AdultPediatricGeriatricDosage Forms & Strengths tablets 25mg 50mg 100mg Obsessive-Compulsive Disorder Conventional tablets 50 mg qHS initially; may increase by 50 mg/day q4-7Days up to 100-300 mg/day Dose >100 mg/day should be divided q12hr Social Phobia (Off-label) Immediate release 50 mg PO qDay; may increase by 50 mg at 1 week interval; usual dose range is 100-300 mg/day Panic Disorder (Off-label) 25-50 mg PO qDay; after several days, gradually increase to 100-200 mg/day; may increase to 300 mg/day for patients who fail to respond after several weeks of treatment Dosing considerations Continue therapy for 1-2 years, and consider discontinuation with close supervision; when discontinuing therapy, a slow taper over 2-6 months is recommended Posttraumatic Stress Disorder (Off-label) 50 mg/day PO initially; may increase dose to 100-250 mg in adults and 100 mg in older adults; not to exceed 300 mg/day Dosing considerations Patients who respond to therapy may need to continue therapy indefinitely May attempt tapering after 6-12 months in patients with acute PTSD; tapering should occur gradually over 2 weeks to 1 month to avoid withdrawal symptoms; tapering should take place over 4-12 weeks in patients at risk of relapse Dosing Modifications Hepatic impairment: Decrease dose Therapy discontinuation To discontinue therapy, gradually taper the dose to minimize the incidence of withdrawal symptoms and allow for detection of re-emerging symptoms Dosage Forms & Strengths tablet 25mg 50mg 100mg Obsessive-Compulsive Disorder <8 years: Safety and efficacy not established Ages 8-17 years (conventional tablets): 25 mg PO qHS initially; may titrate by 25 mg/day increments every 4-7 days to 50-200 mg/day Not to exceed 200 mg (for ages 8-11 years) or 300 mg for adolescents Give doses >50 mg/day divided q12hrThe elderly are prone to SSRI/SNRI-induced hyponatremia; monitor closely Obsessive-Compulsive Disorder Conventional tablets: 25 mg qHS initially; may increase by 50 mg/day q4-7days up to 100-300 mg/day; dose >100 mg/day should be divided q12hr Social Phobia (Off-label) Conventional tablets: 50 mg PO qDay initially; may increase by 50 mg at 1 week interval; usual dose range is 100-300 mg/dayInteraction CheckerEnter a drug name and fluvoxamineNo Results No Interactions Found Interactions FoundContraindicatedSerious - Use AlternativeSignificant - Monitor CloselyMinorAll Interactions Sort By: SeverityName Contraindicated (8)alosetronfluvoxamine will increase the level or effect of alosetron by affecting hepatic enzyme CYP1A2 metabolism. Contraindicated.dihydroergotaminefluvoxamine will increase the level or effect of dihydroergotamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.fezolinetantfluvoxamine will increase the level or effect of fezolinetant by affecting hepatic enzyme CYP1A2 metabolism. Contraindicated. Fezolinetant AUC and peak plasma concentration are increased if coadministered with drugs that are weak, moderate, or strong CYP1A2 inhibitorsisocarboxazidfluvoxamine and isocarboxazid both increase serotonin levels. Contraindicated.lonafarnibfluvoxamine will increase the level or effect of lonafarnib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Lonafarnib is a sensitive CYP3A4 substrate. Coadministration with strong or moderate CYP3A4 inhibitors is contraindicated. mavacamtenfluvoxamine will increase the level or effect of mavacamten by affecting hepatic enzyme CYP2C19 metabolism. Contraindicated. Strong or moderate CYP2C19 inhibitors may increase mavacamten systemic exposure, resulting in heart failure due to systolic dysfunction. ramelteonfluvoxamine will increase the level or effect of ramelteon by affecting hepatic enzyme CYP1A2 metabolism. Contraindicated.selegilinefluvoxamine will increase the level or effect of selegiline by affecting hepatic enzyme CYP2B6 metabolism. Contraindicated.Serious - Use Alternative (133)abametapirabametapir will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug. For 2 weeks after abametapir application, avoid taking drugs that are CYP1A2 substrates. If not feasible, avoid use of abametapir.alfentanilfluvoxamine and alfentanil both increase serotonin levels. Avoid or Use Alternate Drug.almotriptanfluvoxamine will increase the level or effect of almotriptan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.amisulprideamisulpride and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug. ECG monitoring is recommended if coadministered.amitriptylinefluvoxamine and amitriptyline both increase serotonin levels. Avoid or Use Alternate Drug.amoxapinefluvoxamine and amoxapine both increase serotonin levels. Avoid or Use Alternate Drug.anagrelideanagrelide and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.arsenic trioxidefluvoxamine and arsenic trioxide both increase QTc interval. Avoid or Use Alternate Drug.asenapineasenapine and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.asenapine transdermalasenapine transdermal and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.avapritinibfluvoxamine will increase the level or effect of avapritinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of avapritinib with moderate CYP3A4 inhibitors. If unable to avoid, reduce avapritinib starting dose. See drug monograph Dosage Modificationsbuprenorphinebuprenorphine and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine buccalbuprenorphine buccal and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine subdermal implantbuprenorphine subdermal implant and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine transdermalbuprenorphine transdermal and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine, long-acting injectionbuprenorphine, long-acting injection and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.bupropionfluvoxamine increases toxicity of bupropion by Other (see comment). Avoid or Use Alternate Drug. Comment: May lower seizure threshold; keep bupropion dose as low as possible.buspironefluvoxamine and buspirone both increase serotonin levels. Avoid or Use Alternate Drug.cilostazolfluvoxamine increases toxicity of cilostazol by affecting hepatic enzyme CYP2C19 metabolism. Avoid or Use Alternate Drug. Decrease cilostazol dose by 50%; serum levels of 3,4-dehydrocilostazole (active metabolite) increased by strong CYP2C19 inhibitors.cimetidinefluvoxamine will increase the level or effect of cimetidine by affecting hepatic enzyme CYP2C19 metabolism. Avoid or Use Alternate Drug.citalopramfluvoxamine and citalopram both increase serotonin levels. Avoid or Use Alternate Drug. Combinatiomay increase risk of serotonin syndrome or neuroleptic malignant syndromn e like reactions.clomipraminefluvoxamine and clomipramine both increase serotonin levels. Avoid or Use Alternate Drug.clopidogrelfluvoxamine decreases effects of clopidogrel by affecting hepatic enzyme CYP2C19 metabolism. Avoid or Use Alternate Drug. Clopidogrel efficacy may be reduced by drugs that inhibit CYP2C19. Inhibition of platelet aggregation by clopidogrel is entirely due to an active metabolite. Clopidogrel is metaolized to this active metabolite in part by CYP2C19.clozapinefluvoxamine will increase the level or effect of clozapine by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug.colchicinefluvoxamine will increase the level or effect of colchicine by Other (see comment). Avoid or Use Alternate Drug. Colchicine is a P-gp and CYP3A4 substrate. Avoid use with drugs that are both P-gp and strong CYP3A4 inhibitors. If coadministration is necessary, decrease colchicine dose or frequency as recommended in prescribing information. Use of any colchicine product in conjunction with strong CYP3A4 inhibitors is contraindicated in patients with renal or hepatic impairment. cyclobenzaprinefluvoxamine and cyclobenzaprine both increase serotonin levels. Avoid or Use Alternate Drug.dacomitinibfluvoxamine will increase the level or effect of dacomitinib by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Avoid use with CYP3D6 substrates where minimal increases in concentration of the CYP2D6 substrate may lead to serious or life-threatening toxicitiesdesfluranedesflurane and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.desipraminefluvoxamine and desipramine both increase serotonin levels. Avoid or Use Alternate Drug.desvenlafaxinefluvoxamine and desvenlafaxine both increase serotonin levels. Avoid or Use Alternate Drug.dextromethorphanfluvoxamine and dextromethorphan both increase serotonin levels. Avoid or Use Alternate Drug.dihydroergotamine intranasalfluvoxamine will increase the level or effect of dihydroergotamine intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.disopyramidefluvoxamine and disopyramide both increase QTc interval. Avoid or Use Alternate Drug.dolasetronfluvoxamine and dolasetron both increase serotonin levels. Avoid or Use Alternate Drug.dosulepinfluvoxamine and dosulepin both increase serotonin levels. Avoid or Use Alternate Drug.doxepinfluvoxamine and doxepin both increase serotonin levels. Avoid or Use Alternate Drug.dronedaronefluvoxamine will increase the level or effect of dronedarone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.dronedarone will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.duloxetinefluvoxamine will increase the level or effect of duloxetine by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug.fluvoxamine and duloxetine both increase serotonin levels. Avoid or Use Alternate Drug.elacestrantfluvoxamine will increase the level or effect of elacestrant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.eliglustateliglustat and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.eltrombopagfluvoxamine will increase the level or effect of eltrombopag by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug.encorafenibencorafenib and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.entrectinibfluvoxamine will increase the level or effect of entrectinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. avoid coadministration of moderate CYP3A4 inhibitors with entrectinib, a CYP3A4 substrate. If coadministration unavoidabole, reduce dose to 200 mg/day for patients aged 12 y or older with BSA >1.5m2. Resume previous entrectinib dose after discontinuing moderate CYP3A4 inhibitor for 3-5 elimination half-lives.entrectinib and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.ergotaminefluvoxamine will increase the level or effect of ergotamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.eribulineribulin and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.escitalopramfluvoxamine and escitalopram both increase serotonin levels. Avoid or Use Alternate Drug.esomeprazolefluvoxamine will increase the level or effect of esomeprazole by affecting hepatic enzyme CYP2C19 metabolism. Avoid or Use Alternate Drug.etravirinefluvoxamine will increase the level or effect of etravirine by affecting hepatic enzyme CYP2C19 metabolism. Avoid or Use Alternate Drug.everolimusfluvoxamine will increase the level or effect of everolimus by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.fedratinibfluvoxamine will increase the level or effect of fedratinib by Other (see comment). Avoid or Use Alternate Drug. Avoid coadministration of fedratinib (a CYP3A4 and CYP2C19 substrate) with dual CYP3A4 and CYP2C19 inhibitor. Effect of coadminitration of a dual CYP3A4 and CYP2C19 inhibitor with fedratinib not studiedfentanylfluvoxamine and fentanyl both increase serotonin levels. Avoid or Use Alternate Drug.fentanyl transdermalfluvoxamine and fentanyl transdermal both increase serotonin levels. Avoid or Use Alternate Drug.fentanyl transmucosalfluvoxamine and fentanyl transmucosal both increase serotonin levels. Avoid or Use Alternate Drug.fluoxetinefluvoxamine and fluoxetine both increase serotonin levels. Avoid or Use Alternate Drug.gilteritinibgilteritinib will increase the level or effect of fluvoxamine by Other (see comment). Avoid or Use Alternate Drug. Coadministrationwith drugs that inhibit 5HT2B or sigma nonspecific receptors. Avoid use of these drugs with gilteritinib unless coadministration is necessarygilteritinib and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.givosirangivosiran will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP1A2 substrates with givosiran. If unavoidable, decrease the CYP1A2 substrate dosage in accordance with approved product labeling.givosiran will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP2D6 substrates with givosiran. If unavoidable, decrease the CYP2D6 substrate dosage in accordance with approved product labeling.granisetronfluvoxamine and granisetron both increase serotonin levels. Avoid or Use Alternate Drug.hydromorphonefluvoxamine and hydromorphone both increase serotonin levels. Avoid or Use Alternate Drug.ibutilidefluvoxamine and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.imipraminefluvoxamine and imipramine both increase serotonin levels. Avoid or Use Alternate Drug.indapamidefluvoxamine and indapamide both increase QTc interval. Avoid or Use Alternate Drug.infigratinibfluvoxamine will increase the level or effect of infigratinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.isofluraneisoflurane and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.leniolisibleniolisib will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug. Avoid leniolisib with CYP1A2 substrates that have a narrow therapeutic indexlevomilnacipranfluvoxamine and levomilnacipran both increase serotonin levels. Avoid or Use Alternate Drug.lidocainefluvoxamine and lidocaine both increase serotonin levels. Avoid or Use Alternate Drug.linezolidfluvoxamine and linezolid both increase serotonin levels. Avoid or Use Alternate Drug.lofepraminefluvoxamine and lofepramine both decrease serotonin levels. Avoid or Use Alternate Drug.lorcaserinfluvoxamine and lorcaserin both increase serotonin levels. Avoid or Use Alternate Drug.lovastatinfluvoxamine will increase the level or effect of lovastatin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.lurbinectedinfluvoxamine will increase the level or effect of lurbinectedin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.maprotilinefluvoxamine and maprotiline both increase serotonin levels. Avoid or Use Alternate Drug.melatoninfluvoxamine will increase the level or effect of melatonin by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of melatonin with strong CYP1A2 inhibitorsmeperidinefluvoxamine and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.methylene bluefluvoxamine increases toxicity of methylene blue by serotonin levels. Avoid or Use Alternate Drug.metoclopramidefluvoxamine and metoclopramide both increase serotonin levels. Avoid or Use Alternate Drug. Additive effects: Increased risk for serotonin syndrome, neuroleptic malignant syndrome, dystonia, or other extrapyramidal reactionsmetoclopramide intranasalfluvoxamine, metoclopramide intranasal. Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient.mexiletinefluvoxamine will increase the