Medicine Information

Fluver

Name: Fluver
Brand: Fluver
Rating: 4.5 (117 reviews)

Tablet5 mgAntidepressants, SSRIsATC: N06AB08

Generic Name

Fluvoxamine

Manufacturer

Square Pharmaceuticals Ltd.

Country

Bangladesh

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Price Details

Current market pricing information

Variant	Unit Price	Strip Price
fluver 5 mg tablet	৳ 4.00	৳ 40.00

Description

Overview of the medicine

Fluver 5 mg Tablet contains Fluvoxamine, which is a Selective Serotonin Reuptake Inhibitor (SSRI) used to treat various mood and anxiety disorders, including Obsessive-Compulsive Disorder (OCD), depression, and social anxiety disorder. It works by increasing the levels of serotonin in the brain.

Uses & Indications

Obsessive-Compulsive Disorder (OCD)

Major Depressive Disorder (MDD)

Social Anxiety Disorder

Panic Disorder (off-label)

Dosage

Adults

Initial dose 50 mg once daily at bedtime. May increase by 50 mg increments every 4-7 days to a maximum of 300 mg/day. Doses over 150 mg/day usually given in 2 divided doses.

Elderly

Lower initial dose (e.g., 25 mg once daily) and slower titration recommended due to increased sensitivity and potential for adverse effects.

Renal_impairment

No specific dose adjustment for mild to moderate renal impairment. Use with caution in severe impairment; monitor closely.

How to Take

Take orally with or without food, usually once daily at bedtime to minimize nausea and sleep disturbances. Swallow whole; do not crush, chew, or break.

Mechanism of Action

Fluvoxamine selectively inhibits the reuptake of serotonin (5-HT) into presynaptic neurons, thereby increasing the concentration of serotonin in the synaptic cleft. This leads to enhanced serotonergic neurotransmission, which is believed to be responsible for its antidepressant and anxiolytic effects.

Pharmacokinetics

Onset

Therapeutic effects usually seen within 2-4 weeks, though some patients may respond earlier.

Excretion

Mainly excreted via the kidneys (approximately 94% as metabolites and less than 3% as unchanged drug) within 70 hours.

Half life

Approximately 13-15 hours, allowing for once or twice daily dosing.

Absorption

Well absorbed after oral administration, peak plasma concentrations typically reached within 2-8 hours.

Metabolism

Extensively metabolized in the liver, primarily by CYP1A2 and CYP2D6, to inactive metabolites.

Side Effects

Contraindications

Hypersensitivity to fluvoxamine or any component of the formulation.
Concomitant use with Monoamine Oxidase Inhibitors (MAOIs) or within 14 days of discontinuing an MAOI (risk of serotonin syndrome).
Concomitant use with tizanidine, thioridazine, or pimozide (due to potential for QT prolongation and other severe adverse effects).
Co-administration with other serotonergic drugs (e.g., triptans, tricyclic antidepressants, fentanyl, lithium) requires careful monitoring.

Drug Interactions

MAOIs

Concurrent use contraindicated due to risk of serotonin syndrome.

Triptans

Increased risk of serotonin syndrome, monitor closely.

Warfarin

May increase anticoagulant effect, monitor INR.

Theophylline

Increased theophylline plasma levels, reduce theophylline dose.

Aspirin/NSAIDs

Increased risk of bleeding.

Tricyclic Antidepressants (TCAs)

Increased TCA plasma levels, monitor for toxicity.

Benzodiazepines (e.g., Alprazolam, Diazepam)

May increase benzodiazepine plasma levels due to CYP inhibition, adjust dose.

Storage

Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.

Overdose

Symptoms of overdose include nausea, vomiting, diarrhea, somnolence, dizziness, tachycardia, bradycardia, hypotension, seizures, and rarely, coma. Management involves symptomatic and supportive measures. There is no specific antidote. Gastric lavage or activated charcoal may be considered if ingested recently.

Pregnancy & Lactation

Pregnancy Category C. Use only if potential benefit justifies potential risk to the fetus. Fluvoxamine is excreted in human milk; avoid during breastfeeding or use with caution after consulting a physician.

Frequently Asked Questions

Common questions about this medicine

Pack Sizes

30 tablets per box

Shelf Life

24 to 36 months from the date of manufacture

Availability

Available in pharmacies and hospitals

Approval Status

Approved by FDA and DGDA

Patent Status

Off-patent

WHO Essential Medicine

Yes

Clinical Trials

Fluvoxamine has undergone numerous clinical trials demonstrating its efficacy and safety for approved indications, particularly OCD and depression. Ongoing post-marketing surveillance continues to monitor for new information.

Lab Monitoring

Liver function tests (baseline and periodically)
Serum sodium levels (especially in elderly or those on diuretics)
INR (if co-administered with warfarin)

Doctor Notes

Initiate therapy with a low dose and titrate gradually to minimize adverse effects.
Monitor patients for suicidality, especially at the beginning of treatment and during dose changes.
Be aware of potential drug interactions, particularly with other serotonergic agents and CYP1A2 substrates.
Educate patients about the importance of adherence and not discontinuing the medication abruptly.

Patient Guidelines

Do not stop taking this medicine abruptly, as it may cause withdrawal symptoms. Consult your doctor for a gradual reduction plan.
Take Fluver exactly as prescribed by your doctor, even if you start to feel better.
Be aware of the potential for increased suicidal thoughts, especially at the start of treatment or when the dose is changed. Report any unusual changes in mood or behavior to your doctor.
Avoid driving or operating heavy machinery until you know how this medicine affects you, as it may cause dizziness or drowsiness.

Missed Dose Advice

If a dose is missed, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose.

Driving Precautions

Fluver may cause drowsiness, dizziness, or blurred vision. Patients should be cautioned about operating hazardous machinery, including automobiles, until they are reasonably certain that Fluver therapy does not adversely affect their ability to engage in such activities.

Lifestyle Advice

Avoid alcohol consumption while taking this medication.
Maintain a balanced diet and regular exercise to support overall mental and physical well-being.
Practice stress-reduction techniques such as meditation or yoga.