fluvoxamine (Luvox and Luvox CR have been discontinued)

  • Pharmacy Author:
    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: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

What is the dosage for fluvoxamine?

  • 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.

Which drugs or supplements interact with fluvoxamine?

  • All SSRIs, including fluvoxamine, should not be taken with any of the monoamine 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.
  • Fluvoxamine also may inhibit the elimination and increase the blood levels of theophylline (Theodur, Uniphyl), alprazolam (Xanax), and triazolam (Halcion) leading to side effects from these drugs.
  • Fluvoxamine may increase the effect of warfarin (Coumadin, Jantoven), leading to excessive bleeding. Warfarin therapy should be monitored more frequently in patients who also are taking fluoxetine.
  • Combining SSRIs with aspirin, nonsteroidal anti-inflammatory drugs or other drugs that affect bleeding may increase the likelihood of upper gastrointestinal bleeding. Fluvoxamine may increase blood levels of tizanidine (Zanaflex), thioridazine (Mellaril), alosetron (Lotronex), and pimozide (Orap), leading to increased side effects of these drugs.
Medically Reviewed by a Doctor on 7/11/2016

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