Florest

Indications

Fluvoxamine is an antidepressant used to treat obsessive-compulsive disorder (OCD), a condition with unwanted repeated thoughts and urges to repeat actions, and to treat depression in adults. Doctors may also use it for some anxiety disorders. It is prescription only.

How It Works

Fluvoxamine belongs to the selective serotonin reuptake inhibitor (SSRI) group. Serotonin is a natural chemical messenger in the brain that helps control mood, anxiety and repetitive thoughts. Fluvoxamine blocks the re-uptake of serotonin by nerve cells, so more of it stays active between them. Benefit builds slowly, usually over 2 to 6 weeks for depression and sometimes longer for OCD.

Dosage and Administration

Take exactly as prescribed. Treatment is usually started at a low dose, often once daily at bedtime, and increased gradually by the doctor according to response. Larger daily amounts may be split into two doses. Swallow the tablet whole with water, with or without food. Keep taking it even when you feel better, and do not stop suddenly; your doctor will lower the dose slowly when it is time to stop.

Interactions

Fluvoxamine strongly affects liver enzymes that break down many other drugs, so interactions are important. Do not take it with Tizanidine, Pimozide, Thioridazine, Ramelteon or within 14 days of an MAO inhibitor such as Linezolid or Selegiline. It can raise blood levels of Theophylline, Clozapine, Olanzapine, Caffeine, Warfarin, some benzodiazepines such as Diazepam, and some heart medicines. Taking it with Tramadol, Triptans, other antidepressants, Lithium or St John Wort can cause serotonin syndrome. With Aspirin, NSAIDs or blood thinners the risk of bleeding rises. Tell your doctor about all medicines you take.

Contraindications

• Allergy to Fluvoxamine.
• Use with Tizanidine, Pimozide, Thioridazine or Ramelteon.
• Use with, or within 14 days of stopping, an MAO inhibitor.

Side Effects

Common effects include nausea, which often settles after the first weeks, sleepiness or trouble sleeping, dizziness, dry mouth, headache, sweating, loss of appetite, constipation or diarrhoea, nervousness and sexual problems such as low desire or delayed orgasm.

Get urgent medical help for thoughts of suicide or self-harm, unusual agitation or high mood, a fit, unusual bleeding or bruising, black stools, confusion with fever, fast heartbeat, muscle twitching and sweating (possible serotonin syndrome), or an allergic reaction with swelling or breathing difficulty.

Pregnancy and Lactation

Use in pregnancy only if your doctor decides the benefit is greater than the risk; SSRIs in late pregnancy can cause temporary problems in the newborn. Do not stop on your own if you become pregnant; talk to your doctor. Small amounts pass into breast milk; your doctor will advise whether breastfeeding is suitable.

Precautions and Warnings

• Young people under 25 may have more suicidal thoughts at the start of treatment or after dose changes; family should watch closely.
• Use with care in epilepsy, liver disease, bleeding disorders, glaucoma and bipolar disorder.
• It may cause drowsiness; do not drive until you know how it affects you.
• Avoid alcohol and limit caffeine, as caffeine levels can rise.
• Stopping suddenly can cause dizziness, irritability and flu-like feelings.

Overdose

Overdose can cause vomiting, drowsiness, fast or slow heartbeat, low blood pressure, fits and coma. Get emergency medical help at once.

Therapeutic Class

Antidepressant, selective serotonin reuptake inhibitor (SSRI).

Storage

Store below 30°C in a dry place, away from light and out of the reach of children.