Fluvoxamine (Dosage)

Fluvoxamine is an SSRI antidepressant with a profile similar to fluoxetine, selectively inhibits the reuptake of serotonin by CNS neurons.

Interference is minimal with noradrenergic processes. It has low affinity for alpha-adrenergic, ß-adrenergic, histaminergic, muscarinic, dopaminergic and serotonergic cholinergic receptors.

CONTRAINDICATIONS

Hypersensitivity to fluvoxamine.

In combination with tizanidine and MAOI antidepressants, initiate treatment with fluvoxamine two weeks after the end of irreversible MAOI, or the day after finishing reversible MAOI and wait for a week between interruption of fluvoxamine and administration of any MAOI.

CAUTIONS

Cautions in patients with renal insufficiency and liver failure.

Precautions should be taken in patients with a history of suicide attempts or suicidal thoughts, or clinical worsening, or with a significant degree of suicidal ideation before the start of treatment, in patients with a history of mania and hypomania, who have had seizure episodes; epilepsy and in patients with akathisia / psychomotor agitation.

There exists risk of neuroleptic malignant syndrome, especially when administered concomitantly with other serotonergic and / or neuroleptic agents. There is a risk of hyponatremia.

Precautions in patients with diabetes mellitus (control of blood glucose can be altered).

Caution should be exercised in individuals with bleeding disorders: gastrointestinal bleeding, gynecological bleeding, and other skin or mucosal bleedings, especially in the elderly, and when administered concomitantly with substances that affect platelet function or increase the level of risk of haemorrhage, history of bleeding disorders and conditions that predispose them.

Precautions in all age patients.

Abstinence syndrome can occur when treatment is stopped abruptly, so fluvoxamine must be gradually reduced over a period of several weeks or months, according to the needs of each patient.

SIDE EFFECTS

Anorexia, agitation, nervousness, anxiety, insomnia, drowsiness, tremors, headache, vertigo; palpitations/tachycardia, abdominal pain, constipation, diarrhea, dry mouth, dyspepsia, nausea, vomiting, hyperhidrosis, sweating, asthenia and malaise.

PHARMACOLOGIC INTERACTIONS

The treatment with fluvoxamine is contraindicated in concomitance with tizanidine and MAOIs.

Fluvoxamine potentiates the action and toxicity of: tricyclic antidepressants, neuroleptics, tacrine, theophylline, methadone, mexiletine, thioridazine, warfarin, oral anticoagulants, caffeine, ropinirole, propranolol, phenytoin, astemizole, terfenadine, cisapride, benzodiazepines, cyclosporine.

Fluvoxamine potentiates its toxicity when administered together with triptans, tramadol, linezolid, SSRI, Hypericum and lithium.

There is a risk of prolongation of the cardiac QT interval/Torsade de Pointes if fluvoxamine is administered together with terfenadine, astemizole or cisapride

Avoid alcohol consumption during treatment with fluvoxamine.

BRAND NAMES:

• Dumirox ®
• Luvox ®