Luvox

General information

Luvox is an antidepressant belonging to the group of selective serotonin reuptake inhibitors (SSRIs). The drug is used to treat various mental disorders associated with an imbalance of serotonin in the brain. It helps to improve mood, reduce anxiety and cope with obsessive compulsive states, providing a stable therapeutic effect with prolonged use.

Trade name

Luvox

International Nonproprietary Name (INN)

Fluvoxamine

Form of release

The drug is available in the form of film-coated tablets. Available dosages: 50 mg and 100 mg. The tablets are round in shape, white or slightly yellowish in color, with a separating groove on one side for easy dosing.

Composition

Acting substance

Fluvoxamine maleate - one tablet contains 50 mg or 100 mg of the active component depending on the dosage.

Auxiliary components

Microcrystalline cellulose, lactose monohydrate, magnesium stearate, croscarmellose sodium, hypromellose, titanium dioxide, macrogol. The composition of excipients may vary depending on the manufacturer, so before use it is recommended to clarify the information in the instructions attached to the package.

Pharmacological properties

Pharmacodynamics

Luvox acts by selective inhibition of serotonin reuptake in the synapses of neurons of the central nervous system. Serotonin is a neurotransmitter that plays a key role in the regulation of mood, sleep, appetite and emotional state. Increasing the concentration of serotonin in the synaptic cleft helps to improve the transmission of nerve impulses, which leads to a reduction in symptoms of depression and anxiety. The drug has minimal affinity for other receptors (e.g., adrenergic, dopaminergic, or histamine receptors), which reduces the likelihood of side effects typical of other classes of antidepressants. Therapeutic effects are apparent after 1-4 weeks of regular administration.

Pharmacokinetics

Absorption

After oral administration, fluvoxamine is rapidly and almost completely absorbed from the gastrointestinal tract. Bioavailability is about 90-95%, regardless of food intake. The maximum plasma concentration is reached 3-8 hours after administration.

Distribution

Fluvoxamine is well distributed in body tissues, including the brain. The volume of distribution is about 25 liters/kg. Binding to plasma proteins (mainly to albumin) reaches 77-80%. The drug penetrates the blood-brain barrier, which ensures its effectiveness in psychiatric disorders.

Metabolism

Metabolism of fluvoxamine occurs in the liver by oxidative demethylation with the participation of cytochrome P450 enzymes, mainly CYP1A2 isoenzyme. At least 9 metabolites are formed, of which two have weak pharmacologic activity and the rest are considered inactive. Fluvoxamine is a potent inhibitor of CYP1A2 and moderately affects CYP2C and CYP3A4, which is important to consider in combination therapy.

Excretion

The drug is excreted predominantly by the kidneys as metabolites (about 94% of the dose taken). Unchanged fluvoxamine constitutes less than 3% of the excreted substance. The elimination half-life varies from 13 to 18 hours, which allows the drug to be taken once or twice a day. In patients with renal or hepatic impairment, excretion may be delayed, requiring dose adjustment.

Indications for use

Luvox is indicated for the treatment of the following diseases and conditions:

• Depressive disorders of varying degrees of severity;
• Obsessive-compulsive disorder (OCD);
• Anxiety disorders, including generalized anxiety disorder;
• Social phobia (social anxiety disorder);
• Post Traumatic Stress Disorder (PTSD).

The drug can be used both in monotherapy and as part of a complex treatment under the supervision of a doctor.

Contraindications

The use of Luvox is prohibited under the following conditions:

• Hypersensitivity to fluvoxamine or any of the auxiliary components of the drug;
• Simultaneous administration of monoamine oxidase inhibitors (MAOIs) - it is necessary to maintain an interval of at least 14 days after the end of MAO inhibitors;
• Severe hepatic insufficiency;
• Children under 8 years of age (for the treatment of OCD) and under 18 years of age (for other indications);
• Period of breastfeeding;
• Simultaneous use with drugs that prolong the QT interval (e.g., class IA and III antiarrhythmic agents).

The drug is prescribed with caution in epilepsy, diabetes mellitus, blood coagulation disorders and tendency to bleeding.

Method of administration and dosage

How to take

Luvox tablets are taken orally, drinking enough water (100-200 ml). The drug can be taken regardless of food, but to reduce the risk of gastric irritation, it is recommended to take it during or after meals. Tablets should not be chewed or crushed, except when it is necessary to divide the dosage according to the risk.

Dosages for adults and children

Adults

The initial dose for depression is 50-100 mg per day, taken once in the evening. If the effect is insufficient, the dose is gradually increased (by 50 mg every 4-7 days) up to the maximum dose of 300 mg per day, divided into 2-3 doses. For the treatment of OCD, the initial dose is the same, with a possible increase to 300 mg per day.

Children (from 8 years old, only for OCD)

The initial dose is 25 mg per day, with possible increase by 25 mg every 4-7 days until effective, but not more than 200 mg per day, divided into 2 doses.

Dose adjustment in certain conditions

Dose adjustment is usually not required in mild to moderate renal impairment. In severe renal failure (creatinine clearance less than 30 ml/min), treatment is started with the minimum dose (25-50 mg) under strict medical supervision. In moderate hepatic insufficiency the initial dose is reduced by 50%, and in severe hepatic insufficiency the drug is contraindicated.

Side effects

The following adverse reactions may accompany the administration of Luvox:

• Nervous system: headache, dizziness, drowsiness, insomnia, anxiety, tremor, confusion;
• Gastrointestinal tract: nausea, vomiting, diarrhea, constipation, decreased appetite, dry mouth;
• Cardiovascular system: tachycardia, decreased blood pressure;
• Skin: increased sweating, rash, itching;
• Other: fatigue, weakness, weight changes, sexual dysfunction (decreased libido, erectile dysfunction).

The majority of side effects are temporary and decrease during the first weeks of treatment. If seizures, severe allergic reactions, or suicidal thoughts occur, discontinue immediately and consult a physician.

Overdose

Symptoms of overdose

Exceeding the recommended dose of Luvox may be manifested by nausea, vomiting, diarrhea, drowsiness, dizziness, rapid heartbeat, and decreased blood pressure. In severe cases, seizures, coma, or abnormal heart rhythm may occur.

First aid measures

If an overdose is suspected, it is necessary to immediately stop taking the drug and seek medical attention. Until the arrival of a doctor, gastric lavage (if the drug has been taken recently) and intake of activated charcoal are recommended. There is no specific antidote, symptomatic therapy is carried out. Hemodialysis is ineffective due to high binding of the drug to plasma proteins.

Interaction with other drugs

Influence on the effect of other drugs

Luvox inhibits cytochrome P450 enzymes (especially CYP1A2), which may increase blood concentrations of such drugs as caffeine, theophylline, propranolol, warfarin and some neuroleptics. This requires dose adjustment of the latter. Concomitant administration with MAO inhibitors or drugs prolonging the QT interval is strictly prohibited due to the risk of serotonin syndrome or arrhythmias.

Compatibility with alcohol and food

Alcohol increases the sedative effect of Luvox and increases the risk of adverse reactions from the central nervous system (drowsiness, confusion). It is recommended to refrain from drinking alcohol during treatment. Food has no significant effect on absorption of the drug, but administration with caffeine may increase its metabolism and cause irritability.

Special instructions

Use in pregnancy and breastfeeding

Luvox is not recommended for use during pregnancy, unless the benefit to the mother exceeds the potential risk to the fetus. The drug penetrates into breast milk, therefore breastfeeding should be discontinued for the period of treatment.

Effect on driving and mechanisms

The drug may cause drowsiness, dizziness and decreased concentration, especially at the beginning of treatment or when increasing the dose. Patients should refrain from driving and working with dangerous mechanisms until individual reaction to the drug is evaluated.

Particularities of use in elderly people and children

In elderly patients (over 65 years old) the initial dose should be minimal (25-50 mg per day) with gradual increase under medical supervision due to possible slowing down of metabolism. In children, the drug is used only for the treatment of OCD from the age of 8 years, with strict adherence to the dosage and under the supervision of a specialist.

Storage conditions

Temperature regime

Store at a temperature of 15 to 25 ° C.

Protect from light, moisture, children

The drug should be stored in the original package in a dry place, protected from direct sunlight and out of reach of children. Do not use after the expiration date indicated on the package (usually 3 years from the date of manufacture).