Fluvoxamine (Oral)

Overview

Fluvoxamine is used in the treatment of (OCD) obsessive compulsive disorder.

It is a member of the selective serotonin reuptake inhibitor (SSRI) group of medicines. While it is not known precisely how this medication works, it is thought that it increases the activity of serotonin in the brain.

Fluvoxamine is only available with a doctor's prescription and is prescribed as either tablets or extended release capsules.

Condition treated

  • Obsessive compulsive disorder (OCD)

Type Of Medicine

  • Selective serotonin reuptake inhibitor (SSRI)

Side Effects

In addition to the required effects of Fluvoxamine, there may be other unwanted side effects that occur. While not all side effects may occur, you may need to seek medical attention in certain cases where they do.

You should consult your doctor immediately if you experience any of the following side effects from the use of Fluvoxamine:

Occurring less commonly:

  • Behavioral changes
  • Difficulty with urination
  • Mental changes
  • Mood changes
  • Troubled breathing
  • Twitching

Occurring only rarely:

  • Absence of body movements
  • Agitation
  • Blurring of vision
  • Chills
  • Clumsiness
  • Confusion or disorientation
  • Convulsions or seizures
  • Decrease in body movements
  • Diarrhea
  • Experiencing excitement you cannot control
  • Fever
  • Inability to move eyes
  • Increased body movements
  • Loss of coordination
  • Menstrual changes
  • Nosebleeds
  • Overactive reflexes
  • Peeling of the skin
  • Reddening or irritation of eyes
  • Redness, tenderness, itching or burning of the skin
  • Restlessness
  • Shivering
  • Skin rash
  • Soreness of the throat
  • Sweating
  • Trembling or shaking
  • Unsteadiness
  • Unusual bruising
  • Unusual milk secretion (in females)
  • Unusual, incomplete or sudden movements of the body of face
  • Weakness

Other side effects can also occur that do not normally require that you seek medical attention. These side effects are usually mild and would not normally indicate that a wider medical problem is occurring. While you would not normally need to contact a doctor about the following side effects, you may do so for advice if they are bothersome or ongoing.

Occurring more commonly:

  • Change in sexual performance
  • Changed sexual desire
  • Constipation
  • Headaches
  • Trouble sleeping
  • Unusual tiredness

Occurring less commonly:

  • Abdominal pains
  • Stomach pain
  • Changed sense of taste
  • Decreased appetite
  • Feeling of constant movement of surroundings or self
  • Frequent need to urinate
  • Heartburn
  • Increased sweating
  • Unusual weight gain
  • Unusual weight loss

Other side effects can also occur that are not listed herein. If you experience any other side effects from use of this medication, you should contact your healthcare professional for advice on what to do.

Dosage

This medication should only ever be taken as directed by your doctor. You should not take more of it, use it more frequently than prescribed or take it for longer than ordered. Doing so will increase the likelihood of side effects occurring.

This medication will be provided with a medication guide that you should read and understand before beginning use. If you do not understand the guide, ask any questions of your doctor before use.

Fluvoxamine may be taken either without or without food. It should normally be taken before you go to bed, unless you have been instructed otherwise.

If you are taking the extended release tablets, they should be swallowed whole. You should not damage the tablet in any way before taking it and you should not take broken tablets.

The dose of Fluvoxamine given to each patient will differ for a range of different reasons. You should take this medication only as directed by a doctor. The information that follows is for guideline purposes only and should not be used to adjust the dose of your medication.

When treating obsessive compulsive disorder with extended release tablets:

  • Adults should be started on a dose of 100mg taken once daily. This dose may be adjusted as required up to a maximum of 300mg taken daily.
  • Children must have their dose determined in each case by a doctor.

When treating obsessive compulsive disorder with tablets:

  • Adults should receive an initial dose of 50mg before bed every day. This dose may be increased as required, but should not normally exceed 300mg taken daily. If your dose exceeds 100mg, you may need to take it in split doses through the day.
  • Teenagers and children aged between 8 and 17 should take 25mg before bed. The dose can be increased to 200-300mg taken daily, depending on age. When the daily dose exceeds 50mg, the dose should be split into two doses.
  • Children below the age of eight must have their dose determined in each case by a doctor.

If a dose of this medication is missed, you should take it as soon as you can. If you are close to your next dose being due, however, then you should simply skip the dose and return to your usual schedule of treatment. Never take a double dose of this medication.

Interactions

Certain medications should not be used in conjunction with others because they may react in the body and cause severe unwanted side effects. Some drugs can prevent others from working or can increase the risk of certain side effects occurring. Patients should inform their doctor of all treatments and substances they are taking before beginning use of Fluvoxamine. This is particularly important with the following medications.

The use of Fluvoxamine with the following is not recommended. If you are taking any of the following then your doctor may decide not to prescribe Fluvoxamine:

  • Tranylcypromine
  • Tizanidine
  • Thioridazine
  • Terfenadine
  • Selegiline
  • Safinamide
  • Rasagiline
  • Ramelteon
  • Procarbazine
  • Phenelzine
  • Pargyline
  • Moclobemide
  • Metoclopramide
  • Methylene Blue
  • Linezolid
  • Levomethadyl
  • Isocarboxazid
  • Iproniazid
  • Furazolidone
  • Cisapride
  • Bromopride
  • Astemizole
  • Alosetron
  • Agomelatine

The use of Fluvoxamine with the following medications would not normally be recommended. In some cases, however, it may still be the best treatment available for you and your doctor may prescribe both, with adjustments made to the doses of medication taken:

  • Zolmitriptan
  • Ziprasidone
  • Warfarin
  • Vortioxetine
  • Vorapaxar
  • Vilazodone
  • Valdecoxib
  • Tryptophan
  • Treprostinil
  • Trazodone
  • Tramadol
  • Toloxatone
  • Tolmetin
  • Tolfenamic Acid
  • Tirofiban
  • Tinzaparin
  • Ticlopidine
  • Ticagrelor
  • Tiaprofenic Acid
  • Theophylline
  • Tenoxicam
  • Tasimelteon
  • Tapentadol
  • Tamoxifen
  • Sumatriptan
  • Sulindac
  • Sulfinpyrazone
  • St John's Wort
  • Sodium Salicylate
  • Sibutramine
  • Sertraline
  • Selexipag
  • Salsalate
  • Salicylic Acid
  • Rofecoxib
  • Rizatriptan
  • Rivaroxaban
  • Reviparin
  • Proquazone
  • Propyphenazone
  • Propionic Acid
  • Proglumetacin
  • Prasugrel
  • Pranoprofen
  • Pomalidomide
  • Pixantrone
  • Piroxicam
  • Pirfenidone
  • Piperaquine
  • Piketoprofen
  • Phenylbutazone
  • Phenprocoumon
  • Phenindione
  • Pentosan Polysulfate Sodium
  • Paroxetine
  • Parnaparin
  • Parecoxib
  • Palonosetron
  • Oxyphenbutazone
  • Oxycodone
  • Oxaprozin
  • Ospemifene
  • Nimesulide
  • Beta Cyclodextrin
  • Nimesulide
  • Niflumic Acid
  • Nialamide
  • Nepafenac
  • Naratriptan
  • Naproxen
  • Nadroparin
  • Nabumetone
  • Morniflumate
  • Mirtazapine
  • Milnacipran
  • Methylergonovine
  • Meperidine
  • Meloxicam
  • Mefenamic Acid
  • Meclofenamate
  • Lumiracoxib
  • Loxoprofen
  • Lornoxicam
  • Lorcaserin
  • Levomilnacipran
  • Ketorolac
  • Ketoprofen
  • Iobenguane I 123
  • Indomethacin
  • Iloprost
  • Ibuprofen Lysine
  • Ibuprofen
  • Hydroxytryptophan
  • Heparin
  • Granisetron
  • Frovatriptan
  • Fondaparinux
  • Flurbiprofen
  • Fluoxetine
  • Flufenamic Acid
  • Floctafenine
  • Feprazone
  • Fepradinol
  • Fentanyl
  • Fenoprofen
  • Fenfluramine
  • Felbinac
  • Etoricoxib
  • Etofenamate
  • Etodolac
  • Escitalopram
  • Ergotamine
  • Ergonovine
  • Ergoloid Mesylates
  • Eptifibatide
  • Epoprostenol
  • Enoxaparin
  • Eltrombopag
  • Eliglustat
  • Eletriptan
  • Edoxaban
  • Duloxetine
  • Droxicam
  • Droperidol
  • Doxorubicin Hydrochloride Liposome
  • Doxorubicin
  • Donepezil
  • Domperidone
  • Dolasetron
  • Dipyrone
  • Dipyridamole
  • Dihydroergotamine
  • Diflunisal
  • Dicumarol
  • Diclofenac
  • Dextromethorphan
  • Dexketoprofen
  • Dexibuprofen
  • Dexfenfluramine
  • Desvenlafaxine
  • Desirudin
  • Dermatan Sulfate
  • Defibrotide
  • Danaparoid
  • Dalteparin
  • Cyclobenzaprine
  • Clozapine
  • Clorgyline
  • Clopidogrel
  • Clonixin
  • Citalopram
  • Cilostazol
  • Choline Salicylate
  • Certoparin
  • Celecoxib
  • Cangrelor
  • Bupropion
  • Buprenorphine
  • Bufexamac
  • Bromfenac
  • Bivalirudin
  • Bendamustine
  • Bemiparin
  • Aspirin
  • Asenapine
  • Ardeparin
  • Apixaban
  • Antithrombin III Human
  • Anisindione
  • Ancrod
  • Anagrelide
  • Amtolmetin Guacil
  • Amoxapine
  • Amiodarone
  • Almotriptan
  • Acenocoumarol
  • Acemetacin
  • Aceclofenac
  • Abciximab

Use of the following medications with Fluvoxamine may increase the risk of certain side effects occurring. Your doctor may still prescribe both to you, but may make adjustments to the dose or frequency with which you use them:

  • Zolpidem
  • Triazolam
  • Tacrine
  • Ropivacaine
  • Roflumilast
  • Propranolol
  • Phenytoin
  • Olanzapine
  • Midazolam
  • Mexiletine
  • Methadone
  • Lithium
  • Imipramine
  • Haloperidol
  • Ginkgo
  • Galantamine
  • Fosphenytoin
  • Diazepam
  • Cyclosporine
  • Clomipramine
  • Amitriptyline

Other drug interactions with Fluvoxamine can also occur, so you should be sure to inform your doctor of all medications that you are taking before beginning treatment.

The presence of other medical conditions can also have an impact on the use of medications. Medical problems may prohibit the use of certain treatments because the problems may be worsened by the treatments' use or they may impact on the safety and effectiveness of the treatment. You should inform your doctor of all conditions from which you suffer before you begin treatment and this is especially important in the following cases:

Fluvoxamine may have greater effect in patients with liver disease because of the slower removal of the medication from the body that will occur. Caution should be used.

The following conditions may be worsened by the use of this medication:

  • Bipolar disorder
  • Bleeding problems
  • Glaucoma
  • Hyponatraemia
  • Mania
  • Seizures

Other medical conditions not listed here could also affect or be affected by the use of Fluvoxamine. Ensure your doctor is fully aware of your entire medical history before beginning treatment with this medication.

Fluvoxamine can also interact with tobacco. Patients should avoid the use of tobacco while they are using this medication. If this is a problem for you, then you should discuss it with your doctor and you may need to be treated for this addiction before you can begin use of Fluvoxamine.

You should avoid the consumption of alcohol during the use of this treatment.

Warnings

Before taking any medication you should understand the risks of use and weigh these against the benefits of use. You should make the decision to begin treatment with Fluvoxamine having considered this and all of the following with your doctor:

Allergies

If you have any allergies, then you must share these with your doctor before beginning treatment. This is especially important if you have ever had a bad or unusual reaction to any medications that you have taken in the past.

Pediatric

The safe and efficient use of Fluvoxamine has been demonstrated in children using tablets from the age of 8 to 17. These tablets can, however, cause a decrease in appetite and weight in these young patients, so they will need to have weight and growth monitored.

The use of extended release capsules has not been tested in children under 8 years of age and the safety and efficiency of use has not yet been established.

Geriatric

There are no known problems that limit the use of Fluvoxamine in the elderly. Elderly patients are more likely to suffer from both liver problems and hyponatraemia, however, which may impact on the medication's use or the dose administered.

Pregnancy

You should inform your doctor if you are pregnant before you begin use or if you may become pregnant during use. There is a risk involved when using this medication during pregnancy that should be discussed with your doctor. Other treatments may need to be found.

Breastfeeding

There are no adequate studies to determine the risks of breastfeeding while using this medication. You should discuss this with your doctor to determine the best course of action. Weigh the possible risks against the benefits of continuing breastfeeding before doing so.

You will need to have your progress checked regularly by your doctor when using this treatment. This will allow for you to be assessed for unwanted side effects and will allow for changes to the dose you're taking to be made for best effect.

You should not take Fluvoxamine in conjunction with or in the same period as a monoamine oxidase (MAO) inhibitor. If you have taken one of these treatments then you must wait for at least two weeks before beginning use of Fluvoxamine. Likewise, when stopping use of Fluvoxamine, you should also wait two weeks before beginning use of an MAO treatment. If you do not follow this, then you will experience the following symptoms:

  • Confusion and disorientation
  • Agitation
  • Restlessness
  • High body temperature
  • High blood pressure
  • Convulsions
  • Stomach and intestinal problems

These symptoms can lead to much more serious medical complications and must be avoided at all times. Ensure that you are aware of the nature of all other medications you are taking and ensure the prescribing doctor is always aware that you are taking Fluvoxamine.

A serious condition called serotonin syndrome may occur when Fluvoxamine is taken in conjunction with other medications. You should not take any other medications for the duration of this treatment unless you have been ordered to by your doctor. Medications that may trigger this condition when used with Fluvoxamine include the herbal remedy St John's Wort and certain migraine medications.

Fluvoxamine can cause mood changes to occur in patients and may trigger unusual behavior to be displayed. If you start experiencing changes in behavior or suicidal thoughts, you must inform your doctor immediately. Changes can include a simple tendency towards getting upset, an increase in reckless behavior and an increase in energy. Be alert to these changes and ask family and friends to look out for changes in behavior for you, too.

Before beginning treatment you should inform your doctor if anyone in your family has attempted to commit suicide or suffers from bipolar disorder in the past.

Some people may become drowsy, less alert or less able to think clearly during treatment, especially around the times of dosing. It may also cause a blurring of vision and poor control of the muscles. You should learn how you react to this medication in the first few weeks and should avoid driving and operating machinery in this time. Remember that it is your responsibility to ensure that you are safe to operate a car or machinery and must not put yourself or others at risk. Do not do anything that could be dangerous to you or to others if you were to become less alert or were suddenly less able to see clearly.

You should not stop use of this medication abruptly without talking to your doctor, even if it is causing unwanted side effects. This medication can create dependency and you will experience withdrawal symptoms if you stop taking it suddenly. Symptoms can include confusion, headaches, irritability, tingling, numbness, troubled sleep, weakness, drowsiness and restlessness. If you wish to cease use, then your doctor will determine a plan to gradually reduce your dose and, in doing so, reduce your dependency on the medication.

Patients taking Fluvoxamine will be at greater risk of developing bleeding problems. This will be increased if you are taking any medications that thin the blood. Such medications are available over the counter and include aspirin and ibuprofen. You should not take any medications in conjunction with Fluvoxamine unless you have been expressly ordered to by your doctor.

Hyponatremia can be caused when taking Fluvoxamine. If you become confused or have problems with memory and stability, then you should contact your doctor. These may be symptoms caused by a lack of sodium in the blood.

If you display any signs of allergy including swelling, rash, hives and difficulty breathing during the use of this medication, then you should seek immediate medical attention. These may be signs of a serious allergic reaction to the medication.

Storage

You should store Fluvoxamine well out of the reach of children and in a cool, dry place. Prevent the medication from freezing and keep it out of direct sunlight.

You should dispose of any outdated or unwanted medication properly, as directed by your healthcare professional.

Summary

Fluvoxamine is used to treat patients who suffer from obsessive compulsive disorder. It is not known exactly how this medication works but it is believed to stimulate the serotonin levels in the brain to increase activity.

Fluvoxamine needs to be taken regularly and consistently to work and should be taken exactly as it has been prescribed. When you first begin treatment, the dose may be gradually increased and it can take several weeks before any noticeable changes begin to occur. You should continue treatment as instructed, even if you believe that the treatment is not working.

Once you are taking a regular dose of this medication it is important that you continue use to prevent withdrawal symptoms from occurring. If you wish to stop use, then your doctor will need to determine a dosing plan to gradually reduce your dose of medication.

Fluvoxamine interacts with a wide range of medications in the body, including over the counter treatments and herbal remedies. Before beginning use, it is vital that you inform your doctor of all treatments that you are taking to ensure that you are able to avoid any interactions that may occur. Drug interactions can cause very serious side effects and Fluvoxamine can interact with a significant number of common treatments. Do not take any medications in conjunction with Fluvoxamine without first having them approved by your doctor.