Case Evaluation

Fluvoxamine: Fluvoxamine Overview

Fluvoxamine

Generic Name: Fluvoxamine

Brand Name: Luvox

Drug Class And Mechanism:

Fluvoxamine is an antidepressant medication that affects the chemicals within the brain that serve as messengers between the nerve cells. These chemical messengers are called neurotransmitters. Many experts believe that an imbalance in these neurotransmitters is the cause of depression. Fluvoxamine works by inhibiting the uptake by the nerve cells of a neurotransmitter, serotonin, an action which results in more serotonin in the brain. Fluvoxamine is in the class of drugs called selective serotonin reuptake inhibitors (SSRIs), a class that also includes fluoxetine (Prozac) sertraline (Zoloft), and paroxetine (Paxil). Fluvoxamine was approved by the FDA for the treatment of obsessive-compulsive disorder on December, 1994.

Prescription: yes

Generic Available: yes

Preparations: Tablets (oval): 50mg (yellow).

Storage: Tablets should be kept at room temperature, 15-30°C (59-86°F).

Prescribed For: Fluvoxamine is currently FDA-approved for use in obsessive-compulsive disorder (OCD). However, like other SSRIs, it also has been used in the treatment of major depression. It also has been used in the management of obesity, bulimia, schizophrenia, and panic disorder. Dosing: Fluvoxamine is given as a single daily dose, usually in the morning. As with all antidepressants, it may take a few weeks of treatment before the full effects become manifest. Elderly patients, debilitated persons, and patients with certain kidney or liver diseases may need lower doses.

Drug Interactions: All SSRIs (selective serotonin reuptake inhibitors), including fluvoxamine, should not be taken with any of the MAO (mono-amine oxidase) inhibitor-class of antidepressants, for example, isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), and procarbazine (Matulane). Such combinations may lead to confusion, high blood pressure, tremor, and increased activity. This same type of interaction also may occur with selegiline (Eldepryl), fenfluramine (Pondimin), and dexfenfluramine (Redux). Fluvoxamine can inhibit the rate of metabolism of astemizole (Hismanal). This can theoretically can lead to dangerous heart arrythmias. Terfenadine (Seldane) is metabolized in the same way as astemizole. Thus, fluvoxamine should not be used with these two antihistamines. Fluvoxamine also can inhibit the metabolism of clozapine (Clozaril), necessitating dosage reductions of clozapine. Fluvoxamine also inhibits theophylline) Theodur, Slobid, Uniphyl) metabolism, sometimes leading to toxicity (e.g. nausea, vomiting). Other drugs which may be similarly affected include warfarin (Coumadin), alprazolam (Xanax), and triazolam (Halcion).

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