Fluvoxamine

The recommended adult dose of fluvoxamine ranges from 50 mg to 300 mg depending on circumstances. A low dose of fluvoxamine (e.g., 50 mg) is usually used to start treatment, with increases in dose every few days as tolerated until the best dose is reached.

Doses of up to 150 mg are taken once daily at bedtime. Doses above 150 mg are taken twice daily, with 150 mg being taken at bedtime.

The tablets should be swallowed whole with water and without chewing.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take Fluvoxamine exactly as prescribed by your doctor. If you forget a dose of fluvoxamine, skip the missed dose and go back to your regular schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store Fluvoxamine at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

In addition to its desired action, this medication may cause some adverse effects, notably: it may decrease your appetite; it may cause dryness of the mouth; it may cause headaches; it may cause dizziness - use caution when getting up from a lying or sitting position and use caution if driving; it may cause nausea or, rarely, vomiting; it may cause difficulty falling or staying asleep. Each person may react differently to a treatment. If you think this medication may be causing adverse effects (including those described here, or others), talk to your health care professional. He or she can help you to determine whether or not the medication is the source of the problem.

50 mg
Each white, round, biconvex, film-coated tablet, scored and engraved "PRO 50" on one side, plain on the other side, contains 50 mg of fluvoxamine maleate. Nonmedicinal ingredients: magnesium stearate, mannitol, hydroxypropyl methylcellulose, polydextrose, polyethylene glycol, titanium dioxide, and carnauba wax.

100 mg
Each white, round, biconvex, film-coated tablet, scored and engraved "PRO 50" on one side, plain on the other, contains 100 mg of fluvoxamine maleate. Nonmedicinal ingredients: magnesium stearate, mannitol, hydroxypropyl methylcellulose, polydextrose, polyethylene glycol, titanium dioxide, and carnauba wax.

Do not take Fluvoxamine if you:

• are allergic to fluvoxamine or any ingredients of the medication
• are also taking thioridazine, Tizanidine, Pimozide, or any of the following medications that are no longer available in Canada: cisapride, terfenadine, astemizole, ramelteon, or mesoridazine
• have taken an MAO inhibitor (e.g., Tranylcypromine, Phenelzine, Linezolid) within the last 14 days

There may be an interaction between fluvoxamine and any of the following:

• Abiraterone acetate
• acetylsalicylic acid (ASA)
• alcohol
• Amiodarone
• Amlodipine
• amphetamines (e.g., Dextroamphetamine, lisdexamphetamine)
• general anesthetics (medications used to put people to sleep before surgery)
• antihistamines (e.g., cetirizine, doxylamine, Diphenhydramine, Hydroxyzine, Loratadine)
• antipsychotics (e.g., Chlorpromazine, Clozapine, Haloperidol, Olanzapine, Quetiapine, Risperidone)
• Baclofen
• barbiturates (e.g., butalbital, pentobarbital, Phenobarbital)
• benzodiazepines (e.g., Alprazolam, Diazepam, Lorazepam)
• Bromocriptine
• Bupropion
• Buspirone
• Celecoxib
• chloral hydrate
• chloroquine
• cincalacet
• Clopidogrel
• cocaine
• Cyclosporine
• dabigatran
• Dacarbazine
• Deferasirox
• Desmopressin
• Dextromethorphan
• diabetes medications (e.g., chlorpropamide, glipizide, Glyburide, insulin, Metformin, Rosiglitazone)
• Diltiazem
• Dipyridamole
• dofetilide
• ergot alkaloids (e.g., ergotamine, Dihydroergotamine)
• estrogens (e.g., conjugated estrogen, Estradiol, ethinyl estradiol)
• Flutamide
• Gemfibrozil
• glucosamine
• grapefruit juice
• Heparin
• HIV non-nucleoside reverse transcriptase inhibitors (NNRTIs; e.g., delavirdine, efavirenz, etravirine, nevirapine)
• HIV protease inhibitors (e.g., atazanavir, indinavir, ritonavir, saquinavir)
• Ifosfamide
• linezolid
• lithium
• low molecular weight heparins (e.g., Dalteparin, Enoxaparin, Tinzaparin)
• Methadone
• methoxsalen
• Metoclopramide
• mexilitine
• Mirtazapine
• monoamine oxidase inhibitors (M.O.S. e.g., Moclobemide, Rasagiline, Selegiline, tranylcypromine)
• methadone
• muscle relaxants (e.g., Cyclobenzaprine, methocarbamol, orphenadrine)
• narcotic pain relievers (e.g., Codeine, Fentanyl, Morphine, Oxycodone)
• Nifedipine
• non-steroidal anti-inflammatory medications (NSAIDs; e.g., Diclofenac, Ibuprofen, Naproxen)
• Olopatadine
• omega-3 fatty acids
• Pentoxifylline
• Primaquine
• Propranolol
• quinidine
• quinine
• quinolone antibiotics (e.g., ciprofloxacin, Norfloxacin, Ofloxacin)
• rasagiline
• rifampin
• Rivaroxaban
• Roflumilast
• Ropinirole
• St. John's wort
• scopolamine
• seizure medications (e.g., Carbamazepine, Clobazam, Levetiracetam, phenobarbital, Phenytoin, primidone, Topiramate, Valproic acid, zonisamide)
• selective serotonin reuptake inhibitors (SSRIs; e.g., Citalopram, Fluoxetine, Paroxetine, Sertraline)
• serotonin antagonists (anti-emetic medications; e.g., Granisetron, Ondansetron)
• serotonin/norepinephrine reuptake inhibitors (SNRIs; e.g., Desvenlafaxine, Duloxetine, Venlafaxine)
• theophyllines (e.g., Aminophylline, Oxtriphylline, Theophylline)
• thiazide diuretics (water pills; e.g., Hydrochlorothiazide, Indapamide, Metolazone)
• Thyroid replacements (e.g., desiccated thyroid, Levothyroxine)
• Ticagrelor
• Ticlopidine
• tizanidine
• Tramadol
• Trazodone
• tricyclic antidepressants (e.g., Desipramine, Nortriptyline)
• triptans (e.g., Sumatriptan, Rizatriptan)
• Tryptophan
• tyrosine kinase inhibitors (e.g., Bosutinib, Dasatinib, imatinib, Nilotinib)
• urokinase
• Vitamin E
• Warfarin
• Zolpidem
• Zopiclone

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Fluvoxamine. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Fluvoxamine.

Bleeding: Fluvoxamine, like other SSRI medications, may cause an increased risk of bleeding, particularly if you are taking acetylsalicylic acid (Asa) or other medications that affect how the Blood Clots. If you notice any signs of bleeding, such as frequent nosebleeds, unexplained bruising, or black and tarry stools, notify your doctor as soon as possible. Your doctor will order routine blood tests to make sure potential problems are caught early.

Bones: Fluvoxamine, like other SSRI medications, may increase the risk of bone fracture, especially if you are a senior or have Osteoporosis or other major risk factors for breaking a bone. Take extra care to avoid falls, especially if you get dizzy or have Low Blood Pressure. Your doctor may monitor your bones while you are taking Fluvoxamine.

Change in blood sugar levels: Changes in blood sugar levels have been reported in the early stages of treatment in people taking fluvoxamine, whether or not they have been diagnosed with Diabetes. People with diabetes may find it necessary to monitor their blood sugar more frequently while using Fluvoxamine.

If you have diabetes or are at risk for developing diabetes, discuss with your doctor how Fluvoxamine may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Fluvoxamine, and whether any special monitoring is needed.

Drowsiness/reduced alertness: Some people who take fluvoxamine may become drowsy. Avoid activities that require complete mental alertness, judgment, and physical coordination (such as driving a car or performing hazardous tasks) until you determine how fluvoxamine affects you.

Glaucoma: Fluvoxamine may cause the symptoms of glaucoma (increased pressure in the eye) to become worse. If you have glaucoma, discuss with your doctor how Fluvoxamine may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Fluvoxamine, and whether any special monitoring is needed. Report any changes in vision to your doctor as soon as possible while you are taking Fluvoxamine.

Seizures: There have been occasional reports of seizures occurring with fluvoxamine. If you have a history of Epilepsy or medical conditions that increase the risk of seizures, discuss with your doctor how Fluvoxamine may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Fluvoxamine, and whether any special monitoring is needed.

Serotonin Syndrome or Neuroleptic Malignant Syndrome: Severe reactions are possible when fluvoxamine is combined with other medications that act on serotonin, such as tricyclic antidepressants and certain medications used to treat migraines. These combinations must be avoided. Symptoms of a reaction may include muscle rigidity and spasms, difficulty moving, changes in mental state including delirium and agitation. Coma and death are possible.

If you are taking antidepressants, discuss with your doctor how Fluvoxamine may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Fluvoxamine, and whether any special monitoring is needed.

Stopping the medication: Stopping Fluvoxamine suddenly may lead to side effects such as dizziness; abnormal dreams; confusion; burning, prickling, or tingling skin; difficulty concentrating; fatigue; anxiety or agitation; shaking; nausea or vomiting; or sweating. If you are thinking of stopping the medication, check with your doctor first.

Suicidal or agitated behaviour: Adults and children taking Fluvoxamine may feel agitated (restless, anxious, aggressive, emotional, and feeling not like themselves), or they may want to hurt themselves or others. These symptoms may occur within several weeks after the person starts taking Fluvoxamine. If you experience these side effects or notice them in a family member who is taking Fluvoxamine, contact your doctor immediately. You should be closely monitored by your doctor for emotional and behaviour changes while taking Fluvoxamine.

Pregnancy: It has been reported that babies born to women who took medications of this kind during the last trimester of their pregnancy may experience adverse effects (such as breathing problems, seizures, trouble feeding, jitteriness, irritability, and constant crying). Fluvoxamine should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Fluvoxamine, contact your doctor immediately.

Breast-feeding: Fluvoxamine passes into breast milk. If you are a breast-feeding mother and are taking fluvoxamine, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and efficacy of Fluvoxamine have not been established for children and adolescents under 18 years of age. The use of Fluvoxamine by people in this age group may cause behavioural and emotional changes, such as suicidal thoughts and behaviour.

This medication is typically used only once a day. However, your pharmacist may have suggested a different schedule that is more appropriate for you. Take it regularly and continuously to maintain its beneficial effects. Important: Follow the instructions on the label. Do not use more of this product, or more often, than prescribed. It is not advisable to stop using this product suddenly, particularly if you have been on it for several weeks. If you are considering stopping the medication, talk to your pharmacist first. This medication should not be chewed or crushed. This medication may be taken with or without food. Consuming alcohol may intensify the effect of this product. If you choose to drink alcohol, do so in moderation. Talk to your health care professional to find out exactly how much alcohol you can drink.