Fluvoxamine

Fluvoxamine Brand Names- Luvox | Luvox CR

What is Fluvoxamine

Fluvoxamine is a selective serotonin reuptake inhibitor (SSRI). It is indicated to treat obsessive-compulsive disorder (OCD) in adult and pediatric patients 8 years and older.

An extended-release formulation was indicated for the treatment of social anxiety disorder in adults as well, but the manufacturer asked for the voluntary removal of this indication.

Unlike other SSRIs, fluvoxamine is not approved to treat major depression; however, the drug is used off-label for this condition in adults.

Other off-label uses in adults include generalized anxiety disorder (GAD), premenstrual dysphoric disorder (PMDD), post-traumatic stress disorder, and panic disorder. Limited data suggest efficacy in children as young as 6 years old for various childhood anxiety disorders.

Fluvoxamine has the shortest half-life of all the SSRIs. Sedation appears to be more common with fluvoxamine than with some other SSRIs in adults.

However, activation symptoms have been frequently observed in pediatric patients; therefore, close monitoring is recommended for early identification of increased motor activity and behavioral activation symptoms in children and adolescents receiving fluvoxamine.

Product labels for all antidepressants contain a boxed warning related to an increased risk of suicidality in children, adolescents, and young adults during the initial stages of therapy with an antidepressant, whether treating depression or other psychiatric conditions.

Therefore, the necessity of pharmacologic therapy should be carefully considered in these populations, taking into account the risks of treatment versus clinical need.

Fluvoxamine was originally approved by the FDA in 1994.

Indications

1. bulimia nervosa
2. depression
3. generalized anxiety disorder (GAD)
4. obsessive-compulsive disorder (OCD)
5. panic disorder
6. posttraumatic stress disorder (PTSD)
7. premenstrual dysphoric disorder (PMDD)
8. separation anxiety disorder
9. social phobia (social anxiety disorder)

For the treatment of obsessive-compulsive disorder (OCD)

Side Effects

1. abdominal pain
2. acne vulgaris
3. agitation
4. agranulocytosis
5. akathisia
6. alopecia
7. amblyopia
8. amenorrhea
9. amnesia
10. anaphylactoid reactions
11. anemia
12. angina
13. angioedema
14. anorexia
15. anuria
16. anxiety
17. aphonia
18. aplastic anemia
19. apnea
20. arthralgia
21. asthenia
22. ataxia
23. atopic dermatitis
24. AV block
25. bleeding
26. blurred vision
27. bone fractures
28. bradycardia
29. bronchospasm
30. bullous rash
31. cardiac arrest
32. cardiomyopathy
33. chest pain (unspecified)
34. chills
35. cholecystitis
36. cholelithiasis
37. colitis
38. coma
39. conjunctivitis
40. constipation
41. cough
42. cystitis
43. dehydration
44. delirium
45. depression
46. diabetes mellitus
47. diarrhea
48. diplopia
49. dizziness
50. drowsiness
51. dysarthria
52. dysgeusia
53. dyskinesia
54. dysmenorrhea
55. dyspepsia
56. dysphagia
57. dyspnea
58. dystonic reaction
59. dysuria
60. ecchymosis
61. edema
62. ejaculation dysfunction
63. elevated hepatic enzymes
64. emotional lability
65. epistaxis
66. eructation
67. esophagitis
68. euphoria
69. exfoliative dermatitis
70. fatigue
71. fecal incontinence
72. fever
73. flatulence
74. flushing
75. furunculosis
76. galactorrhea
77. gastritis
78. gastroesophageal reflux
79. GI bleeding
80. GI obstruction
81. gingivitis
82. glossitis
83. goiter
84. growth inhibition
85. hallucinations
86. headache
87. hematemesis
88. hematoma
89. hematuria
90. hemoptysis
91. hemorrhoids
92. hepatitis
93. hiccups
94. hoarseness
95. hostility
96. hypercholesterolemia
97. hyperglycemia
98. hyperhidrosis
99. hyperkinesis
100. hyperlipidemia
101. hypersalivation
102. hypertension
103. hypertonia
104. hyperventilation
105. hypoglycemia
106. hypokalemia
107. hyponatremia
108. hyporeflexia
109. hypotension
110. hypothyroidism
111. hypotonia
112. ileus
113. impaired cognition
114. impotence (erectile dysfunction)
115. increased urinary frequency
116. influenza
117. insomnia
118. irritability
119. jaundice
120. laryngitis
121. laryngospasm
122. lethargy
123. leukocytosis
124. leukopenia
125. libido decrease
126. libido increase
127. lymphadenopathy
128. malaise
129. mania
130. melena
131. menorrhagia
132. muscle paralysis
133. myalgia
134. myasthenia
135. mydriasis
136. myocardial infarction
137. myoclonia
138. myopathy
139. nausea
140. neonatal abstinence syndrome
141. nephrolithiasis
142. nocturia
143. ocular pain
144. oliguria
145. orgasm dysfunction
146. osteopenia
147. pallor
148. palpitations
149. pancreatitis
150. paranoia
151. paresthesias
152. parosmia
153. peptic ulcer
154. pericarditis
155. peripheral vasodilation
156. persistent pulmonary hypertension of the newborn
157. pharyngitis
158. phlebitis
159. phobia
160. photophobia
161. photosensitivity
162. platelet dysfunction
163. polyuria
164. porphyria
165. priapism
166. pseudoparkinsonism
167. psychosis
168. purpura
169. QT prolongation
170. rash
171. renal failure (unspecified)
172. rhabdomyolysis
173. seborrhea
174. seizures
175. serotonin syndrome
176. SIADH
177. sinus tachycardia
178. sinusitis
179. skin discoloration
180. ST-T wave changes
181. Stevens-Johnson syndrome
182. stomatitis
183. stroke
184. suicidal ideation
185. syncope
186. tardive dyskinesia
187. teeth grinding (bruxism)
188. thrombocytopenia
189. torsade de pointes
190. torticollis
191. toxic epidermal necrolysis
192. tremor
193. trismus
194. urinary retention
195. urticaria
196. vaginitis
197. vasculitis
198. ventricular tachycardia
199. vertigo
200. visual impairment
201. vomiting
202. weight gain
203. weight loss
204. withdrawal
205. xerophthalmia
206. xerosis
207. xerostomia
208. yawning

Monitoring Parameters

• blood pressure
• growth rate
• heart rate
• weight

Contraindications

• abrupt discontinuation
• anticoagulant therapy
• apheresis
• AV block
• bipolar disorder
• bleeding
• bone fractures
• bradycardia
• breast-feeding
• cardiomyopathy
• celiac disease
• children
• closed-angle glaucoma
• dehydration
• driving or operating machinery
• electroconvulsive therapy (ECT)
• ethanol ingestion
• females
• fever
• geriatric
• growth inhibition
• heart failure
• hepatic disease
• human immunodeficiency virus (HIV) infection
• hyperparathyroidism
• hypocalcemia
• hypokalemia
• hypomagnesemia
• hyponatremia
• hypothermia
• hypothyroidism
• hypovolemia
• increased intraocular pressure
• long QT syndrome
• mania
• MAOI therapy
• myocardial infarction
• neonates
• osteoporosis
• pheochromocytoma
• pregnancy
• QT prolongation
• rheumatoid arthritis
• seizure disorder
• sickle cell disease
• sleep deprivation
• stroke
• suicidal ideation
• systemic lupus erythematosus (SLE)
• thrombolytic therapy
• tobacco smoking

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• Umeclidinium; Vilanterol
• Urokinase
• Valerian, Valeriana officinalis
• Vandetanib
• Vardenafil
• Vasopressin, ADH
• Vemurafenib
• Venetoclax
• Venlafaxine
• Verapamil
• Vilazodone
• Vinblastine
• Vinorelbine
• Vorapaxar
• Voriconazole
• Vorinostat
• Vortioxetine
• Warfarin
• Zanubrutinib
• Ziprasidone
• Zolmitriptan
• Zolpidem