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Fluvoxamine Maleate Generic Name & Formulations
Legal Class
Rx
General Description
Fluvoxamine maleate 25mg, 50mg+, 100mg+; tabs; +scored.
Pharmacological Class
SSRI.
How Supplied
Contact supplier
Manufacturer
Fluvoxamine Maleate Indications
Indications
Obsessive-compulsive disorder.
Fluvoxamine Maleate Dosage and Administration
Adult
≥18yrs: initially 50mg at bedtime, increase in 50mg increments at 4–7 day intervals; range 100–300mg/day; max 300mg/day. Divide total daily doses >100mg into 2 doses; give larger portion at bedtime. Elderly, hepatic impairment: use lower initial dose and titrate more slowly.
Children
Females may respond to lower dose. <8yrs: not established. 8–17yrs: initially 25mg at bedtime, increase in 25mg increments at 4–7 day intervals; usual range 50–200mg/day. Max 8–11yrs: 200mg/day; 12–17yrs: 300mg/day. Divide total daily doses >50mg into 2 doses; give larger portion at bedtime. Hepatic impairment: use lower initial dose and titrate more slowly.
Fluvoxamine Maleate Contraindications
Contraindications
Concomitant alosetron, tizanidine, pimozide, thioridazine. During or within 14 days of MAOIs; do not start an MAOI during or within 14 days of fluvoxamine. Concomitant linezolid, IV methylene blue.
Fluvoxamine Maleate Boxed Warnings
Boxed Warning
Suicidality and antidepressants.
Fluvoxamine Maleate Warnings/Precautions
Warnings/Precautions
Increased risk of suicidal thinking and behavior in children, adolescents, and young adults; monitor for clinical worsening or unusual changes. Screen for bipolar disorder. Monitor for serotonin syndrome; discontinue if occurs. History of seizures (discontinue if occurs), mania/hypomania. ECT. Cardiovascular disease. Liver dysfunction. Angle-closure glaucoma. Conditions that affect metabolism or hemodynamic response. Hyponatremia (esp. in elderly). Sexual dysfunction. Reduced activity of CYP2D6. Reevaluate periodically. Write ℞ for smallest practical amount. Avoid abrupt cessation. Elderly. Labor & delivery. Pregnancy (esp. during 3rd trimester). Nursing mothers: monitor infants.
Fluvoxamine Maleate Pharmacokinetics
See Literature
Fluvoxamine Maleate Interactions
Interactions
See Contraindications. Prolongation of QT interval with pimozide, thioridazine. Avoid alcohol. Concomitant ramelteon: not recommended. Increased risk of serotonin syndrome with other serotonergic drugs, triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, tryptophan, buspirone, amphetamines, St. John's wort, linezolid, IV methylene blue; monitor. Potentiates diazepam (not recommended), triazolam and alprazolam (reduce their doses by at least ½), midazolam, theophylline (reduce its dose by ⅔ and monitor), warfarin, carbamazepine, tricyclic antidepressants (reduce their doses and monitor), propranolol, metoprolol (reduce their doses), clozapine, methadone, tacrine. Caution with drugs that inhibit CYP2D6 (eg, quinidine) or 3A4, phenytoin, diltiazem. Increased risk of bleeding with concomitant NSAIDs, aspirin, warfarin, and others that affect coagulation. Monitor mexiletine levels. Smokers may have increased metabolism.
Fluvoxamine Maleate Adverse Reactions
Adverse Reactions
Nausea, somnolence, insomnia, asthenia, nervousness, dyspepsia, abnormal ejaculation, sweating, anorexia, tremor, vomiting, anorgasmia, decreased libido, dry mouth, rhinitis, taste perversion, urinary frequency. Children: also agitation, depression, dysmenorrhea, flatulence, hyperkinesia, rash.
Fluvoxamine Maleate Clinical Trials
See Literature
Fluvoxamine Maleate Note
Notes
Formerly known under the brand name Luvox.
Fluvoxamine Maleate Patient Counseling
See Literature
