Fluvoxamine belongs to the class of medications called selective serotonin reuptake inhibitors (SSRIs). It is used for the treatment of depression and obsessive-compulsive disorder (OCD). It helps to reduce anxiety and unpleasant thoughts associated with OCD and improves mood by treating depression.

Serotonin reuptake inhibitors work by increasing the amount of a neurotransmitter (a chemical found in the brain) called serotonin. Although you may start feeling better within a few weeks of treatment, the full effects of the medication may not be evident until several weeks of treatment have passed.

Your doctor may have suggested this medication for conditions other than the ones listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

The recommended adult dose of fluvoxamine ranges from 50 mg to 300 mg depending on circumstances, taken once daily at bedtime. 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. The tablets should be swallowed 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 very important that this medication be taken regularly and exactly as prescribed by your doctor. If you forget a dose of fluvoxamine and your dose is once a day, take it as soon as you remember (if you remember it the same day), and then go back to your regular schedule. If your dose is twice a day, skip the missed dose and go back to your regular schedule. Do not take a double dose to make up for a missed one.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

Luvox® is available in strengths of 50 mg and 100 mg.

50 mg: Each film-coated, round, scored, white tablet, stamped with "291" twice on one side and a stylized "S" on the other, contains 50 mg of fluvoxamine.

100 mg: Each film-coated, oval, scored, white tablet, stamped with "313" twice on one side and a stylized "S" on the other, contains 100 mg of fluvoxamine.

Nonmedicinal ingredients: colloidal anhydrous silica, maize starch, mannitol, methylhydroxypropyl cellulose, polyethylene glycol, pregelatinized starch, sodium stearyl fumarate, talc, and titanium dioxide. This medication does not contain gluten, lactose, sodium metabisulfite, or tartrazine.

Fluvoxamine should not be taken by anyone who:

• is allergic to fluvoxamine or any of the ingredients of the medication
• has taken a MAO inhibitor within the last 14 days
• is also taking cisapride, terfenadine, or astemizole

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor. Your health professional may be able to help you deal with some of the effects.

The following side effects may go away as your body becomes used to the medicine; check with your doctor if they continue or become bothersome.

More common
• constipation
• dizziness
• drowsiness
• headache
• nausea
• trouble sleeping
• unusual tiredness
• vomiting

Less common
• abdominal pain
• change in taste sensation
• decreased appetite
• diarrhea
• dryness of mouth
• feeling of constant movement of self or surroundings
• feeling of fast or irregular heartbeat
• frequent urination
• heartburn
• increased sweating
• trembling or shaking
• unusual weight gain or loss

Check with your doctor as soon as possible if any of the following side effects occur:

More common
• change in sexual performance or desire

Less common
• behaviour, mood, or mental changes
• trouble breathing
• trouble urinating
• twitching

Rare
• absence of or decrease in body movements
• blurred vision
• clumsiness or unsteadiness
• convulsions (seizures)
• inability to move eyes
• increase in body movements
• menstrual changes
• nose bleeds
• red or irritated eyes
• redness, tenderness, itching, burning, or peeling of skin
• skin rash
• sore throat, fever, and chills
• symptoms of serotonin syndrome, including:
  • diarrhea
  • fever
  • increased sweating
  • mood or behaviour changes
  • overactive reflexes
  • racing heartbeat
  • restlessness
  • shivering or shaking
• talking, feeling, and acting with excitement and activity you cannot control
• unusual bruising
• unusual, incomplete, or sudden body or facial movements
• unusual secretion of milk (females)
• weakness

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Drowsiness/reduced alertness: Sedation may occur for some people who take fluvoxamine. Therefore, use appropriate caution with activities that require complete mental alertness, judgment, and physical coordination (such as driving a car or performing hazardous tasks) until you establish that fluvoxamine does not affect you in this way.

Seizures: People with a history of seizures should use fluvoxamine with caution. Anyone who develops seizures should stop taking the medication and contact their doctor.

Stopping the medication: Stopping this medication suddenly may lead to side effects. If you are thinking of stopping the medication, check with your doctor first.

Suicidal or agitated behaviour: Adults and children taking this medication 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 people start taking this medication. People should be closely monitored by their doctor for emotional and behavioural changes.

Pregnancy: The safe use of fluvoxamine during pregnancy has not been established. It has been reported that babies born to pregnant women who have taken fluvoxamine during the last trimester of pregnancy may be adversely affected. Physicians and pregnant women should carefully consider the benefits and the risks of all treatment options.

Breast-feeding: The safe use of fluvoxamine while breast-feeding has not been established. Fluvoxamine passes into breast milk in small quantities. Therefore, it should not be taken by nursing women unless, in the opinion of their doctor, the expected benefits outweigh the risks.

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

The following medications may affect how fluvoxamine works or increase the risk of side effects:

• alcohol
• buspirone
• bromocriptine
• carbamazepine
• dextromethorphan
• dihydroergotamine
• fenfluramine
• levodopa
• meperidine
• MAO inhibitors (e.g., phenelzine, tranylcypromine)
• nefazodone
• sumatriptan
• trazodone
• tricyclic antidepressants (e.g., desipramine, nortriptyline)
• tryptophan

The following medications may be affected by fluovoxamine:

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. In many cases, interactions are intended or are managed by close monitoring. 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 this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that 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.