Fluvoxamine, also known as Luvox, is an antidepressant medication primarily used to treat obsessive-compulsive disorder (OCD). [1] Fluvoxamine is a selective serotonin reuptake inhibitor (SSRI), which works by restoring the balance of a natural substance called serotonin in the brain.

Fluvoxamine brand names

Fluvoxamine (sounds like floo-VOX-a-meen) is the generic name for the drug. [8] It is also known as Fluvoxamine Maleate. [8] Luvox, and Luvox CR are the brand names. Fluvoxamine maleate extended-release capsules are available as 100 mg and 150 mg doses or as oral tablets (100mg; 25 mg; 50 mg). [8]

What is Fluvoxamine prescribed for?

Fluvoxamine is primarily used to treat obsessive-compulsive disorder (OCD). [14] Obsessive-compulsive disorder causes unwanted, persistent ideas, thoughts, urges, actions, obsessions, or behaviors that are repetitive, deliberate, and intentional that are considered excessive or unnecessary by the individual. OCD behaviors can cause extreme distress and problems with social and job-related functioning. [9]

Fluvoxamine is often used to treat depression other and obsessive-compulsive disorders. [7] However, it can also be prescribed ‘off-label’ for certain conditions. Off-label drug usage occurs when a drug designed for one condition has a use for another, but you should never take fluvoxamine without proper medical advice.

Some of the off label uses for fluvoxamine include:

How does Fluvoxamine work?

Fluvoxamine belongs to a class of medications called serotonin reuptake inhibitors (SSRIs). SSRIs increase the amount of serotonin in the brain. Serotonin is a naturally occurring substance in our brains, but sometimes the levels are lower than they should be. SSRIs help increase the amount, and the effectiveness of how it is processed. [5]

Serotonin serves many essential functions in the brain and body. Serotonin is important in almost all brain functions, and it regulates cardiovascular, pulmonary, gastrointestinal (GI), genitourinary systems, and the central nervous system. It helps regulate behaviors such as mood, perception, memory, anger, aggression, fear, responses to stress, appetite, addiction, and sexual functions. It also helps with motor control, sleep, body temperature, and regulation of multiple organs in the body. [4]

How is Fluvoxamine usually taken?

Fluvoxamine maleate is taken orally and is available in tablets and extended-release capsules. [5] It is always important to follow your doctor's directions. Fluvoxamine should not be crushed or chewed, only swallowed. You may take it with food, but it is not required. [9]

Your doctor will determine the dosage based on age, symptoms, and pre-existing medical conditions. The starting dose is usually between 50-100 mg, taken at night before bedtime. Typically, your dose will increase gradually, in 50 mg increments (as tolerated) until it reaches the ‘maximum therapeutic benefit’ dose. Your dose will not exceed 300 mg per day. [5]

How long does Fluvoxamine stay in your system?

Many factors, such as age, weight, metabolism, dose, and use frequency, can impact how long a drug remains in the body. Fluvoxamine remains in the system for 3-5 days on average [11], about 12 days in the brain [19], five days in the blood [19], three days in urine, and 1-2 days [9]. Most drugs can remain in hair follicles for around 90 days. [2]

Fluvoxamine side effects

Whilst medications offer many benefits to improve symptoms and disorders, they often come with side effects, most of which will reduce or stop with time. Drugs can affect people differently, but often the benefits outweigh the possibility of adverse effects, so it is important to discuss options with your healthcare provider.

Fluvoxamine can cause a range of physical and mental side effects, which vary in severity.

Common side effects may include [9]:

  • Tiredness, excessive yawning and dizziness
  • Nervousness, agitation, anxiety
  • Trouble sleeping (insomnia)
  • Dry mouth
  • Headache
  • Stuffy nose or sore throat
  • Heartburn
  • Nausea or vomiting
  • Constipation, diarrhea, stomach pain and gas
  • Change in the way foods taste
  • Decreased appetite and weight loss
  • Excessive sweating
  • Skin rash
  • Muscle aches or pain
  • Heavy menstrual periods
  • Decreased sex drive or sexual problems
  • Increased urination
  • Tremors (involuntary shaking, like hands) [9]

You may experience one or more of these milder symptoms for a short time after starting fluvoxamine, but after some time, your body will adjust, and they may go away. If symptoms worsen or persist, talk to your healthcare provider.

Severe side effects are less common, but they are possible.

You should call your healthcare provider if you experience severe side effects [9] such as:

  • Suicidal thoughts or behaviors
  • Blurry vision, eye pain, swelling, redness
  • Restlessness, nervousness, or dizziness
  • Hyperthermia (abnormally high temperature)
  • Seizures or convulsions
  • Coma (unconsciousness)
  • Delirium (confused thinking, lack of awareness of surroundings
  • Over-responsive body reflexes
  • Rapid changes in blood pressure
  • Easy bruising or unusual bleeding [9]

Rarely, flucoxamine can cause an allergic reaction, If you show signs of an allergic reaction, seek emergency help immediately. [9]

Signs of allergy include:

  • Skin rashes, blisters or hives
  • Joint pain
  • Fever
  • Swelling of your face, lips, or tongue
  • Difficulty breathing

SSRIs can cause a rare but severe and life-threatening condition called Serotonin Syndrome. Seek immediate emergency medical attention If you experience any of the following:

  • Agitation
  • Hallucinations (seeing or hearing something not there)
  • Fever, sweating or shivering
  • Rapid heart rate
  • Stiff, inflexible muscles or muscle jerking or twitching
  • Nausea followed by vomiting
  • Diarrhea that lasts more than a few days
  • Loss of coordination [9]

Fluvoxamine has a black box warning, which is the most serious warning from the Food and Drug Administration (FDA). This is because fluvoxamine may increase suicidal thoughts or actions in some children, teenagers, or young adults. Whilst this is rare, suicidal thoughts or actions are more likely to occur during the first few months of treatment or during dose adjustments. If you experience any suicidal thoughts or thoughts of harming yourself, call your doctor right away.

Fluvoxamine precautions

Certain medications taken with fluvoxamine may increase the risk of bleeding occurrences, so be sure to talk to your doctor about any prescriptions or over-the-counter medicines you are taking. Drugs such as aspirin, NSAIDs (like ibuprofen or naproxen) [9], or blood thinners (Coumadin® and Jantoven®), taken while on fluvoxamine can increase your bleeding risk for gastrointestinal bleeding, petechiae (small pinpoint spots on the skin that is from bleeding), life-threatening bleeding events such as hemorrhages, hematomas, or ecchymoses (may look like bruises but is damage to large blood vessels), [9]

You should tell your healthcare provider If you have ever experienced [9]:

  • Bipolar disorder
  • Seizures
  • Liver or kidney disease
  • Heart disease or stroke
  • High blood pressure
  • Abnormal Bleeding
  • An electrolyte imbalance (low levels of sodium in your blood).[9]

There are warnings for certain health conditions, such as:

Pregnancy/breastfeeding: Fluvoxamine taken during pregnancy could harm the baby, but abruptly stopping the medication is not safe for you. Do not start or stop taking Fluvoxamine without talking to your doctor. Do not breastfeed while on Fluvoxamine. [9]

Angle-closure glaucoma: Fluvoxamine can increase the risk of acute angle closure. If you have blurred vision, red, painful eyes, headache, nausea, vomiting, or see colored halos around lights, you should seek medical help immediately. [9]

It is important to keep scheduled appointments with your healthcare provider and take your medication as prescribed. Do not stop Fluvoxamine or start a new medication without talking to your healthcare provider.

Fluvoxamine interactions

Some foods can cause drug-food interactions or alter how a medication works. Avoid alcohol and grapefruit products and limit caffeine intake while taking fluvoxamine [9]. Don’t smoke while taking fluvoxamine, as smoking affects the way the body processes fluvoxamine compared to nonsmokers [9]

You should tell your doctor if you have ever had any of the following conditions [9]:

  • Bipolar disorder or mania
  • Seizures or convulsions
  • Glaucoma
  • Heart, liver, or kidney problems
  • Hypertension (high blood pressure) or a stroke
  • Bleeding problems
  • Low amounts of sodium in your blood [9]

Keep a list of all prescription and non-prescription drugs, herbal, and supplement products you are taking and share it with your healthcare provider.

Fluvoxamine is one SSRI that can cause serotonin syndrome. Fluvoxamine can increase the risk of serotonin syndrome when taken with other serotonin-related medications. Some examples include tricyclic antidepressants, fentanyl, lithium, tramadol, tryptophan, buspirone, amphetamines, and St. John’s Wort. [9]

Dangerous interactions can occur between fluvoxamine and Monoamine Oxidase Inhibitors (MAOIs). You should not take MAOIs while taking fluvoxamine, as this could cause a potentially fatal condition called serotonin syndrome. You must not take MAOI medication two weeks before fluvoxamine or two weeks after ending fluvoxamine. [9]

Fluvoxamine use while taking MAOIs can result in severe health issues such as low blood pressure and heart rate, increased sleepiness, poor cognitive and motor functioning, dangerous heart arrhythmias (irregular or fast heart rhythm), and rarely, death. [9]

MAOIs include (but are not limited to) Isocarboxazid, linezolid, methylene blue injection, phenelzine, tranylcypromine, tizanidine, thioridazine, and alosetron. [9]

Other medications that interact with fluvoxamine and may increase unpleasant side effects include [9]:

  • Opioid medications (methadone)
  • Heart medications (mexiletine, diltiazem, metoprolol, digoxin beta-blockers)
  • Blood thinners (Coumadin® and Jantoven®)
  • Water pills (diuretics)
  • Migraine medicines (Imitrex or Maxalt)
  • Anxiety, mood disorder, and mental illness medications (clozapine, lithium, benzodiazepines, alprazolam, diazepam, lorazepam, tacrine, tryptophan, sumatriptan, antidepressants, and antipsychotics).
  • Bronchodilators (theophylline)
  • Tricyclic antidepressants (amitriptyline, clomipramine, dosulepin, imipramine, lofepramine and nortriptyline) [9]

Fluvoxamine storage

Fluvoxamine should be stored in a cool, dark, dry place and away from high humidity. It should not be exposed to temperatures above 30º C (86º F). Keep fluvoxamine in its original pill bottle, with the cap screwed on tightly. [9]

Fluvoxamine should be kept in a safe location away from children. Prescription medications should not be shared or given to someone else. Failure to keep drugs away from children and others can cause severe health problems and may be fatal. It is illegal to share or sell medication with others.

You should not flush unused medication down the toilet or throw it in the trash. You can check with your local pharmacy or health provider's office about how to safely dispose of unused medicines or for information on drug-take-back programs.

What to do if you overdose on fluvoxamine

Deliberate or accidental overdose of fluvoxamine can result in death. [9] It is important to seek emergency medical attention immediately if someone shows any signs of overdose [9], such as:

  • Nausea, vomiting, and diarrhea
  • Trouble breathing
  • Racing or abnormal heartbeat
  • Extreme sleepiness
  • Shakiness
  • Dilated pupils
  • Seizure

You should immediately contact the poison control center on 1-800-222-1222 for additional treatment information if a drug overdose is suspected. [9][1]

If someone has collapsed, is unconscious, has a seizure, or has problems breathing, call 911 immediately for emergency services. [1] Delaying treatment of severe symptoms can cause long-term damage or even death.

Frequently asked questions about fluvoxamine

Fluvoxamine vs. fluoxetine: What’s the difference?

Prozac (fluoxetine) and Luvox (fluvoxamine) are SSRI antidepressants used to treat depression or obsessive-compulsive disorders. The side effects of Luvox and Prozac are similar.

The main difference between Prozac and Luvox is that Prozac was originally approved to treat major depression, and Luvox was originally approved to treat obsessive-compulsive disorder. Fluvoxamine works faster than fluoxetine in resolving depression symptoms and improving sleep. [7]

How long does fluvoxamine take to work?

It can take up to six weeks to feel the full treatment effects of fluvoxamine (or other SSRIs). [5]

Resources:

  1. AHFS Patient Medication Information [Internet]. Bethesda (MD): American Society of Health-System Pharmacists, Inc.; c2022. Fluvoxamine; Retrieved from URL: https://pubmed.ncbi.nlm.nih.gov/?term=Fluvoxamine&filter=simsearch2.ffrft&filter=years.2006-2022
  2. Arnold, A. (2018). How Long Do Drugs Stay in Your Hair? Retrieved from URL: https://www.usdrugtestcenters.com/drug-test-blog/242/how-long-do-drugs-stay-in-your-hair.html.
  3. Bains N, Abdijadid S. Major Depressive Disorder. [Updated 2022 Jun 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-.Available from: https://www.ncbi.nlm.nih.gov/books/NBK559078/
  4. Berger M, Gray JA, Roth BL. The expanded biology of serotonin. Annu Rev Med. 2009;60:355-66. doi: 10.1146/annurev.med.60.042307.110802. PMID: 19630576; PMCID: PMC5864293.
  5. Chu A, Wadhwa R. Selective Serotonin Reuptake Inhibitors. [Updated 2022 May 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nih.gov/books/NBK554406/
  6. Crow S. Treatment of Binge Eating Disorder. Curr Treat Options Psychiatry. 2014 Dec;1(4):307-314. doi: 10.1007/s40501-014-0023-4. PMID: 26251823; PMCID: PMC4523274.
  7. Dalery, J., & Honig, A. (2003). Fluvoxamine versus fluoxetine in major depressive episode: a double-blind randomised comparison. Human psychopharmacology, 18(5), 379–384. https://doi.org/10.1002/hup.490
  8. [email protected]: FDA-approved drugs (no date) FDA. Retrieved from URL: https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=BasicSearch.process
  9. (2017). FLUVOXAMINE MALEATE capsule, extended-release. Dailymed. Retrieved from URL: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=8bbd7e39-b9ab-4716-9522-aa8c4b92210e&audience=consumer
  10. Hay P. (2020). Current approach to eating disorders: a clinical update. Internal medicine journal, 50(1), 24–29. https://doi.org/10.1111/imj.14691
  11. Irons J. (2005). Fluvoxamine in the treatment of anxiety disorders. Neuropsychiatric disease and treatment, 1(4), 289–299. Retrieved from URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2424117/pdf/ndt-0104-289.pdf
  12. Jefferson J. W. (2001). Social Anxiety Disorder: More Than Just a Little Shyness. Primary care companion to the Journal of clinical psychiatry, 3(1), 4–9. https://doi.org/10.4088/pcc.v03n0102
  13. Milano W, Siano C, Putrella C, Capasso A. Treatment of bulimia nervosa with fluvoxamine: a randomized controlled trial. Adv Ther. 2005 May-Jun;22(3):278-83. doi: 10.1007/BF02849936. PMID: 16236688.
  14. National Center for Biotechnology Information (2022). PubChem Compound Summary for CID 5324346, Fluvoxamine. Retrieved from URL: https://pubchem.ncbi.nlm.nih.gov/compound/Fluvoxamine.
  15. (2022). Panic Disorder: When Fear Overwhelms. National Institute of Mental Health. Retrieved from URL: https://www.nimh.nigov/health/publications/panic-disorder-when-fear-overwhelms
  16. Singh, A. R., & Veale, D. (2019). Understanding and treating body dysmorphic disorder. Indian journal of psychiatry, 61(Suppl 1), S131–S135. https://doi.org/10.4103/psychiatry.IndianJPsychiatry_528_18
  17. Stoffers J, Völlm BA, Rücker G, Timmer A, Huband N, Lieb K. Pharmacological interventions for borderline personality disorder. Cochrane Database of Systematic Reviews 2010, Issue 6. Art. No.: CD005653. DOI: 10.1002/14651858.CD005653.pub2
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  19. Williams K, Brignell A, Randall M, Silove N, Hazell P. Selective serotonin reuptake inhibitors (SSRIs) for autism spectrum disorders (ASD). Cochrane Database of Systematic Reviews 2013, Issue 8. Art. No.: CD004677. DOI: 10.1002/14651858.CD004677.pub3