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products). In children, the dosage may also be based on their age and gender. To reduce your risk of side effects, your doctor may direct you to start this medication at a low dose and gradually increase your dose. Follow your doctor’s instructions carefully.

 

Do not increase your dose or use this drug more often or for longer than prescribed. Your condition will not improve any faster, and your risk of side effects will increase. Take this medication regularly to get the most benefit from it. To help you remember, take it at the same time(s) each day.

 

It is important to continue taking this medication even if you feel well. Do not stop taking this medication without consulting your doctor. Some conditions may become worse when this drug is suddenly stopped. Also, you may experience symptoms such as mood swings, headache, tiredness, sleep changes, and brief feelings similar to electric shock. To prevent these symptoms while you are stopping treatment with this drug, your doctor may reduce your dose gradually. Consult your doctor or pharmacist for more details. Report any new or worsening symptoms immediately.

 

It may take up to several weeks before you get the full benefit of this drug.

 

Tell your doctor if your condition does not improve or if it worsens.

Antidepressant medications are used to treat a variety of conditions, including depression and other mental/mood disorders. These medications can help prevent suicidal thoughts/attempts and provide other important benefits. However, studies have shown that a small number of people (especially people younger than 25) who take antidepressants for any condition may experience worsening depression, other mental/mood symptoms, or suicidal thoughts/attempts. Therefore, it is very important to talk with the doctor about the risks and benefits of antidepressant medication (especially for people younger than 25), even if treatment is not for a mental/mood condition.

 

Tell the doctor immediately if you notice worsening depression/other psychiatric conditions, unusual behavior changes (including possible suicidal thoughts/attempts), or other mental/mood changes (including new/worsening anxiety, panic attacks, trouble sleeping, irritability, hostile/angry feelings, impulsive actions, severe restlessness, very rapid speech). Be especially watchful for these symptoms when a new antidepressant is started or when the dose is changed.

 

Pregnancy Risk: Category C (Risk cannot be ruled out)

You should check with your doctor immediately if any of these side effects occur when taking fluvoxamine:

Less common

  • Behavior, mood, or mental changes
  • trouble with breathing
  • trouble with urinating
  • twitching

Rare

  • Absence of or decrease in body movements
  • agitation
  • blurred vision
  • chills
  • clumsiness or unsteadiness
  • confusion
  • convulsions (seizures)
  • diarrhea
  • fever
  • inability to move the eyes
  • increase in body movements
  • menstrual changes
  • nosebleeds
  • overactive reflexes
  • poor coordination
  • red or irritated eyes
  • redness, tenderness, itching, burning, or peeling of the skin
  • restlessness
  • shivering
  • skin rash
  • sore throat
  • sweating
  • talking or acting with excitement you cannot control
  • trembling or shaking
  • unusual bruising
  • unusual, incomplete, or sudden body or facial movements
  • unusual secretion of milk (in females)
  • weakness

Some of the side effects that can occur with fluvoxamine may not need medical attention:

More common

  • Change in sexual performance or desire
  • constipation
  • headache
  • trouble sleeping
  • unusual tiredness

Less common

  • Abdominal or stomach pain
  • change in sense of taste
  • decreased appetite
  • feeling of constant movement of self or surroundings
  • frequent urination
  • heartburn
  • increased sweating

unusual weight gain or loss

Before taking fluvoxamine, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

 

Before using this medication, tell your doctor or pharmacist your medical history, especially of: personal or family history of bipolar/manic-depressive disorder, personal or family history of suicide attempts, liver problems, seizures, low sodium in the blood, intestinal ulcers/bleeding (peptic ulcer disease) or bleeding problems, personal or family history of glaucoma (angle-closure type).

 

This drug may make you dizzy or drowsy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Avoid alcoholic beverages.

 

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

 

Older adults may be more sensitive to the side effects of this drug, especially bleeding, or loss of coordination. Older adults may also be more likely to develop a type of salt imbalance (hyponatremia), especially if they are taking “water pills” (diuretics). Loss of coordination can increase the risk of falling.

 

Children may be more sensitive to the side effects of this drug, especially loss of appetite and weight loss. Monitor weight and height in children who are taking this drug.

 

During pregnancy, this medication should be used only when clearly needed. It may harm an unborn baby. Also, babies born to mothers who have used this drug during the last 3 months of pregnancy may infrequently develop withdrawal symptoms such as feeding/breathing difficulties, seizures, muscle stiffness, or constant crying. If you notice any of these symptoms in your newborn, tell the doctor promptly.

 

Since untreated mental/mood problems (such as depression, obsessive compulsive disorder, post-traumatic stress disorder) can be a serious condition, do not stop taking this medication unless directed by your doctor. If you are planning pregnancy, become pregnant, or think you may be pregnant, immediately discuss with your doctor the benefits and risks of using this medication during pregnancy.

 

This drug passes into breast milk. Consult your doctor before breast-feeding.

 

Interactions

 

Some products that may interact with this drug include: other drugs that can cause bleeding/bruising (including antiplatelet drugs such as clopidogrel, NSAIDs such as ibuprofen, “blood thinners” such as warfarin).

 

Aspirin can increase the risk of bleeding when used with this medication. However, if your doctor has directed you to take low-dose aspirin for heart attack or stroke prevention (usually at dosages of 81-325 milligrams a day), you should continue taking it unless your doctor instructs you otherwise. Ask your doctor or pharmacist for more details.

 

This medication can slow down the removal of other medications from your body, which may affect how they work. Examples of affected drugs include alosetron, clozapine, methadone, melatonin, pimozide, ramelteon, tacrine, thioridazine, tizanidine, certain benzodiazepines such as alprazolam/diazepam/triazolam, certain beta-blockers such as metoprolol/propranolol, tricyclic antidepressants such as imipramine, among others.

 

Taking MAO inhibitors with this medication may cause a serious (possibly fatal) drug interaction. Avoid taking MAO inhibitors (isocarboxazid, linezolid, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, selegiline, tranylcypromine) during treatment with this medication. Most MAO inhibitors should also not be taken for two weeks before and after treatment with this medication. Ask your doctor when to start or stop taking this medication.

 

The risk of serotonin syndrome/toxicity increases if you are also taking other drugs that increase serotonin. Examples include street drugs such as MDMA/”ecstasy,” St. John’s wort, certain antidepressants (including other SSRIs such as fluoxetine/paroxetine, SNRIs such as duloxetine/venlafaxine), tryptophan, among others. The risk of serotonin syndrome/toxicity may be more likely when you start or increase the dose of these drugs.

 

This medication can increase the effects of caffeine. Avoid drinking large amounts of beverages containing caffeine (coffee, tea, colas) or eating large amounts of chocolate or taking nonprescription products that contain caffeine.

 

Tell your doctor or pharmacist if you are taking other products that cause drowsiness including alcohol, antihistamines (such as cetirizine, diphenhydramine), drugs for sleep or anxiety (such as alprazolam, diazepam, zolpidem), muscle relaxants, and narcotic pain relievers (such as codeine).

 

Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.

 

Cigarette smoking decreases blood levels of this medication. Tell your doctor if you smoke or if you have recently stopped smoking.

 

This medication may interfere with certain medical/laboratory tests (including brain scan for Parkinson’s disease), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.

If overdose is suspected, contact a poison control center or emergency room immediately.

 

Notes

Do not share this medication with others.

 

Keep all regular medical and psychiatric appointments.

 

Missed Dose

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

 

Storage

Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.

 

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

 

 

 

 

 

Brands

 

Available Brands

Voxamine [ Brown & Burk Phils ]

 

Also marketed as

Faverin [ Solvay Pharma ]

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