FLUVOXAMINE MALEATE

Fluvoxamine Maleate 50mg, Oral tablet

Alcohol

· Severity: Moderate

· Notes for Consumers: Avoid drinking alcohol-containing beverages while you are taking Fluvoxamine. The combination may effect your ability to think clearly or may alter your behavior. Do not drive, operate machinery or take part in hazardous acitivities if you have been drinking any alcohol-containing beverages.

· Notes for Professionals: As with other psychotropic medications, patients should be advised to avoid alcohol while taking fluvoxamine. Studies involving single 40 gram doses of ethanol (oral administration in one study and intravenous in the other) and multiple dosing with fluvoxamine (50 mg twice daily) revealed no effect of either drug on the pharmacokinetics or pharmacodynamics of the other. Multiple doses have not been studied. It is possible that ethanol may adversely effect mood or behavior.

Fluvoxamine Maleate 50mg, Oral tablet

Caffeine-containing Foods/Beverages

· Severity: Moderate

· Notes for Consumers: Although an interaction is possible, these drugs are often used together. Side effects from Caffeine may get worse if you take Fluvoxamine. Too much Caffeine can cause effects like nausea, nervousness, or sleeplessness. You may need to limit your Caffeine intake if these occur. Common foods and beverages containing caffeine include coffee, teas, colas and chocolate. Many non-prescription drugs and diet aids may also contain caffeine.

· Notes for Professionals: Inhibitors of CYP1A2, such as fluvoxamine, may inhibit the hepatic oxidative metabolism of caffeine. No specific management is recommended except in patients who complain of caffeine-related side effects. In such patients, the dosage of caffeine-containing medications or the ingestion of caffeine-containing products may need to be reduced.

Fluvoxamine Maleate 50mg, Oral tablet

Marijuana

· Severity: Moderate

· Notes for Consumers: Marijuana may affect the effectiveness of fluvoxamine in treating your condition, There may also be additive side effects. You may feel drowsy or more tired. Do not drive or operate machinery until you know how these drugs affect you. Contact your health care provider immediately if you notice slurred speech, confusion, increases heart rate, palpitations, or any other unusual side effects if you choose to use these drugs together.

· Notes for Professionals: Use together is not recommended; advise patients not to use marijuana without the advice of their health care professional. Marijuana smoking induces CYP1A2 through activation of the aromatic hydrocarbon receptor, in a manner that is similar to tobacco smoking, which is known to increase fluvoxamine elimination by about 25%. Fluvoxamine is an inhibitor of CYP2C9 and CYP3A4, 2 isoenzymes responsible for the metabolism of marijuana's most psychoactive compound, delta-9-tetrahydrocannabinol (Delta-9-THC). Of the over 70 phytocannabinoids in marijuana, delta-9-tetrahydrocannabinol (9THC), cannabidiol (CBD) and cannibinol are the 3 main constituents, regardless of the route of administration (e.g., inhaled, ingested). Any changes in Delta-9-THC and 11-OH-THC plasma concentrations may result in an altered marijuana effect profile. In addition, the additive pharmacodynamic effects of these 2 agents have not been studied and there may be additive effects on CNS function.

Fluvoxamine Maleate 50mg, Oral tablet

Grapefruit juice

· Severity: Moderate

· Notes for Consumers: In general, fluvoxamine can be taken with or without most foods. Grapefruit juice and grapefruit might increase the appearance of side effects of Fluvoxamine, but it is not clear if this interaction is significant for all people. If possible, limit or avoid ingesting grapefruit juice while taking Fluvoxamine. At the very least, do not significantly change your daily intake of grapefruit and grapefruit juice.

· Notes for Professionals: Patients who are stabilized on a fluvoxamine regimen should not significantly alter their consumption of grapefruit juice and patients starting fluvoxamine should limit or avoid grapefruit juice intake. The mean peak and AUC of fluvoxamine were increased in a study where patients were given grapefruit juice 3 times a day for 5 days prior to receiving fluvoxamine. Altered P-glycoprotein-mediated transport, initiated by grapefruit juice, is the suspected mechanism of action. Sporadic case reports of this potential interaction have appeared in the literature.

Fluvoxamine Maleate 50mg, Oral tablet

Tobacco

· Severity: Moderate

· Notes for Consumers: Tobacco smoking may reduce the effectiveness of Fluvoxamine in treating your condition. Tobacco smoke contains substances that speed the removal of Fluvoxamine from the body, which in theory can make this drug less effective. Alternatively, if you take Fluvoxamine and suddenly stop Tobacco smoking, you may experience Fluvoxamine related side effects like sweating, upset stomach, nausea/vomiting, drowsiness, tremor, or difficulty sleeping. Make sure your prescriber is aware that you smoke Tobacco or if you plan to stop smoking.

· Notes for Professionals: Fluvoxamine is a substrate for the isozymes CYP1A2 and CYP2D6. Tobacco smoke contains polycyclic aromatic hydrocarbons that induce hepatic CYP450 microsomal enzymes (e.g., CYP1A1, CYP1A2, CYP2E1) and tobacco smoking increases the metabolism of fluvoxamine. Smokers have a 25% increase in metabolism over non-smokers. Conversely, because the effect on hepatic microsomal enzymes is not related to the nicotine component of tobacco, the sudden cessation of tobacco smoking may result in a reduced clearance of fluvoxamine, despite the initiation of a nicotine replacement product. Monitor the patient for the desired clinical effects when changes in smoking status occur.

<b>DISCLAIMER:</b><em> This drug information content is provided for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Patients should always consult their physician with any questions regarding a medical condition and to obtain medical advice and treatment. Drug information is sourced from GSDD (Gold Standard Drug Database ) provided by Elsevier.</em>