Fluvoxamine Extended-Release Rx
Generic Name and Formulations:
Fluvoxamine maleate 100mg, 150mg; ext-rel caps.
Various generic manufacturers
Indications for Fluvoxamine Extended-Release:
Swallow whole. ≥18yrs: initially 100mg once daily at bedtime; may increase in 50mg increments at 1-week interval; range 100–300mg/day; max 300mg/day. Elderly, hepatic impairment: initially 100mg and titrate slowly.
Concomitant alosetron, tizanidine, pimozide, thioridazine, ramelteon. During or within 14 days of MAOIs; do not start an MAOI during or within 14 days of fluvoxamine. Concomitant linezolid, IV methylene blue.
Suicidality and antidepressants.
Increased risk of suicidal thinking and behavior in children, adolescents, and young adults; monitor for clinical worsening or unusual changes. Screen for bipolar disorder. Monitor for serotonin syndrome; discontinue if occurs. History of seizures (discontinue if occurs), mania/hypomania. ECT. Cardiovascular disease. Liver dysfunction. Angle-closure glaucoma. Conditions that affect metabolism or hemodynamic response. Reduced activity of CYP2D6. Reevaluate periodically. Write ℞ for smallest practical amount. Avoid abrupt cessation. Elderly. Labor & delivery. Pregnancy (Cat.C); 3rd trimester: consider tapering dose. Nursing mothers: not recommended.
See Contraindications. Prolongation of QT interval with pimozide, thioridazine. Avoid alcohol. Increased risk of serotonin syndrome with other serotonergic drugs, triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, tryptophan, buspirone, amphetamines, St. John's wort, linezolid, IV methylene blue; monitor. Potentiates diazepam (not recommended), triazolam and alprazolam (reduce their doses by at least ½), midazolam, theophylline (reduce its dose by ⅔ and monitor), warfarin, carbamazepine, tricyclic antidepressants (reduce their doses and monitor), propranolol, metoprolol (reduce their doses), clozapine, methadone, tacrine. Caution with drugs that inhibit CYP2D6 (eg, quinidine) or CYP3A4, phenytoin, diltiazem. Increased risk of bleeding with concomitant NSAIDs, aspirin, warfarin, and others that affect coagulation. Monitor mexiletine levels. Smokers may have increased metabolism.
Abnormal ejaculation, anorexia, anorgasmia, asthenia, diarrhea, nausea, somnolence, sweating, tremor, anxiety, decreased libido, myalgia, pharyngitis, vomiting, dyspepsia, dizziness, insomnia, yawning; hyponatremia (discontinue if symptomatic).
Formerly known under the brand name Luvox CR.
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