Free Content Directory Tokelau: fluvoxamine

floo-VOX-a-meen MAL-ee-ate

Oral route(Capsule, Extended Release;Tablet)

Antidepressants increased the risk of suicidal thinking and behavior in children, adolescents, and young adults with major depressive disorder (MDD) and other psychiatric disorders in short-term studies. Short term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24, and there was a reduction in risk with antidepressants compared to placebo in adults aged 65 and older. This risk must be balanced with the clinical need. Monitor patients closely for clinical worsening, suicidality, or unusual changes in behavior. Families and caregivers should be advised of the need for close observation and communication with the prescriber . Fluvoxamine maleate tablets are not approved for use in pediatric patients except for patients with obsessive compulsive disorder (OCD) .

Commonly used brand name(s)

In the U.S.

Luvox

Luvox CR

Available Dosage Forms:

Capsule, Extended Release

Tablet

Therapeutic Class: Antidepressant

Pharmacologic Class: Fluvoxamine

Uses For fluvoxamine

Fluvoxamine is used to treat obsessive compulsive disorder (OCD). It belongs to a group of medicines known as selective serotonin reuptake inhibitors (SSRIs). These medicines are thought to work by increasing the activity of a chemical called serotonin in the brain. .

fluvoxamine is available only with your doctor's prescription.

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although this use is not included in product labeling, fluvoxamine is used in certain patients with the following medical condition:

Mental depression.

Before Using fluvoxamine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For fluvoxamine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to fluvoxamine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of fluvoxamine tablets in children 8 to 17 years of age. Because fluvoxamine may cause weight loss or a decrease in appetite, children who will be taking fluvoxamine for a long time should have their weight and growth measured by the doctor regularly.

Appropriate studies have not been performed on the relationship of age to the effects of fluvoxamine extended-release capsules in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of fluvoxamine in the elderly. However, elderly patients are more likely to have hyponatremia (low sodium in the blood) and liver problems, which may require an adjustment in the dose for patients receiving fluvoxamine.

Pregnancy

	Pregnancy Category	Explanation
All Trimesters	C	Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking fluvoxamine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using fluvoxamine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Alosetron

Astemizole

Cisapride

Furazolidone

Isocarboxazid

Levomethadyl

Methylene Blue

Metoclopramide

Phenelzine

Ramelteon

Rasagiline

Terfenadine

Thioridazine

Tizanidine

Using fluvoxamine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Abciximab

Aceclofenac

Acemetacin

Acenocoumarol

Alclofenac

Almotriptan

Ancrod

Anisindione

Antithrombin III Human

Apazone

Ardeparin

Aspirin

Bendamustine

Benoxaprofen

Bivalirudin

Bromfenac

Bufexamac

Carprofen

Certoparin

Cilostazol

Citalopram

Clometacin

Clonixin

Clopidogrel

Clorgyline

Dalteparin

Danaparoid

Defibrotide

Dermatan Sulfate

Desirudin

Desvenlafaxine

Dexfenfluramine

Dexketoprofen

Dextromethorphan

Diclofenac

Dicumarol

Diflunisal

Dihydroergotamine

Dipyridamole

Dipyrone

Droperidol

Droxicam

Duloxetine

Eletriptan

Eltrombopag

Enoxaparin

Eptifibatide

Ergoloid Mesylates

Ergonovine

Ergotamine

Escitalopram

Etodolac

Etofenamate

Felbinac

Fenbufen

Fenfluramine

Fenoprofen

Fentiazac

Floctafenine

Flufenamic Acid

Fluoxetine

Flurbiprofen

Fluvoxamine

Fondaparinux

Frovatriptan

Heparin

Ibuprofen

Indomethacin

Indoprofen

Iproniazid

Isoxicam

Ketoprofen

Ketorolac

Linezolid

Lornoxicam

Magnesium Salicylate

Meclofenamate

Mefenamic Acid

Meloxicam

Methylergonovine

Milnacipran

Mirtazapine

Moclobemide

Nabumetone

Nadroparin

Naproxen

Naratriptan

Nepafenac

Nialamide

Niflumic Acid

Nimesulide

Oxaprozin

Oxycodone

Oxyphenbutazone

Pargyline

Parnaparin

Paroxetine

Pentosan Polysulfate Sodium

Phenindione

Phenprocoumon

Phenylbutazone

Pirazolac

Piroxicam

Pirprofen

Prasugrel

Procarbazine

Propyphenazone

Proquazone

Reviparin

Rizatriptan

Salicylic Acid

Salsalate

Selegiline

Sertraline

Sibutramine

St John's Wort

Sulindac

Sumatriptan

Suprofen

Tapentadol

Tenidap

Tenoxicam

Theophylline

Tiaprofenic Acid

Ticlopidine

Tinzaparin

Tirofiban

Tolmetin

Toloxatone

Tramadol

Tranylcypromine

Vilazodone

Warfarin

Zolmitriptan

Zomepirac

Using fluvoxamine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Amitriptyline

Asenapine

Clomipramine

Clozapine

Cyclosporine

Diazepam

Fosphenytoin

Galantamine

Ginkgo

Haloperidol

Imipramine

Lithium

Methadone

Mexiletine

Midazolam

Olanzapine

Phenytoin

Propranolol

Roflumilast

Ropivacaine

Tacrine

Triazolam

Tryptophan

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Proper Use of fluvoxamine

Take fluvoxamine exactly as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

fluvoxamine should come with a Medication Guide. It is very important that you read and understand this information. Be sure to ask your doctor about anything you do not understand.

Fluvoxamine may be taken with or without food or on a full or empty stomach. Take fluvoxamine at bedtime, unless your doctor tells you otherwise.

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

If you are taking fluvoxamine, do not take other medicines containing fluvoxamine.

Dosing

The dose of fluvoxamine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of fluvoxamine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For treatment of obsessive-compulsive disorder:
- For oral dosage form (extended-release capsules):
  - Adults—At first, 100 milligrams (mg) once a day, at bedtime. Your doctor may increase your dose if needed. However, the dose usually is not more than 300 mg per day.
  - Children—Use and dose must be determined by your doctor.
- For oral dosage form (tablets):
  - Adults—At first, 50 milligrams (mg) once a day, at bedtime. Your doctor may increase your dose if needed. However, the dose usually is not more than 300 mg per day. If your daily dose is higher than 100 mg, your doctor may want you to take it in two divided doses.
  - Children 8 to 17 years of age—At first, 25 mg once a day at bedtime. Your doctor may increase your dose if needed. However, the dose usually is not more than 200 mg per day. If your daily dose is higher than 50 mg, your doctor may want you to take it in two divided doses.
  - Children younger than 8 years of age—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of fluvoxamine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

For twice-a-day dosing: Skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using fluvoxamine

It is very important that your doctor check your progress at regular visits, to allow for changes in your dose and to help reduce any side effects. You might have to take fluvoxamine for up to 10 or 12 weeks before you begin to feel better.

Do not take alosetron (Lotronex®), pimozide (Orap®), ramelteon (Rozerem™), thioridazine (Mellaril®), or tizanidine (Zanaflex®) while you are taking fluvoxamine. If you do, it could increase the amounts of these medicines in your body which may cause serious unwanted effects.

Do not take fluvoxamine if you have taken a monoamine oxidase (MAO) inhibitor such as isocarboxazid, phenelzine, selegiline, tranylcypromine, Eldepryl®, Marplan®, Nardil®, or Parnate® within the past 14 days. Do not start taking an MAO inhibitor within 14 days of stopping fluvoxamine. If you do, you may develop agitation, coma, extreme muscle stiffness, sudden high body temperature, or other severe unwanted effects.

Make sure your doctor knows about all the other medicines you are using. Fluvoxamine may cause serious conditions called serotonin syndrome or neuroleptic malignant syndrome (NMS)-like reactions when taken with certain medicines such as linezolid (Zyvox®), lithium, tryptophan, or some pain or migraine medicines (e.g., tramadol [Ultram®], sumatriptan [Imitrex®], zolmitriptan [Zomig®], or rizatriptan [Maxalt®]). Check with your doctor first before taking any other medicines.

Avoid drinking alcohol while taking fluvoxamine.

Since smoking may decrease the treatment effects of fluvoxamine, it is best to avoid smoking while you are using it. If you have any questions about this, check with your doctor.

Check with your doctor as soon as possible if you develop a skin rash, hives, or itching while you are taking fluvoxamine.

Fluvoxamine may cause some people to be agitated, irritable or display other abnormal behaviors. It may also cause some children, teenagers, and young adults to have suicidal thoughts and tendencies or to become more depressed. Some people may have trouble sleeping, get upset easily, have a big increase in energy, or start to act reckless. If you, your child, or your caregiver notice any of these side effects, tell your doctor or your child's doctor right away. Let the doctor know if you or anyone in your family has bipolar disorder (manic-depressive) or has tried to commit suicide.

Fluvoxamine may cause some people to become drowsy or less able to think clearly, or to have blurred vision or poor muscle control. Make sure you know how you react to fluvoxamine before you drive, use machines, or do anything else that could be dangerous if you are not alert, able to see clearly, or able to control your movements well.

Do not suddenly stop taking fluvoxamine without first checking with your doctor. Your doctor may want you to reduce gradually the amount you are taking before stopping completely. This is to decrease the chance of having discontinuation symptoms such as agitation, confusion, headache, irritability, numbness or tingling feeling, restlessness, trouble in sleeping, or unusual drowsiness or weakness.

fluvoxamine may increase your risk for bleeding problems. Make sure your doctor knows if you are also taking other medicines that thin the blood, such as aspirin, nonsteroidal anti-inflammatory agents also called NSAIDs (e.g., ibuprofen, naproxen, Advil®, Aleve®, Celebrex®, or Motrin®), or warfarin (Coumadin®, Jantoven®).

Hyponatremia (low sodium in the blood) may occur with fluvoxamine. Stop using the medicine and check with your doctor right away if you have confusion, difficulty concentrating, headaches, memory problems, weakness, and unsteadiness.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal (e.g., St. John's wort) or vitamin supplements.

fluvoxamine Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

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

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, fever, and chills

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

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose

Coma

dizziness

drowsiness

dryness of the mouth

fast, slow, or irregular heartbeat

large pupils

low blood pressure

nausea

vomiting

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Change in sexual performance or desire

constipation

headache

trouble with 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

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: fluvoxamine side effects (in more detail)

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More fluvoxamine resources

Fluvoxamine Side Effects (in more detail)
Fluvoxamine Use in Pregnancy & Breastfeeding
Drug Images
Fluvoxamine Drug Interactions
Fluvoxamine Support Group
30 Reviews for Fluvoxamine - Add your own review/rating

fluvoxamine Concise Consumer Information (Cerner Multum)

Fluvoxamine MedFacts Consumer Leaflet (Wolters Kluwer)

Fluvoxamine Prescribing Information (FDA)

Fluvoxamine Maleate Monograph (AHFS DI)

Luvox CR Prescribing Information (FDA)

Luvox CR Extended-Release Capsules MedFacts Consumer Leaflet (Wolters Kluwer)

Compare fluvoxamine with other medications

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Free Content Directory Tokelau

Tuesday, 25 September 2012

fluvoxamine