Fluvoxamine CR
LUVOX CR
Pronunciation: floo-VOX-a-meen
“gLove-ox man”
Sterile glove → for OCD
Fluffer inHibitor (fluoxetine, fluvoxamine, fluconazole)
What it isControlled-release serotonin-reuptake inhibitor and sigma-1 agonist; OCD and social anxiety disorder.
Why this oneIt is taken once nightly, and the CR label adds social anxiety disorder to OCD.
What limits itPotent CYP1A2 inhibition makes caffeine, clozapine, and tizanidine interactions clinically important; nausea and sexual effects remain.
FDA-approved for
- OCD (2008)
- social anxiety disorder (2008)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Obsessive-compulsive disorder (OCD) | Adults | 100 mg QHS | Increase 50 mg weekly to maximum therapeutic benefit | 300 mg/day |
Titration Increase in 50 mg increments weekly.
Renal Undefined.
Hepatic Decreased clearance (~30%); titrate slowly following the initial 100 mg dose.
Instructions
- Do not crush or chew capsules
- Taper gradually rather than abruptly stopping
Available strengths
- ER cap 100, 150 mg
- tab 25, 50, 100 mg
Contraindications
- Coadministration with thioridazine, tizanidine, pimozide, alosetron, or ramelteon
- MAOIs (for psychiatric disorders) concomitantly or within 14 days; do not start in patients treated with linezolid or IV methylene blue
Cautions
- Serotonin syndrome
- Activation of mania (screen for bipolar disorder)
- Angle-closure glaucoma
- Multiple CYP-mediated drug interactions (clozapine, methadone, theophylline)
- Discontinuation symptoms
Adverse reactions
- Abnormal ejaculation
- Anorexia
- Anorgasmia
- Asthenia
- Diarrhea
- Nausea
- Somnolence
- Sweating
- Tremor
Pregnancy Undefined.
Lactation Undefined.
Cost
| Strength | #/mo | generic $/mo | CostPlus | |
|---|---|---|---|---|
| 100 mg | ER cap | 4 q-wk | $16.31 | offered |
| 150 mg | ER cap | 4 q-wk | $15.89 | out of stock |
Other forms: Fluvoxamine
⚠ BOXED WARNING
- Suicidal thoughts and behaviors in patients under 25
Classes and tags
Clinical profile
Serotonin and MAOI
Provisional washout figures
Elevating mechanismSRI
Exposure dependenceTherapeutic exposure; severe toxicity requires meaningful MAO-A inhibition
Evidence confidenceHigh
InterpretationClinically significant SRI. A second SRI generally represents therapeutic duplication/additive adverse effects, not the classic life-threatening interaction.
Open Fluvoxamine CR in the interactive console ↗
