Why is Fluvoxamine maleate prescribed?

If you are sensitive to or have ever had an allergic reaction to fluvoxamine or similar drugs, such as Prozac and Zoloft, do not take Fluvoxamine maleate. Make sure your doctor is aware of any drug reactions you have experienced.

Never combine fluvoxamine with Mellaril or Orap, or take it within 14 days of taking an MAO inhibitor such as Nardil or Parnate. (See "Most important fact about Fluvoxamine maleate.")

Special warnings about Fluvoxamine maleate

In clinical studies, SSRI antidepressants increased the risk of suicidal thinking and behavior in children and adolescents with depression and other psychiatric disorders. Anyone considering the use of fluvoxamine or any other antidepressant in a child or adolescent must balance this risk with the clinical need. Fluvoxamine must be used with caution in children with depression. Fluvoxamine is only approved for treating obsessive-compulsive disorder in children 8 years and older.

Additionally, the progression of major depression is associated with a worsening of symptoms and/or the emergence of suicidal thinking or behavior in both adults and children, whether or not they are taking antidepressants. Individuals being treated with fluvoxamine and their caregivers should watch for any change in symptoms or any new symptoms that appear suddenly--especially agitation, anxiety, hostility, panic, restlessness, extreme hyperactivity, and suicidal thinking or behavior--and report them to the doctor immediately. Be especially observant at the beginning of treatment or whenever there is a change in dose.

You should discuss all your medical problems with your doctor before starting therapy with fluvoxamine, as certain physical conditions or diseases may affect your reaction to it.

If you suffer from seizures, use Fluvoxamine maleate cautiously. If you experience a seizure while taking fluvoxamine, stop taking the drug and call your doctor immediately.

If you have a history of mania (excessively energetic, out-of-control behavior), use Fluvoxamine maleate cautiously.

If you have liver disease, your doctor will adjust the dosage.

Fluvoxamine may cause you to become drowsy or less alert and may affect your judgment. Therefore, avoid driving, operating dangerous machinery, or participating in any hazardous activity that requires full mental alertness until you know your reaction to this medication.

Fluvoxamine can also deplete the body's supply of salt, especially in older adults and people who take diuretics or suffer from dehydration. Under these conditions, your doctor will check your salt levels regularly.

If you develop a rash or hives, or any other allergic-type reaction, notify your physician immediately.

Possible food and drug interactions when taking Fluvoxamine maleate

Do not drink alcohol while taking Fluvoxamine maleate. If you smoke, be sure to tell your doctor before starting fluvoxamine therapy, as your dosage may need adjustment.

If fluvoxamine is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining fluvoxamine with the following:

Anticoagulant drugs such as Coumadin
Antidepressant medications such as Anafranil, Elavil, and Tofranil, as well as the MAO inhibitors Nardil and Parnate
Blood pressure medications known as beta blockers, including Inderal and Lopressor
Carbamazepine (Tegretol)
Clozapine (Clozaril)
Diltiazem (Cardizem)
Lithium (Eskalith, Lithobid)
Methadone (Dolophine)
Mexiletine (Mexitil)
Phenytoin (Dilantin)
Pimozide (Orap)
Quinidine (Quinidex)
Sumatriptan (Imitrex)
Tacrine (Cognex)
Theophylline (Theo-Dur)
Thioridazine (Mellaril)
Tranquilizers and sedatives such as Halcion, Valium, Versed, and Xanax
Tryptophan

Special information if you are pregnant or breastfeeding

The effects of fluvoxamine in pregnancy have not been adequately studied. If you are pregnant or plan to become pregnant, consult your doctor immediately. Fluvoxamine passes into breast milk and may cause serious reactions in a nursing baby. If Fluvoxamine maleate is essential to your health, your doctor may advise you to discontinue breastfeeding until your treatment with fluvoxamine is finished.

Recommended dosage for Fluvoxamine maleate

OBSESSIVE-COMPULSIVE DISORDER

Adults

The usual starting dose is one 50-milligram tablet taken at bedtime. Your doctor may increase your dose, depending upon your response. The maximum daily dose is 300 milligrams. If you take more than 100 milligrams a day, your doctor will divide the total amount into 2 doses; if the doses are not equal, you should take the larger dose at bedtime. Older adults and people with liver problems may need a reduced dosage.

Children

For children ages 8 to 17, the recommended starting dose is 25 milligrams taken at bedtime. The dose may be increased to a maximum of 200 milligrams daily for children under 11, and 300 milligrams for children aged 11 to 17. Young girls sometimes respond to lower doses than boys do. Larger daily dosages are divided in two, as for adults.

Overdosage

Any medication taken in excess can have serious consequences. An overdose of fluvoxamine can be fatal. If you suspect an overdose, seek medical help immediately.

• Common symptoms of fluvoxamine overdose include:
  Coma, breathing difficulties, sleepiness, rapid heartbeat, nausea, vomiting

Other possible symptoms include convulsions, tremor, diarrhea, exaggerated reflexes, and slow or irregular heartbeat. After recovery, some overdose victims have been left with kidney complications, bowel damage, an unsteady gait, or dilated pupils.