fluvoxamine
Fluvoxamine maleate is a selective serotonin reuptake inhibitor (SSRI). It's one of the first-choice treatment options for obsessive-compulsive disorder (OCD) in adults and children ages 8 years and older. Fluvoxamine is taken by mouth, typically once or twice daily, depending on your dose and whether you're taking the immediate-release tablet or the extended-release capsule. Fluvoxamine can cause a number of unpleasant side effects, including nausea, sleep problems, and headache. The brand name (Luvox) is no longer available.
What is Fluvoxamine?
What is Fluvoxamine used for?
How Fluvoxamine works
Fluvoxamine is a selective serotonin reuptake inhibitor (SSRI). It boosts serotonin levels in the brain, which can help with symptoms of OCD.
Drug facts
Side effects of Fluvoxamine
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Nausea (40%)
- Headache (22%)
- Sleepiness (22%)
- Trouble sleeping (21%)
- Dry mouth (14%)
- Weakness, feeling like you have no energy (14%)
- Nervousness (12%)
- Dizziness (11%)
- Diarrhea (11%)
- Constipation (10%)
- Upset stomach (10%)
- Trouble sleeping (35%)
- Nausea (34%)
- Headache (32%)
- Sleepiness (27%)
- Weakness, feeling like you have no energy (26%)
- Diarrhea (18%)
- Loss of appetite (13%)
- Dizziness (12%)
Less Common Side Effects
- Cold and flu symptoms
- Vomiting
- Gas
- Change in taste
- Tremor
- Anxiety
- Low sex drive
- Delayed ejaculation
- Depressed mood
- Sweating
- Urinating more often
Fluvoxamine serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Suicidal thoughts or behavior
- Seizure
- Serotonin syndrome: fast heart rate, sweating, muscle stiffness or spasms, fever, confusion
- Serious bleeding: bruising that doesn't improve, black-colored stools, pink or red urine, unusual bleeding from the nose or gums
- Low blood sodium levels: weakness, confusion, difficulty concentrating, headache, memory problems
- Severe allergic reaction: trouble breathing, swelling in the face or tongue, rash
More on Fluvoxamine side effects
The following Fluvoxamine side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Less common
Behavior, mood, or mental changes
trouble with breathing
trouble with urinating
twitching
Rare
Absence of or decrease in body movements
agitation
blurred vision
chills
clumsiness or unsteadiness
confusion
convulsions (seizures)
inability to move the eyes
increase in body movements
menstrual changes
nosebleeds
overactive reflexes
poor coordination
red or irritated eyes
redness, tenderness, itching, burning, or peeling of the skin
restlessness
shivering
skin rash
sweating
talking or acting with excitement you cannot control
trembling or shaking
unusual bruising
unusual, incomplete, or sudden body or facial movements
unusual secretion of milk (in females)
weakness
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Change in sexual performance or desire
headache
trouble sleeping
unusual tiredness
Less common
Abdominal or stomach pain
change in sense of taste
decreased appetite
feeling of constant movement of self or surroundings
increased sweating
unusual weight gain or loss
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Fluvoxamine
Pros
- First-choice treatment option for OCD
- Can be used in children as young as 8 years old
- Available as a lower-cost generic medication
- Can take before bedtime to sleep through drowsiness side effect
Cons
- Might need to take twice daily, depending on your dose
- Can cause a lot of side effects, such as sleepiness, trouble sleeping, and loss of appetite
- Can interact with many medications, such as sumatriptan (Imitrex), carbamazepine (Tegretol), and diltiazem (Cardizem)
Pharmacist tips for Fluvoxamine
- If you're starting fluvoxamine for the first time, your provider will have you try a lower dose and raise it slowly over time, depending on how your body is responding to the medication. Have regular check-ins with your provider, especially in the beginning. Let them know how the medication is affecting your OCD symptoms and if you're having any side effects.
- Start by taking fluvoxamine once a day at bedtime. You can take it with or without food.
- If you're taking fluvoxamine immediate-release tablets and your dose is higher than 100 mg, your provider will ask you to take it as divided doses, twice a day. If you prefer to only take fluvoxamine once a day, ask your provider about switching to the extended-release capsules.
- If you're taking the fluvoxamine extended-release (ER) capsules, make sure you don't crush, chew, or open them. ER capsules work by releasing the medicine slowly in your body throughout the day, and tampering with the capsule can cause you to get too much medication too fast.
- Before starting fluvoxamine, talk to your provider about all the medications that you take. Some medications can have very serious interactions if they're combined with fluvoxamine.
- Avoid drinking alcohol while you're taking fluvoxamine. Mixing alcohol with this medication can cause side effects like sleepiness, confusion, and dizziness.
- Don't stop fluvoxamine unless instructed by your provider. Stopping the medication too quickly can lead to withdrawal symptoms.
- There isn't a specific amount of time you'll need to take fluvoxamine. In general, it can take several months of consistent (non-stop) treatment for you to see the benefits in your OCD symptoms.
- Common side effects of fluvoxamine include sleepiness and not being able to concentrate. Avoid driving or doing tasks that require a lot of concentration until you know how this medication affects you.
Common questions about Fluvoxamine
Fluvoxamine is currently still on the market, but only available as generic medications. It's unclear why brand name Luvox is no longer available. Talk with your provider if you've more questions about the availability of fluvoxamine.
Most SSRIs are taken to help with depression and anxiety. But fluvoxamine is only approved to treat obsessive-compulsive disorder (OCD). In addition, fluvoxamine is more likely to cause side effects, such as diarrhea and nausea, compared to other SSRIs. It also tends to have a higher risk for medication interactions. If you're not sure about which SSRI is right for you, talk with your mental health provider.
It might take 4 to 6 weeks of taking fluvoxamine before you start to see an improvement in your OCD symptoms. For some people, however, it can take 10 to 12 weeks. Be patient, and don't stop taking this medication without talking to your mental health provider first.
No, fluvoxamine isn't a controlled substance because it's unlikely to lead to addiction or dependence.
In general, weight gain is a side effect of SSRI medications. But not all SSRIs have the same risk for weight gain. People who took fluvoxamine extended-release in clinical studies experienced similar weight gain as people who took placebo. People who took fluvoxamine immediate-release (IR) reported both weight gain and weight loss, but children tended to experience weight loss more often than weight gain. If you're concerned about how fluvoxamine might affect body weight, talk with your provider.
Fluvoxamine is only FDA-approved to treat OCD. Researchers have looked at how well this medication works for certain anxiety conditions, including panic disorder and social anxiety, but more studies are needed in these areas. Talk to your provider if you're looking for ways to manage your anxiety.
If you become pregnant or are planning to become pregnant, let your provider know. Limited research doesn't clearly link fluvoxamine to any major birth defects or with a higher risk of miscarriage, but more studies are needed in these areas. In general, babies born to mothers who took SSRIs during pregnancy are at risk for having adaptation syndrome at birth, and can experience trouble feeding or sleeping. Your provider can talk with you about your options for treating OCD during pregnancy.
You should avoid drinking alcohol when you're taking SSRIs like fluvoxamine. Mixing the two can worsen the medication's side effects like sleepiness, confusion, and dizziness. Drinking alcohol can also worsen mental health conditions, making it harder for fluvoxamine to work well for you.
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Risks and warnings for Fluvoxamine
Fluvoxamine can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Suicidal thoughts and behavior
- Risk factors: Age 24 or younger
Fluvoxamine can cause suicidal thoughts or behavior, especially in people under the age of 25. Watch for new or worsening depression, suicidal thoughts or behavior, especially during the first few months of treatment or with a dose change. Let your healthcare provider know right away if you notice any unusual changes in mood or behavior while taking this medication.
Serotonin syndrome
- Risk factors: Taking other medications that can affect the serotonin levels in your body
Serotonin syndrome is a rare, but potentially life-threatening condition where there's too much serotonin in the body. Your risk goes up if you use fluvoxamine with other medications that affect serotonin levels (e.g., antidepressants, lithium, triptans for migraines, St. John's wort). Tell your pharmacist about all medications and over-the-counter products you take before starting fluvoxamine so they can check for any interactions. Symptoms of too much serotonin include a fast heart rate, sweating, muscle stiffness or spasms, fever, and confusion. Tell your healthcare provider or get medical help right away if you have any of these symptoms.
Dangerous medication interactions
- Risk factors: Taking thioridazine, tizanidine (Zanaflex), pimozide, alosetron (Lotronex), or benzodiazepines
Fluvoxamine can interact with a lot of medications. Some interactions can lead to serious, life-threatening heart problems. Make sure your healthcare provider and pharmacist know all medications you take from all providers before starting fluvoxamine, so you can avoid this and other serious medication interactions.
Worsening of glaucoma
- Risk factors: Narrow angle glaucoma
Many antidepressants, including fluvoxamine, can cause changes to the eyes. These changes are usually minor and don't affect most people. However, if you have narrow angle glaucoma, fluvoxamine can worsen your eye condition. If you notice any changes to your vision while taking fluvoxamine, let your provider and eye care professional know right away.
Withdrawal symptoms
- Risk factors: Stopping fluvoxamine suddenly
Stopping fluvoxamine suddenly can cause withdrawal symptoms such as nausea, anxiety, agitation, flu-like symptoms, trouble sleeping, and dizziness. Your provider will help you stop fluvoxamine safely and slowly over time. Don't try to stop fluvoxamine on your own and without the supervision of a healthcare provider.
Higher bleeding risk
- Risk factors: Taking other blood-thinning medications (including aspirin, NSAIDs, or warfarin)
Fluvoxamine can raise your risk of bleeding or bruising, especially if you're also taking aspirin, NSAIDs, or blood thinners. Tell your healthcare provider about any bruising that doesn't improve, or if you have black-colored stools, pink or red urine, or unusual bleeding from the nose or gums. If you're on blood thinners, your provider might recommend a change in your dose.
Mania
- Risk factors: Personal or family history of bipolar disorder
Sometimes, depression is the first symptom of bipolar disorder. Treating someone who has bipolar disorder with an antidepressant can cause a manic episode (great excitement, euphoria, delusions, and overactivity). This is more likely to happen in people who are at higher risk of bipolar disorder. Your provider will discuss your history and possible symptoms of bipolar disorder before starting you on fluvoxamine.
Seizures
- Risk factors: History of seizures
Although it's rare to get seizures while taking fluvoxamine, it's still a possibility. If you have a history of seizures or are more prone to getting seizures, let your healthcare provider know before starting this medication.
Low sodium levels in the blood
- Risk factors: Older adults | Taking diuretic medications ("water pills") | Low fluids in the body
In some very rare cases, fluvoxamine can cause low sodium levels in the blood. You might need to have regular blood tests done while taking fluvoxamine to make sure the sodium in your blood stays at a normal level. Tell your healthcare provider right away if you experience weakness, confusion, difficulty concentrating, headache, or memory problems while taking this medication.
Sexual problems
SSRI medications, like fluvoxamine, can cause sexual problems such as ejaculation failure, lower sex drive, erectile dysfunction, and inability to orgasm. Let your provider know if you experience any sexual problems, as they can give you ways to manage these side effects.
Fluvoxamine dosage
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 25mg | 30 tablets | $15.44 | $0.51 |
| 50mg | 30 tablets | $16.28 | $0.54 |
| 100mg | 90 tablets | $33.38 | $0.37 |
Typical dosage for Fluvoxamine
- Adults: The typical starting dose is 50 mg by mouth at bedtime. Your provider will adjust your dose based on how you respond to the medication. The maximum recommended dose is 300 mg per day, given in divided doses.
- Children (aged 8 to 17 years old): The typical starting dose is 25 mg by mouth at bedtime. Your child's provider will adjust their dose based on how they respond to the medication. The maximum recommended dose is 200 mg per day, given in divided doses.
- Adults: The typical starting dose is 100 mg by mouth at bedtime. Your provider might raise your dose weekly up to the maximum dose of 300 mg per day.
Your dose might differ if you're an older adult or have liver problems.
Interactions between Fluvoxamine and other drugs
More on Fluvoxamine interactions
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Agomelatine
- Alosetron
- Astemizole
- Bromopride
- Cisapride
- Eliglustat
- Furazolidone
- Iproniazid
- Isocarboxazid
- Levomethadyl
- Linezolid
- Methylene Blue
- Metoclopramide
- Moclobemide
- Pargyline
- Phenelzine
- Pimozide
- Procarbazine
- Ramelteon
- Rasagiline
- Selegiline
- Terfenadine
- Thioridazine
- Tizanidine
- Tranylcypromine
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Abciximab
- Acalabrutinib
- Aceclofenac
- Acemetacin
- Acenocoumarol
- Alfentanil
- Almotriptan
- Alprazolam
- Amiodarone
- Amoxapine
- Amphetamine
- Amtolmetin Guacil
- Anagrelide
- Ancrod
- Anisindione
- Antithrombin III Human
- Apixaban
- Ardeparin
- Asenapine
- Aspirin
- Avapritinib
- Bemiparin
- Bendamustine
- Benzhydrocodone
- Benzphetamine
- Bivalirudin
- Bosutinib
- Brigatinib
- Bromfenac
- Bufexamac
- Buprenorphine
- Bupropion
- Butorphanol
- Cangrelor
- Carvedilol
- Celecoxib
- Certoparin
- Choline Salicylate
- Cilostazol
- Citalopram
- Clonixin
- Clopidogrel
- Clorgyline
- Clozapine
- Codeine
- Colchicine
- Cyclobenzaprine
- Dalteparin
- Danaparoid
- Defibrotide
- Deflazacort
- Dermatan Sulfate
- Desirudin
- Desmopressin
- Desvenlafaxine
- Dexfenfluramine
- Dexibuprofen
- Dexketoprofen
- Dextroamphetamine
- Dextromethorphan
- Diclofenac
- Dicumarol
- Diflunisal
- Dihydrocodeine
- Dihydroergotamine
- Dipyridamole
- Dipyrone
- Dolasetron
- Domperidone
- Donepezil
- Doxorubicin
- Doxorubicin Hydrochloride Liposome
- Droperidol
- Droxicam
- Duloxetine
- Edoxaban
- Eletriptan
- Elexacaftor
- Encorafenib
- Enoxaparin
- Entrectinib
- Epoprostenol
- Eptifibatide
- Ergoloid Mesylates
- Ergonovine
- Ergotamine
- Escitalopram
- Etodolac
- Etofenamate
- Etoricoxib
- Felbinac
- Fenfluramine
- Fenoprofen
- Fentanyl
- Fepradinol
- Feprazone
- Floctafenine
- Flufenamic Acid
- Fluoxetine
- Flurbiprofen
- Fondaparinux
- Frovatriptan
- Granisetron
- Heparin
- Hydrocodone
- Hydromorphone
- Hydroxytryptophan
- Ibrutinib
- Ibuprofen
- Iloprost
- Indomethacin
- Iobenguane I 123
- Iobenguane I 131
- Ivacaftor
- Ivosidenib
- Ketoprofen
- Ketorolac
- Lasmiditan
- Lemborexant
- Levomilnacipran
- Levorphanol
- Lisdexamfetamine
- Lithium
- Lorcaserin
- Lornoxicam
- Loxoprofen
- Lumateperone
- Lumiracoxib
- Lurbinectedin
- Meclofenamate
- Mefenamic Acid
- Melatonin
- Meloxicam
- Meperidine
- Metaxalone
- Methadone
- Methamphetamine
- Methylergonovine
- Milnacipran
- Mirtazapine
- Morniflumate
- Morphine
- Morphine Sulfate Liposome
- Nabumetone
- Nadroparin
- Nalbuphine
- Naproxen
- Naratriptan
- Nepafenac
- Nialamide
- Niflumic Acid
- Nimesulide
- Nimesulide Beta Cyclodextrin
- Olaparib
- Ondansetron
- Ospemifene
- Oxaprozin
- Oxycodone
- Oxymorphone
- Oxyphenbutazone
- Ozanimod
- Palonosetron
- Parecoxib
- Parnaparin
- Paroxetine
- Pemigatinib
- Pentazocine
- Pentosan Polysulfate Sodium
- Pexidartinib
- Phenindione
- Phenprocoumon
- Phenylbutazone
- Piketoprofen
- Piperaquine
- Pirfenidone
- Piroxicam
- Pixantrone
- Pomalidomide
- Pranoprofen
- Prasugrel
- Proglumetacin
- Propyphenazone
- Proquazone
- Remifentanil
- Reviparin
- Rimegepant
- Rivaroxaban
- Rizatriptan
- Rofecoxib
- Safinamide
- Salicylic Acid
- Salsalate
- Selexipag
- Selumetinib
- Sertraline
- Sibutramine
- Sodium Salicylate
- Sonidegib
- St John's Wort
- Sufentanil
- Sulfinpyrazone
- Sulindac
- Sumatriptan
- Tacrolimus
- Tamoxifen
- Tapentadol
- Tasimelteon
- Tazemetostat
- Tenoxicam
- Tezacaftor
- Theophylline
- Tiaprofenic Acid
- Ticagrelor
- Ticlopidine
- Tinzaparin
- Tirofiban
- Tolfenamic Acid
- Tolmetin
- Toloxatone
- Tolvaptan
- Tramadol
- Treprostinil
- Tryptophan
- Ubrogepant
- Valdecoxib
- Venetoclax
- Vilazodone
- Voclosporin
- Vorapaxar
- Vortioxetine
- Warfarin
- Zanubrutinib
- Ziprasidone
- Zolmitriptan
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
How much does Fluvoxamine cost?
$15.44
Fluvoxamine contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Fluvoxamine will not be safe for you to take.
- Currently taking tizanidine (Zanaflex), thioridazine, alosetron (Lotronex), pimozide, linezolid, IV methylene blue
- Having taken any MAOI medication within the past 14 days, or starting a MAOI medication within 14 days of stopping fluvoxamine
What are alternatives to Fluvoxamine?
News about Fluvoxamine
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