FLUVOXAMINE MALEATE ER

Fluvoxamine Maleate 150mg, Oral capsule, extended release

Alcohol

· Severity: Major

· Notes for Consumers: Do not drink alcohol while taking this medication. Drinking alcohol may alter the effects of your medication. Serious side effects may occur. Contact your care team if you experience new or worsening side effects.

· 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 alcohol (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 affect mood or behavior.

Fluvoxamine Maleate 150mg, Oral capsule, extended release

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 150mg, Oral capsule, extended release

Cannabis

· Severity: Major

· Notes for Consumers: Discuss cannabis use with your care team. The effects of your medication may be altered if used with cannabis.

· Notes for Professionals: Use together is not recommended; advise patients not to use cannabis without the advice of their health care professional. Cannabis 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 cannabis's most psychoactive compound, delta-9-tetrahydrocannabinol (Delta-9-THC). Of the over 70 phytocannabinoids in cannabis, 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 cannabis 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 150mg, Oral capsule, extended release

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 150mg, Oral capsule, extended release

Tobacco

· Severity: Major

· Notes for Consumers: Do not smoke or use tobacco products while taking this medication. When used together, your medication may not work as well for you.

· Notes for Professionals: Advise patients to avoid smoking tobacco while taking fluvoxamine. Smoking tobacco has been observed to increase the metabolism of fluvoxamine by 25% and may reduce its efficacy.

<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>