Fluvoxamine is an antidepressant in a group of drugs called selective serotonin reuptake inhibitors. Fluvoxamine affects chemicals in the brain that may become unbalanced and cause obsessive-compulsive symptoms. Fluvoxamine is used to treat obsessive-compulsive disorders involving recurring thoughts or actions.

You may have an increased risk of suicidal thoughts or behavior at the start of treatment with an antidepressant medication, especially if you are under 18 years old. Talk with your doctor about this risk. While you are taking fluvoxamine you will need to be monitored for worsening symptoms of depression and/or suicidal thoughts during the first weeks of treatment, or whenever your dose is changed.

In addition to you watching for changes in your own symptoms, your family or other caregivers should be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

Contact your doctor promptly if you have any of the following side effects, especially if they are new symptoms or if they get worse:

• mood changes
• anxiety
• panic attacks
• trouble sleeping
• irritability
• agitation
• aggressiveness
• severe restlessness
• mania (mental and/ or physical hyperactivity)
• thoughts of suicide or hurting yourself

Do not take fluvoxamine together with:

• thioridazine (Mellaril®)
• terfenadine (Seldane®)
• astemizole (Hismanal®)
• cisapride (Propulsid®)
• pimozide (Orap®)
• isocarboxazid (Marplan®)
• phenelzine (Nardil®)
• rasagiline (Azilect®)
• selegiline (Eldepryl®, Emsam®)
• tranylcypromine (Parnate®)

You must wait at least 14 days after stopping an MAOI before you can take fluvoxamine. After you stop taking fluvoxamine, you must wait at least 14 days before you can start taking an MAOI.

SSRI antidepressants may cause serious or life-threatening lung problems in newborn babies whose mothers take the medication during pregnancy. However, you may have a relapse of depression if you stop taking your antidepressant during pregnancy. If you are planning a pregnancy, or if you become pregnant while taking fluvoxamine, do not stop taking the medication without first talking to your doctor.

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Your doctor may occasionally change your dose to make sure you get the best results from the medication.

Take each dose with water. Try to take the medicine at the same time each day. Follow the directions on your prescription label. It may take 4 weeks or more for you to start feeling better. Do not stop using fluvoxamine without first talking to your doctor. You may have unpleasant side effects if you stop taking this medication suddenly.

You may have an increased risk of suicidal thoughts or behavior at the start of treatment with an antidepressant medication, especially if you are under 18 years old. Talk with your doctor about this risk. While you are taking fluvoxamine you will need to be monitored for worsening symptoms of depression and/or suicidal thoughts during the first weeks of treatment, or whenever your dose is changed. In addition to you watching for changes in your own symptoms, your family or other caregivers should be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

Do not use fluvoxamine if you are using any of the following drugs:

• thioridazine (Mellaril®)
• terfenadine (Seldane®)
• astemizole (Hismanal®)
• cisapride (Propulsid®)
• pimozide (Orap®)
• isocarboxazid (Marplan®)
• phenelzine (Nardil®)
• rasagiline (Azilect®)
• selegiline (Eldepryl®, Emsam®)
• tranylcypromine (Parnate®)

Serious and sometimes fatal reactions can occur when these medicines are taken with fluvoxamine. You must wait at least 14 days after stopping an MAO inhibitor before you can take fluvoxamine. After you stop taking fluvoxamine, you must wait at least 14 days before you can start taking an MAOI. Before taking fluvoxamine, tell your doctor if you have:

• liver disease
• seizures or epilepsy
• bipolar disorder (manic depression)
• history of drug abuse or suicidal thoughts

You may not be able to take fluvoxamine, or you may need a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

SSRI antidepressants may cause serious or life-threatening lung problems in newborn babies whose mothers take the medication during pregnancy. However, you may have a relapse of depression if you stop taking your antidepressant during pregnancy. If you are planning a pregnancy, or if you become pregnant while taking fluvoxamine, do not stop taking the medication without first talking to your doctor. Fluvoxamine can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Seek emergency medical attention if you think you have used too much of this medicine. Symptoms of a fluvoxamine overdose include:

• drowsiness
• nausea
• vomiting
• blurred vision
• rapid heartbeat
• lack of coordination
• trouble breathing
• fainting
• coma

Side Effects

Get emergency medical help if you have any of these signs of an allergic reaction:

• hives
• difficulty breathing
• swelling of your face, lips, tongue, or throat

Call your doctor at once if you have any of these serious side effects:

• tremors, shivering, muscle stiffness or twitching
• seizure (convulsions)
• problems with balance or coordination
• unusual thoughts or behavior
• gitation, confusion, sweating, fast heartbeat

Other less SERIOUS side effects are more likely to occur, such as:

• feeling nervous, restless, or unable to sit still
• sleep problems (insomnia)
• drowsiness, weakness
• urinating more than usual
• loss of appetite
• weight gain or loss
• nausea, vomiting
• diarrhea, gas
• constipation
• upset stomach
• decreased sex drive, impotence, or difficulty having an orgasm
• dry mouth, unpleasant taste in your mouth

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

Before taking fluvoxamine, tell your doctor if you are using ANY of the following medicines:

• clozapine (Clozaril®)
• lithium (Lithobid®, Eskalith®)
• propranolol (Inderal®, Inderal LA®)
• metoprolol (Lopressor®, Toprol XL®)
• carbamazepine (Carbatrol®, Tegretol®)
• warfarin (Coumadin®)
• tryptophan (also called L-tryptophan®)
• mexiletine (Mexitil®)
• theophylline (Aerolate®, Bronkodyl®, Slo-Bid®, Theo-Dur®)
• methadone (Dolophine®, Methadose®)
• tacrine (Cognex®)
• almotriptan (Axert®)
• frovatriptan (Frova®)
• sumatriptan (Imitrex®)
• naratriptan (Amerge®)
• rizatriptan (Maxalt®)
• zolmitriptan (Zomig®)
• diazepam (Valium®)
• alprazolam (Xanax®)
• midazolam (Versed®)
• triazolam (Halcion®)
• amitriptyline (Elavil®)
• citalopram (Celexa®)
• clomipramine (Anafranil®)
• desipramine (Norpramin®)
• escitalopram (Lexapro®)
• fluoxetine (Prozac®, Sarafem®)
• imipramine (Tofranil®)
• nortriptyline (Pamelor®)
• paroxetine (Paxil®)
• sertraline (Zoloft®)

If you are using any of these drugs, you may not be able to use fluvoxamine, or you may need dosage adjustments or special tests during treatment.

There may be other drugs not listed that can affect fluvoxamine. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products.