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

Interactions

  • Abciximab
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  • Acetaminophen; Aspirin, ASA; Caffeine
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  • Aspirin, ASA; Caffeine; Orphenadrine
  • Aspirin, ASA; Carisoprodol
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  • grapefruit juice
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  • Rasagiline
  • Remifentanil
  • Reteplase, r-PA
  • Ribociclib
  • Ribociclib; Letrozole
  • Rilpivirine
  • Riluzole
  • Rimegepant
  • Risperidone
  • Ritonavir
  • Rivaroxaban
  • Rizatriptan
  • Roflumilast
  • Rolapitant
  • Romidepsin
  • Ropinirole
  • Ropivacaine
  • Ruxolitinib
  • Safinamide
  • Salmeterol
  • Salsalate
  • Saquinavir
  • Saxagliptin
  • Segesterone Acetate; Ethinyl Estradiol
  • Selegiline
  • Selpercatinib
  • Selumetinib
  • Sertraline
  • Sevoflurane
  • Short-acting beta-agonists
  • Sibutramine
  • Sildenafil
  • Silodosin
  • Simeprevir
  • Simvastatin
  • Simvastatin; Sitagliptin
  • Siponimod
  • Sirolimus
  • Sodium picosulfate; Magnesium oxide; Anhydrous citric acid
  • Sofosbuvir; Velpatasvir
  • Sofosbuvir; Velpatasvir; Voxilaprevir
  • Solifenacin
  • Sonidegib
  • Sorafenib
  • Sotalol
  • Spironolactone
  • St. John’s Wort, Hypericum perforatum
  • Streptokinase
  • Sufentanil
  • Sumatriptan
  • Sunitinib
  • Tacrine
  • Tacrolimus
  • Tadalafil
  • Talazoparib
  • Tamoxifen
  • Tamsulosin
  • Tapentadol
  • Tasimelteon
  • Tazemetostat
  • Tedizolid
  • Telaprevir
  • Telavancin
  • Telithromycin
  • Tenecteplase
  • Terbinafine
  • Terbutaline
  • Tetrabenazine
  • Tezacaftor; Ivacaftor
  • Theophylline, Aminophylline
  • Thioridazine
  • Thrombin Inhibitors
  • Thrombolytic Agents
  • Ticagrelor
  • Ticlopidine
  • Tinzaparin
  • Tiotropium; Olodaterol
  • Tirofiban
  • Tizanidine
  • tobacco
  • Tofacitinib
  • Tolbutamide
  • Tolterodine
  • Tolvaptan
  • Topiramate
  • Toremifene
  • Torsemide
  • Tramadol
  • Trandolapril; Verapamil
  • Tranylcypromine
  • Trazodone
  • Triamterene
  • Triazolam
  • Triclabendazole
  • Trifluoperazine
  • Trimipramine
  • Triptorelin
  • Ubrogepant
  • Ulipristal
  • 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
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