Fluvoxamine Maleate

Introduction: Fluvoxamine Maleate is a type of antidepressant belonging to the selective serotonin reuptake inhibitor (SSRI) group of medicines. It is prescribed to treat depression and obsessive-compulsive disorder.

How it works: Fluvoxamine inhibits the re-uptake of serotonin in brain neurons, which improves mood and physical symptoms of depression and also relieves symptoms of obsessive-compulsive disorders.

Important Information: This medicine can be taken with or without food. Your doctor may start you on a lower dose and increase it gradually. Do not change the dose or stop taking it without talking to your doctor, even if you feel well.

• Obsessive-Compulsive Disorder
• Depressive illness
• Panic Disorder
• Eating Disorder
• Chronic Tension Headache

SSRIs & related anti-depressant drugs

Selective Serotonin Reuptake Inhibitor (SSRI)

Fluvoxamine blocks the reuptake of serotonin at the serotonin reuptake pump of the neuronal membrane, enhancing the actions of serotonin on 5HT1A autoreceptors. Studies have also demonstrated that fluvoxamine has virtually no affinity for α1- or α2-adrenergic, β-adrenergic, muscarinic, dopamine D2, histamine H1, GABA-benzodiazepine, opiate, 5-HT1, or 5-HT2 receptors, despite having an affinity for binding to σ1 receptors.

Fluvoxamine inhibits the serotonin transporter to increase serotonin levels in the synaptic cleft, resulting in improved mood and reduced OCD symptoms.

Obsessive-Compulsive Disorder (Adult):

• Initially: 50 mg in the evening for 3-4 days.
• If necessary, increase to 300 mg daily (over 150 mg in divided doses).

Obsessive-Compulsive Disorder (Child, 8+ years):

• Initially: 25 mg daily.
• If necessary, increase by 25 mg every 3-4 days to max 200 mg daily in divided doses.

Depression (Adult):

• Initially: 50-100 mg daily in the evening.
• If necessary, increase to 300 mg daily (over 150 mg in divided doses).
• Usual maintenance dose: 100 mg daily.

Children (Depression): Not recommended.

* Use as directed by the registered physician

Oral tablet. Can be taken with or without food, but better to take at a fixed time. Swallow whole, do not chew or crush.

If you miss a dose, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.

Common Side Effects:

• Nausea
• Vomiting
• Dryness in mouth
• Drowsiness
• Insomnia
• Headache
• Increased sweating
• Tremor
• Sexual dysfunction

Precautions:

• Use with caution in patients with a history of mania, seizures, suicidal tendency, cardiac disease, diabetes mellitus, angle-closure glaucoma, history of bleeding disorders.
• May impair performance of skilled tasks (driving).
• Talk to your doctor if you notice sudden mood changes or develop suicidal thoughts.
• Do not stop taking the medication suddenly without talking to your doctor.

Contraindications:

• Hypersensitivity
• Not to be used with thioridazine, terfenadine, astemizole, cisapride, pimozide, aloestron, tizanidine
• Lactation
• Manic phase

Drug Interactions:

• Do not use with MAOIs (or within 14 days of discontinuing MAOIs).
• May increase carbamazepine toxicity and serum levels of theophylline.
• Lithium enhances serotonergic effects of fluvoxamine.
• Anticoagulants may require dosage adjustments.
• Diltiazem may lead to bradycardia.

Food Interactions:

• Unsafe to consume alcohol.

Use in Pregnancy: May be unsafe during pregnancy. Animal studies have shown harmful effects. Your doctor will weigh the benefits and risks.

Use in Lactation: Probably unsafe during breastfeeding. Limited data suggests the drug may pass into breastmilk and harm the baby.

Pediatric Use: Dosage available for children over 8 years with OCD. Not recommended for depression in children.

Geriatric Use: Initial dose: 25 mg once daily. Use with caution.

Renal Impairment: Probably safe in kidney disease. Dose adjustment may not be needed. Please consult your doctor.

Hepatic Impairment: Use with caution in liver disease. Dose adjustment may be needed. Please consult your doctor.

Overdose:

• Symptoms: Gastrointestinal complaints (nausea, vomiting, diarrhea), somnolence, dizziness, tachycardia, bradycardia, hypotension, convulsions, coma.
• Treatment: No specific antidote. Empty stomach and give symptomatic treatment. Medicinal charcoal may be used.

Storage: Store below 25°C, in a cool and dry place, away from light. Keep out of reach of children.

Fluvoxamine Maleate Tablet