fluvoxamine, Luvox, Luvox CR
Omudhome Ogbru, PharmD
Omudhome Ogbru, PharmD
Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Medical and Pharmacy Editor:
GENERIC NAME: fluvoxamine
BRAND NAME: Luvox, Luvox CR
DRUG CLASS AND MECHANISM: Fluvoxamine is a drug that is used for treating several psychiatric disorders. It is a member of the class of drugs called selective serotonin reuptake inhibitors (SSRIs), a class that also includes fluoxetine (Prozac), sertraline (Zoloft), and paroxetine (Paxil). Selective serotonin reuptake inhibitors affect neurotransmitters, chemicals that nerves in the brain use to communicate with each other. Neurotransmitters are released by nerves, travel across the spaces between nerves and then attach to receptors on other nerves. Many experts believe that an imbalance in neurotransmitters is the cause of depression and other psychiatric disorders. Fluvoxamine works by inhibiting the uptake of serotonin, a neurotransmitter, from the spaces between nerve cells following its release. Therefore, there is more serotonin available in the spaces to attach to other nerves and stimulate them. Fluvoxamine was approved by the FDA for the treatment of obsessive-compulsive disorder in December 1994.
GENERIC AVAILABLE: Yes
PREPARATIONS: Tablets: 25, 50 and 100 mg. Tablets (extended release): 100 and 150 mg.
STORAGE: Tablets should be kept at room temperature, 15- 30 C (59-86 F).
PRESCRIBED FOR: Fluvoxamine is used for treating obsessive-compulsive disorder (OCD) and social anxiety disorder. However, like other SSRIs, it also has been used in the treatment of major depression, management of obesity, bulimia, schizophrenia, and panic disorder.
DOSING: The usual starting dose for adults is 50 mg daily given as a single dose at bedtime. The dose may be increased in 50 mg increments every 4-7 days to achieve the desired response. The maximum dose is 300 mg/day. Doses greater than 100 mg should be administered as a divided dose. When using extended release tablets the starting dose is 100 mg at bedtime and the maximum dose is 300 mg.
Children (8 to 17 years old) should start with 25 mg daily given at bedtime, and the dose may be increased by 25 mg every 4-7 days up to a maximum of 200 mg/day (8-11 years old) or 300 mg/day (12-17 years old). Doses greater than 50 mg should be administered as a divided dose.
DRUG INTERACTIONS: All SSRIs, including fluvoxamine, should not be taken with any of the mono-amine oxidase inhibitor (MAOI) class of antidepressants such as isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), and procarbazine (Matulane) other drugs that inhibit monoamine oxidase such as linezolid (Zyvox) and intravenous methylene blue. Such combinations may lead to confusion, high blood pressure, tremor, and increased activity. Fluvoxamine should not be administered within 14 days of discontinuing an MAO inhibitor, and MAO inhibitors should not be administered within 14 days of stopping fluvoxamine. Similar reactions occur if fluvoxamine is combined with other drugs, for example, tryptophan, St. John's wort, meperidine (Demerol), and tramadol (Ultram) that increase serotonin in the brain.
Fluvoxamine can inhibit the elimination of clozapine (Clozaril), necessitating dosage reductions of clozapine.
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