Fluvoxamine: Formula, Indications, Mechanism of Action, Dosage, Side Effects, Warnings, Contraindications and Interactions

It corresponds to drugs called selective serotonin reuptake inhibitors.

Fluvoxamine is a generic drug. It helps increase the amount of a chemical in the brain called serotonin.

This change helps treat the symptoms of obsessive compulsive disorder .

Chemical formula of fluvoxamine

  • C15H21F3N2O2.

Presentation

The active ingredient is fluvoxamine maleate and it comes in two forms: an oral capsule and an oral tablet.

Indications of fluvoxamine

Depression : For the symptomatic relief of depressive illness and obsessive-compulsive disorder, fluvoxamine has been shown to significantly reduce the symptoms of obsessive-compulsive disorder.

Obsessions or compulsions must be experienced as intrusive, markedly distressing, slow, or significantly interfering with the person’s social or occupational functioning.

Mechanism of action

The antidepressant and antiobsessional actions of fluvoxamine are believed to be related to its selective inhibition of presynaptic serotonin reuptake in brain neurons.

There is minimal interference with noradrenergic processes and, in common with other specific serotonin uptake inhibitors, fluvoxamine has very low affinity in vitro for the a1, a2, b1, dopaminergic 2, histamine 1, serotonin 1, serotonin 2 receptors or muscarinics.

Dose

The dosage, form of the medicine, and how often you take the medicine will depend on:

  • Age.
  • The condition being treated.
  • The severity of your condition.
  • Other medical conditions in the patient.
  • The reaction to the first dose.

Dosage for obsessive compulsive disorder

Form: prolonged-release oral capsule.

Adult dosage (ages 18-64): 100mg, 150mg.

The typical dose is 100 mg per day, taken before bedtime.

Your doctor can increase your dose each week by 50 mg if necessary.

The maximum daily dose is 300 mg.

Fluvoxamine has not been confirmed to be safe and effective for use in people under 18 years of age.

Higher dosage (over 65 years): Older adults are more likely to be more sensitive to fluvoxamine and may process the drug more slowly.

So the drug stays in the body longer and this increases the risk of side effects, especially low sodium levels.

Your doctor may adjust your dose to prevent levels of this drug from building up too much in the body.

Side effects of fluvoxamine

Fluvoxamine oral capsule may cause drowsiness, and the side effects of this medication are slightly different for adults and children.

The most common side effects are:

  • Sickness.
  • Drowsiness.
  • Soft spot.
  • Dizziness
  • Anxiety.
  • Trouble sleeping
  • Sexual problems
  • Tremors
  • Lack of appetite.
  • Dry mouth.
  • Diarrhea.
  • Muscle pain.
  • Throat pain.
  • Abdominal pain.
  • Yawning

Additional side effects for children can include:

  • Hyperactivity or agitation.
  • Depression .
  • Heavy menstrual periods.
  • Gases.
  • Eruptions

If these effects are mild, they can go away in a few days or a couple of weeks. If they do not disappear or increase in severity, the doctor should be consulted.

Serious side effects

Serious side effects and their symptoms may include the following:

  • Suicidal thoughts.
  • Acting with dangerous impulses that may pose a danger to himself or to other people.
  • Aggressive or violent behavior.
  • New or worse depression.
  • New or worse anxiety or panic attacks.
  • Agitation, restlessness, anger, or irritability.
  • Trouble sleeping at night.

Serotonin syndrome may occur. These symptoms may include: agitation, hallucinations, coma or other changes in mental status, coordination problems or muscle spasms, fast heartbeat, sweating or fever, nausea, vomiting or diarrhea, and muscle stiffness.

Eye problems can occur and symptoms can include:

  • Pain in the eye
  • Vision changes, such as blurred or double vision.
  • Swelling or redness of the eyes

Manic episodes can also be observed. Symptoms may include: increased energy, severe sleep problems, racing thoughts, reckless behavior, excessive happiness or irritability, talking more or faster than normal.

Warnings and Contraindications

This drug has a black box warning, the most serious of the Food and Drug Administration warning about the dangerous effects of drugs.

Among the warnings are:

Allergies

You should not take this medicine if you have ever had allergic reactions.

Taking the medicine again could even cause death.

Suicide

The possibility of a suicide attempt is inherent in depression and can persist until significant remission occurs.

Therefore, high-risk patients should be closely supervised during therapy and the possible need for hospitalization should be considered.

In order to minimize the possibility of overdose, prescriptions for fluvoxamine should be written for the smallest amount of medication compatible with good patient management.

Serotonin syndrome

This drug can cause a life-threatening condition called serotonin syndrome.

This happens when medications cause excessive build-up of serotonin in your body.

See a doctor immediately if you have any symptoms of this condition, such as agitation, hallucinations, coordination problems, or muscle stiffness.

Abnormal bleeding

This medicine can increase your risk of bleeding or bruising.

The patient may be at increased risk if it is co-administered with aspirin, warfarin , a blood thinner, or a non-steroidal anti-inflammatory drug (such as ibuprofen or naproxen ).

Manic episodes

This drug can increase the risk of mania.

If the patient has a history of mania, the doctor should be consulted before using this medicine.

Seizures

Few cases of seizures have been reported during fluvoxamine administration.

Caution is advised when the drug is administered to patients with a history of seizures.

If you start to have seizures or if the seizures occur more frequently, you should see your doctor to stop it.

Some people who have used this medicine have had seizures.

If you have unstable epilepsy, you should not take this medicine.

If you have a history of seizures or controlled epilepsy , your doctor should monitor you closely if you take this drug.

Electroshock therapy

Concurrent administration with electroshock therapy should be avoided due to the lack of studies in this area.

Combination with alcohol

Fluvoxamine can potentiate the effects of alcohol and increase the level of psychomotor impairment .

Occupational hazards

Sedation can occur in some patients.

Therefore, patients should be warned about participating in activities that require full mental alertness, judgment, and physical coordination, such as driving a car or performing dangerous tasks, until they are reasonably certain that fluvoxamine treatment does not affect them. negatively.

Pregnancy and breastfeeding

The safe use of fluvoxamine during pregnancy and lactation has not been established.

Fluvoxamine is excreted in human milk in small amounts.

Therefore, it should not be administered to women of childbearing potential or nursing mothers, unless, in the opinion of the treating physician, the expected benefits to the patient outweigh the possible risks to the child or fetus.

Kids

Safety and efficacy in children under 18 years of age have not been established.

Certain health conditions

Fluvoxamine should be used with caution in patients with closed-angle glaucoma , a history of myocardial infarction, or unstable heart disease.

Liver disease

If you have a history of liver disease, your body may not clear this drug as quickly as it should. This could lead to a build-up of this medicine in your body.

To avoid this, your doctor may start with a lower dose and monitor you carefully during the dose increase.

Sun sensitivity

Fluvoxamine can make your skin more sensitive to the sun. Which increases your risk of sunburn.

The sun should be avoided as much as possible. If you can’t, be sure to wear protective clothing and sunscreen.

Fluvoxamine interactions

Fluvoxamine can interact with medications such as:

  • Vitamins or herbs.
  • Monoamine oxidase inhibitors, such as phenelzine or tranylcypromine.
  • Linezolid.
  • Thioridazine.
  • Tizanidina.
  • Pimozide.
  • Alosetron.
  • Ramelteon.
  • Benzodiazepines such as alprazolam or diazepam.
  • Clozapina.
  • Methadone.
  • Nonsteroidal anti-inflammatory drugs, such as aspirin, ibuprofen, or naproxen .
  • Lithium.
  • Tacrina.
  • Triptans, like sumatriptan.
  • Tryptophan
  • Diltiazem.
  • Beta-blockers, such as propranolol or metoprolol.
  • Warfarin .
  • Tricyclic antidepressants (ATC).
  • Serotonergic drugs.

If you stop taking the medicine suddenly: stopping fluvoxamine can cause serious symptoms, such as anxiety, irritability, high or low mood, restlessness or changes in sleeping habits.

Symptoms also include headache, sweating, nausea, dizziness, pins and needles, tremors, or confusion.