Fluvoxamine
LUVOX
What it isSerotonin-reuptake inhibitor and sigma-1 agonist; obsessive-compulsive and social anxiety disorders.
Why this oneSigma-1 agonism distinguishes it pharmacologically from the other SSRIs, though its clinical contribution is uncertain.
What limits it⚑ It is the most interaction-prone SSRI: CYP1A2 and CYP2C19 inhibition can dangerously raise clozapine, theophylline, or tizanidine.
FDA-approved for
- OCD (1994)
- social anxiety disorder (2008)
Off-label
- depression
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Obsessive compulsive disorder (OCD) | Adult | 100 mg QHS | per response | 300 mg/day |
Titration Weekly increases of 50 mg as tolerated
Renal Undefined
Hepatic Decreased clearance; may require modified dose and slower titration
Instructions
- Take at bedtime
- Do not crush or chew capsules
- Discontinue gradually (taper)
Contraindications
- MAOIs (concurrently or within 14 days) due to risk of serotonin syndrome
- Concomitant thioridazine, tizanidine, pimozide, alosetron, or ramelteon
Cautions
- Clinical worsening/suicide risk
- Screen for bipolar disorder
- Serotonin syndrome
- Abnormal bleeding (with NSAIDs, aspirin, anticoagulants)
- Activation of mania/hypomania
- Discontinuation syndrome
- Seizures
- Angle-closure glaucoma
- Hyponatremia
Adverse reactions
- Abnormal ejaculation
- Anorexia
- Anorgasmia
- Asthenia
- Diarrhea
- Nausea
- Somnolence
- Sweating
- Tremor
Pregnancy Category C; SSRI exposure in pregnancy associated with PPHN and neonatal complications; weigh risks and benefits.
Lactation Fluvoxamine is secreted in human breast milk.
⚠ BOXED WARNING
- Suicidal thoughts and behaviors in patients under 25
Cost, est. cash$5–$150/month
Generic entry2000
Classes and tags
Clinical profile
Legacy pregnancy categoryC
Defining liabilityStrong CYP1A2/2C19 inhibition creates extensive interactions; sedation and serotonin toxicity are possible.
Mechanism of action: Fluvoxamine ballicule
Open Fluvoxamine in the interactive console ↗
Memory aids: mascots and interaction avatars
Sterile glove → for OCD
Fluffer inHibitor (fluoxetine, fluvoxamine, fluconazole)
