fluvoxamine, Luvox (discontinued), Luvox CR (discontinued) (cont.)

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Withdrawal reactions have been reported after an average of 12 to 36 weeks of treatment, but after as few as 5 weeks. Although most authorities recommend discontinuing treatment by gradually reducing the dose, symptoms still may occur. Symptoms generally appear within a few days of discontinuing medication and persist for an average of 12 days (up to 21 days). They are relieved within 24 hours by re-administering the medication that was discontinued. Antidepressants may increase the risk of suicide in children and adolescents. There are concerns that antidepressants also may increase the risk of suicide in adults. Patients with major depression may experience worsening of depression or suicidal thoughts regardless of whether or not they are treated. Therefore, patients started on antidepressants should be closely observed for signs of worsening suicidal thinking or changes in behavior.



PREPARATIONS: Tablets: 25, 50 and 100 mg. Tablets (extended release): 100 and 150 mg.

STORAGE: Tablets should be kept at room temperature, 15 C - 30 C (59 F - 86 F).

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.

Medically Reviewed by a Doctor on 2/17/2015

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