Monograph Details
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Central Nervous System
> Anxiety/OCD
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Fluvoxamine |
| Manufacturer |
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Various generic manufacturers |
| Legal Classification |
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Rx
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| Pharmacological Class |
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SSRI. |
| Generic Name |
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Fluvoxamine maleate 25mg, 50mg+, 100mg+; tabs; +scored. |
| Indications |
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Obsessive-compulsive disorder. |
| Children |
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Females may respond to lower dose. <8yrs: not recommended. 8–17yrs: initially 25mg at bedtime, increase in 25mg increments at 4–7 day intervals; usual range 50–200mg/day. Max 8–11yrs: 200mg/day; 12–17yrs: 300mg/day. Divide total daily doses >50mg into 2 doses; give larger portion at bedtime. Hepatic impairment: use lower initial dose and titrate more slowly. |
| Adults |
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≥18yrs: initially 50mg at bedtime, increase in 50mg increments at 4–7 day intervals; range 100–300mg/day; max 300mg/day. Divide total daily doses >100mg into 2 doses; give larger portion at bedtime. Hepatic impairment: use lower initial dose and titrate more slowly. |
| Contraindications |
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Concomitant alosetron, tizanidine, pimozide, thioridazine, mesoridazine, ramelteon. During or within 14 days of MAOIs. |
| Precautions |
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Liver dysfunction. History of seizures (discontinue if occurs), mania/hypomania, or drug abuse. ECT. Cardiac or cardiovascular disease. Diseases that affect metabolism or hemodynamic response. SIADH, edema, fluid loss, adrenal disorders, displacement syndromes (monitor electrolytes, BUN, creatinine). Reduced activity of CYP2D6. Suicidal tendencies. Write Rx for smallest practical amount. Elderly. Labor & delivery. Pregnancy (Cat.C). Nursing mothers: not recommended. |
| Interactions |
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See Contraindications. Prolongation of QT interval with pimozide, thioridazine, mesoridazine. Avoid alcohol. Potentiated by other serotonergic drugs, sumatriptan, lithium, tryptophan. Potentiates diazepam (not recommended), triazolam and alprazolam (reduce their doses by at least ½), 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, midazolam. Caution with drugs that inhibit CYP2D6 (eg, quinidine) or 3A4, phenytoin, diltiazem. Monitor mexiletine levels. Smokers may have increased metabolism. |
| Adverse Reactions |
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Somnolence, insomnia, nervousness, tremor, GI upset, anorexia, dry mouth, abnormal ejaculation, asthenia, urinary frequency, sweating, decreased libido, rhinitis, anorgasmia, taste perversion. Children: also agitation, depression, dysmenorrhea, flatulence, hyperkinesia, rash, weight decrease. |
| How Supplied |
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Contact supplier. |
| Additional Resources |
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• Related Prescribing Note |
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