Fluvoxamine Maleate
Mechanism :
Fluvoxamine is a specific serotonin reuptake inhibition in brain neurons. In fluvoxamine maleate had no significant affinity for histaminergic, alpha or beta adrenergic, muscarinic, or dopaminergic receptors.
Indication :
- Obsessive compulsive disorder
- Depression
Contraindications :
Co-administration of thioridazine, terfenadine, astemizole, cisapride, pimozide, alosetron or tizanidine with fluvoxamine maleate is contraindicated. Fluvoxamine maleate tablets are contraindicated in patients with a history of hypersensitivity to fluvoxamine maleate.
Dosing :
Obsessive Compulsive Disorder:
Under 8 years:
Safety and efficacy not established.
8 to 17 years:
Initial immediate release dose: 25 mg orally once a day at bedtime.
Maintenance dose: 25 to 100 mg orally twice a day. The dose may be increased in 25 mg increments every 4 to 7 days, as tolerated, up to a maximum dose of 200 mg per day in children 8-11 years and upto 300 mg in children between 11-17 years.
Adverse Effect :
Nausea, headache, light headedness, restlessness, anxiety, weight loss, seizures, rash, urticaria, fever, neuroleptic malignant syndrome, social disinhibition, euphoria, precipitation of mania, diminished libido, anorgasmia, xerostomia, abnormal ejaculation.
Interaction :
Lithium: There have been reports of both increased and decreased lithium levels.
Benzodiazepines: half-life of concurrently administered diazepam may be prolonged in some patients. Coadministration of alprazolam and fluvoxamine has resulted in increased alprazolam plasma concentrations.
Haloperidol and Clozapine: Elevation of blood levels of haloperidol and clozapine has been observed in patients receiving concomitant fluvoxamine.
Carbamazepine: elevated plasma anticonvulsant concentrations and clinical anticonvulsant toxicity.
Renal Dose :
Dose in Renal Impairment GFR (mL/min)
| 30-50 | Dose as in normal renal function |
| 10-30 | Dose as in normal renal function |
| <10 | Dose as in normal renal function but titrate slowly |
Dose in Patients undergoing Renal Replacement Therapies
| CAPD | Not dialysed. Dose as in GFR<10 mL/min |
| HD | Not dialysed. Dose as in GFR<10 mL/min |
| HDF/High flux | Not dialysed. Dose as in GFR<10 mL/min |
| CAV/VVHD | Unknown dialysability. Dose as in normal renal function |
Hepatic Dose :
Because fluvoxamine is significantly metabolized in the liver, a lower initial dose and a slower increase in dose are advisable.