Anxiety/OCD:

Indications for: Fluvoxamine Extended-Release

Obsessive-compulsive disorder.

Adult Dosage:

Swallow whole. ≥18yrs: initially 100mg once daily at bedtime; may increase in 50mg increments at 1-week interval; range 100–300mg/day; max 300mg/day. Elderly, hepatic impairment: initially 100mg and titrate slowly.

Children Dosage:

Not established.

Fluvoxamine Extended-Release Contraindications:

Concomitant alosetron, tizanidine, pimozide, thioridazine, ramelteon. During or within 14 days of MAOIs; do not start an MAOI during or within 14 days of fluvoxamine. Concomitant linezolid, IV methylene blue.

Boxed Warning:

Suicidality and antidepressants.

Fluvoxamine Extended-Release 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 Extended-Release Classification:

SSRI.

Fluvoxamine Extended-Release Interactions:

See Contraindications. Prolongation of QT interval with pimozide, thioridazine. Avoid alcohol. 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 CYP3A4, phenytoin, diltiazem. Increased risk of bleeding with concomitant NSAIDs, aspirin, warfarin, and others that affect coagulation. Monitor mexiletine levels. Smokers may have increased metabolism.

Adverse Reactions:

Abnormal ejaculation, anorexia, anorgasmia, asthenia, diarrhea, nausea, somnolence, sweating, tremor, anxiety, decreased libido, myalgia, pharyngitis, vomiting, dyspepsia, dizziness, insomnia, yawning.

Note:

Formerly known under the brand name Luvox CR.

How Supplied:

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