fluvoxamine maleate at a glance
Medicine class
Selective serotonin reuptake inhibitor (SSRI) antidepressant
Licensed uses
Major depressive episodes and obsessive compulsive disorder
Administration
Swallow the film-coated tablet with water without chewing
Interaction profile
Strong inhibition of CYP1A2 and CYP2C19 can cause clinically important interactions
What is fluvoxamine maleate used for?
The selected product is licensed for:
Major depressive episodes in adults.
Obsessive compulsive disorder in adults.
Obsessive compulsive disorder in children over 8 years and adolescents; evidence is limited and specialist monitoring is important.
It is not licensed to treat major depressive episodes in people under 18 years.
How does fluvoxamine maleate work?
Fluvoxamine selectively reduces the reuptake of serotonin into brain neurones, increasing serotonin signalling. It has little direct activity at adrenergic, histamine, muscarinic, dopamine or serotonin receptors.
fluvoxamine maleate preparations and strengths
Tablet
Route: Oral
Strengths: 50 mg, 100 mg
How to take fluvoxamine maleate
Follow the prescription label and instructions supplied with the tablets.
Swallow tablets with water without chewing.
The selected tablet is scored and can be divided into equal halves when instructed by the prescriber.
Food does not materially alter fluvoxamine pharmacokinetics.
Avoid alcohol because it can worsen sleepiness and impaired coordination.
High caffeine intake may cause tremor, palpitations, nausea, restlessness or insomnia during treatment.
fluvoxamine maleate side effects
Common or expected effects
- Nausea, sometimes with vomiting
- Abdominal pain, diarrhoea, constipation, indigestion or dry mouth
- Headache or dizziness
- Sleepiness or difficulty sleeping
- Anxiety, agitation, nervousness or tremor
- Sweating
- Reduced appetite
- Weakness or malaise
- Palpitations or a fast heartbeat
Get urgent medical advice
- New or worsening suicidal thoughts or behaviour
- Serotonin syndrome or a neuroleptic malignant syndrome-like reaction
- Seizure, new mania or severe agitation
- Severe skin reaction, blistering or mucosal lesions
- Unusual or significant bleeding
- Symptoms of low sodium, such as marked confusion, weakness or uncontrolled muscle movements
- Severe allergic reaction
fluvoxamine maleate in pregnancy
The selected product should be used during pregnancy only when the woman's clinical condition requires fluvoxamine. SSRI exposure late in pregnancy has been associated with neonatal adaptation symptoms, a small increased risk of persistent pulmonary hypertension in the newborn, and a higher risk of postpartum haemorrhage. Discuss pregnancy plans or a positive pregnancy test promptly with the prescriber; do not stop fluvoxamine abruptly.
fluvoxamine maleate while breastfeeding
Fluvoxamine passes into breast milk in small quantities, and the selected product information says it should not be used while breastfeeding. A prescriber or specialist breastfeeding medicines service should review the benefits of treatment, infant factors and alternatives. Do not stop treatment suddenly without advice.
fluvoxamine maleate interactions
Fluvoxamine has serotonergic interactions and substantial effects on liver drug metabolism. Check prescription, non-prescription and herbal products before starting treatment or making changes.
Monoamine oxidase inhibitors, including moclobemide and linezolid
The combination can cause life-threatening serotonin syndrome and is generally contraindicated; switching requires specified washout periods.
Tizanidine
The combination is contraindicated because fluvoxamine can substantially increase tizanidine exposure and toxicity.
Pimozide
The combination is contraindicated because increased exposure may raise the risk of QT prolongation and serious arrhythmia.
Common questions about fluvoxamine maleate
Answers are fully visible for fast scanning and source review.
Why does fluvoxamine maleate interact with many medicines?
It strongly inhibits CYP1A2 and CYP2C19 and inhibits several other liver enzymes, so it can slow the clearance of medicines metabolised through these pathways.
Does caffeine interact with fluvoxamine maleate?
Yes. Fluvoxamine can increase caffeine levels; high intake may cause shaking, palpitations, nausea, restlessness or insomnia.
Can alcohol be consumed with fluvoxamine maleate?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.