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What conditions does fluvoxamine treat

LUVOX CR Capsules at the same time. Phentermine is a Schedule IV controlled substance. Citalopram: CYP2C19 Inhibitors Moderate may increase the serum concentration of Citalopram. Fluvoxamine-treated patients. Caution is recommended when the drug is administered to patients with a history of convulsive disorders. Fluvoxamine should be avoided in patients with unstable epilepsy and patients with controlled epilepsy should be carefully monitored. Treatment with Fluvoxamine should be discontinued if seizures occur or if seizure frequency increases. Fluvoxamine extended-release capsules are to be used only by the patient for whom it is prescribed. Do not share it with other people. buy gynera vs

PRECAUTIONS - Abnormal Bleeding

Fluvoxamine is a potent inhibitor of CYP1A2 and tizanidine is a CYP1A2 substrate. The effect of Fluvoxamine 100 mg daily for 4 days on the pharmacokinetics and pharmacodynamics of a single 4 mg dose of tizanidine has been studied in 10 healthy male subjects. Tizanidine C max was increased approximately 12-fold range 5-fold to 32-fold elimination half-life was increased by almost 3-fold, and AUC increased 33-fold range 14-fold to 103-fold. If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip themissed dose and resume your usual dosing schedule. Included as part of the PRECAUTIONS section.

About fluvoxamine

Therefore, -feeding is not recommended while using this drug. Consult your doctor before breast-feeding. Capsules should be slowly titrated during initiation of therapy. Cyproheptadine: May diminish the therapeutic effect of Selective Serotonin Reuptake Inhibitors. Flibanserin: CYP3A4 Inhibitors Weak may increase the serum concentration of Flibanserin. Perucca E, Gatti G, Spina E. Clinical Pharmacokinetics of fluvoxamine. Clin Pharmacokinet 1994; 273: 175-90.

Avoid drinking alcohol with fluvoxamine

Daniel DG, Randolph C, Jaskiw G, et al. Coadministration of fluvoxamine increases serum concentrations of haloperidol. J Clin Psychopharmacol 1994 Oct; 145: 340-3. Fluvoxamine maleate is a white to off white, odorless, crystalline powder which is sparingly soluble in water, freely soluble in ethanol and chloroform and practically insoluble in diethyl ether. It is likely that this experience significantly underestimates the degree of accumulation that might occur with repeated diazepam administration. Moreover, as noted with alprazolam, the effect of Fluvoxamine may even be more pronounced when it is administered at higher doses.



Fluvoxamine consumer information

If any of these effects persist or worsen, tell your doctor or promptly. The magnitude of increased weight loss of drug-treated patients over placebo-treated patients is only a fraction of a pound a week. The rate of weight loss is greatest in the first weeks of therapy for both drug and placebo subjects and tends to decrease in succeeding weeks. The possible origins of the increased weight loss due to the various drug effects are not established. The amount of weight loss associated with the use of an "anorectic" drug varies from trial to trial, and the increased weight loss appears to be related in part to variables other than the drugs prescribed, such as the physician-investigator, the population treated and the diet prescribed. Studies do not permit conclusions as to the relative importance of the drug and non-drug factors on weight loss. Venkatesh KK, Castro VM, Perlis RH et al. Impact of antidepressant treatment during pregnancy on obstetric outcomes among women previously treated for depression. Am J Obstet Gynecol. Tell patients to keep Phentermine in a safe place to prevent theft, accidental overdose, misuse or abuse. Selling or giving away Phentermine may harm others and is against the law. Safety and effectiveness in pediatric patients have not been established. Because pediatric obesity is a chronic condition requiring long-term treatment, the use of this product, approved for short-term therapy, is not recommended. Fluvoxamine is secreted in human breast milk. Yale-Brown Obsessive Compulsive Scale CY-BOCS total score of 24. Patients receiving Fluvoxamine maleate experienced mean reductions of approximately six units on the CY-BOCS total score, compared to a three-unit reduction for placebo patients. Ramelteon: When Fluvoxamine 100 mg twice daily was administered for 3 days prior to single-dose coadministration of ramelteon 16 mg and Fluvoxamine, the AUC for ramelteon increased approximately 190-fold and the C max increased approximately 70-fold compared to ramelteon administered alone. Ramelteon should not be used in combination with Fluvoxamine. Fluvoxamine may be taken with or without food. Take fluvoxamine at bedtime, unless your doctor tells you otherwise. Consequently, the dose should be increased in 50 mg increments every 4 to 7 days, as tolerated, until maximum therapeutic benefit is achieved, not to exceed 300 mg per day. It is advisable that a total daily dose of more than 100 mg should be given in two divided doses. If the doses are not equal, the larger dose should be given at bedtime. The efficacy of Fluvoxamine maleate for the treatment of obsessive compulsive disorder was demonstrated in a 10-week multicenter placebo controlled study with 120 outpatients ages 8-17. In addition, 99 of these outpatients continued open-label Fluvoxamine maleate treatment for up to another one to three years, equivalent to 94 patient years. Canadian labeling: Additional contraindications not in US labeling: Hypersensitivity to fluvoxamine or any component of the formulation; concurrent use with astemizole, cisapride, mesoridazine, or terfenadine. CR Capsules and clozapine are used concurrently. No evidence of dependency phenomena was found.



LUVOX CR Capsules affect you

Clin Psychopharmacol 1992 Aug; 124: 296-7. In managing overdosage, consider the possibility of multiple drug involvement. The physician should consider contacting a poison control center for additional information on the treatment of any overdose. Roflumilast: FluvoxaMINE may increase serum concentrations of the active metabolites of Roflumilast. FluvoxaMINE may increase the serum concentration of Roflumilast. Activated charcoal should be administered. Due to the large volume of distribution of this drug, forced diuresis, dialysis, hemoperfusion and exchange transfusion are unlikely to be of benefit. No specific antidotes for Fluvoxamine are known. Fluvoxamine Maleate Tablets can cause sleepiness or may affect your ability to make decisions, think clearly, or react quickly. You should not drive, operate heavy machinery, or do other dangerous activities until you know how Fluvoxamine Maleate Tablets affects you. Do not drink alcohol while using Fluvoxamine Maleate Tablets. Use with caution. The effects may be increased because of slower removal of the medicine from the body. How should I take LUVOX CR Capsules? Harten J, van Bemmel P, Dobrinska MR, et al. Bioavailability of fluvoxamine given with and without food. Biopharm Drug Dispos 1991; 12: 571-6. Biol Psychiatry 1993; 33: 851-2. Suicide Risk and - Pediatric Use. Studies have shown that fluvoxamine is effective in treating children and adolescents with social phobia, separation anxiety disorder, and generalized anxiety disorder. Patients should be monitored for these symptoms when discontinuing treatment with Fluvoxamine Maleate Tablets. A gradual reduction in the dose rather than abrupt cessation is recommended whenever possible. If intolerable symptoms occur following a decrease in the dose or upon discontinuation of treatment, then resuming the previously prescribed dose may be considered. Subsequently, the physician may continue decreasing the dose but at a more gradual rate. atenolol



Important information

Uguz F. Gastrointestinal side effects in the baby of a breastfeeding woman treated with low-dose fluvoxamine. J Hum Lact. Store fluvoxamine extended-release capsules at room temperature between 59 and 86 degrees F 15 and 30 degrees C in a tightly closed container. Avoid temperatures above 86 degrees F 30 degrees C. Store away from heat, moisture, and light. Do not store in the bathroom. Keep fluvoxamine extended-release capsules out of the reach of children and away from pets. May enhance the antiplatelet effect of other Agents with Antiplatelet Properties. Read the Guide provided by your before you start using and each time you get a refill. If you have any questions, consult your doctor or pharmacist. What about self-help and home remedies for depression? Based on the number of male patients. Phentermine hydrochloride is a white, odorless, hygroscopic, crystalline powder which is soluble in water and lower alcohols, slightly soluble in chloroform and insoluble in ether. Phentermine with fenfluramine or dexfenfluramine. The possibility of an association between PPH and the use of Phentermine alone cannot be ruled out; there have been rare cases of PPH in patients who reportedly have taken Phentermine alone. The initial symptom of PPH is usually dyspnea. Other initial symptoms include angina pectoris, syncope or lower extremity edema. Patients should be advised to report immediately any deterioration in exercise tolerance. Treatment should be discontinued in patients who develop new, unexplained symptoms of dyspnea, angina pectoris, syncope or lower extremity edema, and patients should be evaluated for the possible presence of pulmonary hypertension. Ask if you are not sure. Fluvoxamine comes as a tablet and an extended-release capsule to take by mouth. The tablet usually is taken either once daily at bedtime or twice daily, once in the morning and once at bedtime. BMI; hepatic function baseline and as clinically indicated. Metabolism: Fluvoxamine maleate is extensively metabolized by the liver; the main metabolic routes are oxidative demethylation and deamination. Therefore, coadministration of Phentermine and these drug products is not recommended. Low salt sodium levels in the blood. Elderly people may be at greater risk for this. Greater risks for developing a discontinuation syndrome have been associated with antidepressants with shorter half-lives, longer durations of treatment, and abrupt discontinuation. For antidepressants of short or intermediate half-lives, symptoms may emerge within 2 to 5 days after treatment discontinuation and last 7 to 14 days APA, 2010; Fava, 2006; Haddad, 2001; Shelton, 2001; Warner, 2006. vraf.info acillin



Fluvoxamine forms and strengths

Is it possible to prevent depression? Kristensen JH, Hackett LP, Kohan R et al. The amount of fluvoxamine in milk is unlikely to be a cause of adverse effects in breastfed infants. J Hum Lact. Take fluvoxamine extended-release capsules at bedtime unless your doctor tells you otherwise. Antidepressants increase the risk of suicidal thinking and behavior in children, adolescents, and young adults 18 to 24 years of age with major depressive disorder MDD and other psychiatric disorders; consider risk prior to prescribing. NiMODipine: CYP3A4 Inhibitors Weak may increase the serum concentration of NiMODipine. Orap ramelteon Rozerem terfenadine Seldane not available in the US tizanidine Zanaflex or thioridazine. Your doctor will probably tell you not to take fluvoxamine. Propranolol and Other Beta-Blockers: Coadministration of Fluvoxamine maleate 100 mg per day and propranolol 160 mg per day in normal volunteers resulted in a mean five-fold increase range 2 to 17 in minimum propranolol plasma concentrations. In this study, there was a slight potentiation of the propranolol-induced reduction in heart rate and reduction in the exercise diastolic pressure. Limited data suggest fluvoxamine does not accumulate in patients with renal impairment. Canadian labeling recommends initiating therapy at a reduced dosage with close monitoring. If you miss a dose of fluvoxamine extended-release capsules, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once. LUVOX CR is unclear. Decreased appetite and weight loss have been observed in association with the use of Fluvoxamine as well as other SSRIs. Consequently, regular monitoring of weight and growth is recommended if treatment of a child with an SSRI is to be continued long term. discount card for cetirizine



What are the possible side effects of fluvoxamine

ADVICE ABOUT SIDE EFFECTS. Two mothers breastfeeding while taking stable doses of fluvoxamine were studied with timed blood and milk samples over 24 hours. Children younger than 8 years of age: Safety and efficacy have not been established. Treatment with Fluvoxamine Maleate Tablets and any concomitant serotonergic agents, should be discontinued immediately if the above events occur and supportive symptomatic treatment should be initiated. Gorman JR, Kao K, Chambers CD. Breastfeeding among women exposed to antidepressants during pregnancy. J Hum Lact. How should I store Fluvoxamine Maleate Tablets? The presence of other medical problems may affect the use of fluvoxamine. L fluvoxamine serum levels during maternal therapy with fluvoxamine in dosages of 100 to 150 mg daily. Phentermine hydrochloride equivalent to 30 mg Phentermine base. The risk of QT prolongation may be increased if you have certain medical conditions or are taking other drugs that may cause QT prolongation. Before using fluvoxamine, tell your doctor or pharmacist of all the drugs you take and if you have any of the following conditions: certain heart problems heart failure, slow heartbeat, QT prolongation in the EKG family history of certain heart problems QT prolongation in the EKG, sudden cardiac death. Typical actions of amphetamines include central nervous system stimulation and elevation of blood pressure. Tachyphylaxis and tolerance have been demonstrated with all drugs of this class in which these phenomena have been looked for. What is the general approach to treating depression? Children, teenagers, and young adults who take fluvoxamine extended-release capsules may be at increased risk of suicidal thoughts or actions. Watch patients who take fluvoxamine extended-release capsules closely. Contact the doctor at once if new, worsened, or sudden symptoms, such as depressed mood; anxious, restless, or irritable behavior; panic attacks; or any unusual change in mood or behavior, occur. Contact the doctor right away if any signs of suicidal thoughts or actions occur.



Fluvoxamine dosage

This medication can slow down the removal of other medications from your body, which may affect how they work. Vemurafenib: May increase the serum concentration of CYP1A2 Substrates. Management: Consider alternatives to such combinations whenever possible, particularly if the CYP1A2 substrate has a relatively narrow therapeutic index. Fractures: Bone fractures have been associated with antidepressant treatment. Consider the possibility of a fragility fracture if an antidepressant-treated patient presents with unexplained bone pain, point tenderness, swelling, or bruising Rabenda, 2013; Rizzoli, 2012. Fluvoxamine MALEATE TABLETS because this can cause serious heart rhythm problems or sudden death. Nonteratogenic Effects: Neonates exposed to Fluvoxamine Maleate Tablets and other SSRIs or serotonin and norepinephrine reuptake inhibitors SNRIs late in the third trimester have developed complications requiring prolonged hospitalization, respiratory support, and tube feeding. Such complications can arise immediately upon delivery. Reported clinical findings have included respiratory distress, cyanosis, apnea, seizures, temperature instability, feeding difficulty, vomiting, hypoglycemia, hypotonia, hypertonia, hyperreflexia, tremor, jitteriness, irritability, and constant crying. These features are consistent with either a direct toxic effect of SSRIs and SNRIs or, possibly, a drug discontinuation syndrome. Trabert W, Hohagen F, Winkelmann G, et al. A seizure, and electroencephalographic signs of a lowered seizure threshold, associated with fluvoxamine treatment of obsessive-compulsive disorder. Pharmacopsychiatry 1995; 28: 95-7. Hendrick V, Fukuchi A, Altshuler L et al. Use of sertraline, paroxetine and fluvoxamine by nursing women. Br J Psychiatry. Fluvoxamine maleate overdose include gastrointestinal complaints nausea, vomiting and diarrhea coma, hypokalemia, hypotension, respiratory difficulties, somnolence, and tachycardia. Other notable signs and symptoms seen with Fluvoxamine maleate overdose single or multiple drugs include bradycardia, ECG abnormalities such as heart arrest, QT interval prolongation, first degree atrioventricular block, bundle branch block, and junctional rhythm convulsions, dizziness, liver function disturbances, tremor, and increased reflexes. Animal reproduction studies have not been conducted with Phentermine. If this drug is used during pregnancy, or if the patient becomes pregnant while taking this drug, the patient should be apprised of the potential hazard to a fetus. Ther Drug Monit 1992; 143: 194-6. Medication Guide. Read and follow the instructions carefully. Ask your doctor if you have any questions. Table displays the incidence of sexual side effects reported by at least 2% of patients taking Fluvoxamine Maleate Tablets in placebo-controlled trials in depression and OCD. This may not be a complete list of all interactions that may occur. Ask your health care provider if fluvoxamine extended-release capsules may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine. Elderly Subjects: In a study of Fluvoxamine Maleate Tablets at 50 and 100 mg comparing elderly ages 66-73 and young subjects ages 19-35 mean maximum plasma concentrations in the elderly were 40% higher. order ciprofloxacin information



Br J Psychiatry 1994 Mar; 164: 387-95

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of fluvoxamine in the elderly. However, elderly patients are more likely to have hyponatremia low sodium in the blood and liver problems, which may require an adjustment in the dose for patients receiving fluvoxamine. When this medication is used for a long time, it may not work as well. Talk with your doctor if this medication stops working well. There was considerable variation in risk of suicidality among drugs, but a tendency toward an increase in the younger patients for almost all drugs studied. There were differences in absolute risk of suicidality across the different indications, with the highest incidence in MDD. The risk differences drug vs placebo however, were relatively stable within age strata and across indications. Patients should be advised that taking Fluvoxamine Maleate Tablets can cause mild pupillary dilation, which in susceptible individuals, can lead to an episode of angle closure glaucoma. Pre-existing glaucoma is almost always open-angle glaucoma because angle closure glaucoma, when diagnosed, can be treated definitively with iridectomy. Open-angle glaucoma is not a risk factor for angle closure glaucoma. How much of this drug is typically used? Serotonin release by platelets plays an important role in hemostasis. Epidemiological studies of the case-control and cohort design have demonstrated an association between use of psychotropic drugs that interfere with serotonin reuptake and the occurrence of upper gastrointestinal bleeding. These studies have also shown that concurrent use of an NSAID or aspirin may potentiate this risk of bleeding. Tell your doctor or pharmacist if you are taking other products such as alcohol, antihistamines such as cetirizine, diphenhydramine other drugs for sleep or anxiety such as alprazolam, zolpidem muscle relaxants such as carisoprodol, cyclobenzaprine and narcotic pain relievers such as codeine, hydrocodone. What are the possible side effects of Fluvoxamine Maleate Tablets? If you miss a dose of Fluvoxamine Maleate Tablets, take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and take your next dose at the regular time. Do not take two doses of Fluvoxamine Maleate Tablets at the same time. Tell your doctor if your condition persists or worsens. 100 mg tricor pills



Fluvoxamine drug interactions

Table provides the outcome classification by treatment group on the Global Improvement item of the Clinical Global Impression CGI scale for the pediatric study. Fluvoxamine Maleate Tablets and antidepressant medicines may increase suicidal thoughts or actions in some children, teenagers, or young adults within the first few months of treatment or when the dose is changed. See WARNINGS AND PRECAUTIONS. Capsules in patients with concomitant systemic illness is limited. Lotronex TM is a registered trademark of GlaxoSmithKline. How can someone help a person who is depressed? Clin Psychopharmacol 1991 Dec; 116: 391-2. Harten J, Duchier J, Devissaguet J-P, et al. Pharmacokinetics of fluvoxamine maleate in patients with liver cirrhosis after single-dose oral administration. Clin Pharmacokinet 1993; 242: 177-82. If concomitant use of Fluvoxamine Maleate Tablets with other serotonergic drugs, including triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, buspirone, tryptophan, amphetamines, and St. John's Wort is clinically warranted, patients should be made aware of a potential increased risk for serotonin syndrome, particularly during treatment initiation and dose increases. LUVOX CR Capsule therapy. Minerals with AE, No Iron: May enhance the antiplatelet effect of Agents with Antiplatelet Properties. co-amoxiclav



How to use fluvoxamine

Tablets 100 mg: scored, beige, elliptical, film-coated debossed “1221” on one side and scored on the other Contraindications Coadministration of tizanidine, thioridazine, alosetron, or pimozide with Fluvoxamine Maleate Tablets is contraindicated. Lumefantrine: May increase the serum concentration of CYP2D6 Substrates. Clozapine - Elevated serum levels of clozapine have been reported in patients taking Fluvoxamine maleate and clozapine. Since clozapine-related seizures and orthostatic hypotension appear to be dose related, the risk of these adverse events may be higher when Fluvoxamine and clozapine are coadministered. Patients should be closely monitored when Fluvoxamine maleate and clozapine are used concurrently. Tell your doctor if your condition does not improve or if it worsens. She partially breastfed her infant extent not stated for 3 months from birth. No adverse events were seen in the infant who developed normally. Pharmacopsychiatry 1992; 25: 103. Blood Glucose Lowering Agents: Selective Serotonin Reuptake Inhibitors may enhance the hypoglycemic effect of Blood Glucose Lowering Agents. Fluvoxamine were administered a single oral dose of 10 mg of diazepam. Bauer, 2002; Haddad, 2001; NCCMH, 2010; Schatzberg, 2006; Shelton, 2001; Warner, 2006. Fluvoxamine inhibits serotonin 5-HT uptake by platelets as well as by neurons. Agents with Antiplatelet Properties. Bleeding may occur. What treatments are available for depression? Pomalidomide: CYP1A2 Inhibitors Strong may increase the serum concentration of Pomalidomide. Management: Avoid when possible. Monitor toxicity closely when combined. In patients also receiving a P-gp inhibitor and strong CYP3A4 inhibitor, reduce pomalidomide dose by 50% Canadian labeling says to reduce dose with any use of a strong CYP1A2 inhibitor. If urgent treatment with linezolid or IV methylene blue is required in a patient already receiving fluvoxamine and potential benefits outweigh potential risks, discontinue fluvoxamine promptly and administer linezolid or IV methylene blue. Monitor for serotonin syndrome for 2 weeks or until 24 hours after the last dose of linezolid or IV methylene blue, whichever comes first. May resume fluvoxamine 24 hours after the last dose of linezolid or IV methylene blue. The 50mg and 100mg tablets: In addition to the above inactive ingredients, contain synthetic iron oxides. Management of acute Phentermine hydrochloride intoxication is largely symptomatic and includes lavage and sedation with a barbiturate. Experience with hemodialysis or peritoneal dialysis is inadequate to permit recommendations in this regard. Acidification of the urine increases Phentermine excretion.



Side effects of fluvoxamine

Also tell your doctor if you have or have ever had seizures, or heart, kidney, adrenal, or liver disease. Ramelteon: FluvoxaMINE may increase the serum concentration of Ramelteon. Coumadin warfarin may lead to bleeding. Patients with Concomitant Illness. Spigset O. Serotonin syndrome induced by fluvoxamine-lithium interaction. Pharmacopsychiatry 1993 Nov; 26: 263-4. Monitor cardiac rhythm and vital signs. What should I tell my healthcare provider before taking Fluvoxamine Maleate Tablets? Jerling M, Lindström L, Bondesson U, et al. Fluvoxamine inhibition and carbamazepine induction of the metabolism of clozapine: evidence from a therapeutic drug monitoring service. Ther Drug Monit 1994; 164: 368-74. Neurol Neurosurg Psychiatry 1992 Apr; 55: 330-1. Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your or local waste disposal company. purchase now alesse generic



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Prescribing information for fluvoxamine


What is the prognosis for depression?

In some cases, a patient already receiving Fluvoxamine Maleate Tablets therapy may require urgent treatment with linezolid or intravenous methylene blue. If acceptable alternatives to linezolid or intravenous methylene blue treatment are not available and the potential benefits of linezolid or intravenous methylene blue treatment are judged to outweigh the risks of serotonin syndrome in a particular patient, Fluvoxamine Maleate Tablets should be stopped promptly, and linezolid or intravenous methylene blue can be administered. The patient should be monitored for symptoms of serotonin syndrome for two weeks or until 24 hours after the last dose of linezolid or intravenous methylene blue, whichever comes first. sumatriptan

Fluvoxamine in these patients

Abiraterone Acetate: May increase the serum concentration of CYP2D6 Substrates. Management: Avoid concurrent use of abiraterone with CYP2D6 substrates that have a narrow therapeutic index whenever possible. SSRIs and SNRIs see Use In Specific Populations, Geriatric Use. Your methadone dose may need to be changed if you start or stop taking fluvoxamine.

Is it possible to prevent depression?

Before having surgery, tell your doctor or dentist that you are taking this medication. Of the 1087 OCD and depressed patients treated with Fluvoxamine maleate in controlled clinical trials in North America, 22% discontinued due to an adverse reaction. Adverse reactions that led to discontinuation in at least 2% of Fluvoxamine maleate-treated patients in these trials were: nausea 9% insomnia 4% somnolence 4% headache 3% and asthenia, vomiting, nervousness, agitation, and dizziness 2% each. Unlike propranolol and metoprolol which undergo hepatic metabolism, atenolol is eliminated primarily by renal excretion.

Fluvoxamine ingredients

Perucca E, Gatti G, Cipolla G, et al. Inhibition of diazepam metabolism by fluvoxamine: a pharmacokinetic study in normal volunteers. Clin Pharmacol Ther 1994 Nov; 565: 471-6. Swallow fluvoxamine extended-release capsules whole. Do not break, crush, or chew before swallowing. To reduce your risk of side effects, your doctor may direct you to start this medication at a low dose and gradually increase your dose. Follow your doctor's instructions carefully.

Patient may experience dizziness, nausea, vomiting, anxiety, dry mouth, fatigue, insomnia, headache, loss of strength and energy, lack of appetite, diarrhea, constipation, flatulence, sweating a lot, tremors, common cold symptoms, or change in taste. Have patient report immediately to prescriber vision changes, eye pain, eye irritation, signs of depression suicidal ideation, anxiety, emotional instability, or confusion signs of low sodium headache, difficulty focusing, memory impairment, confusion, weakness, seizures, or change in balance signs of bleeding vomiting blood or vomit that looks like coffee grounds; coughing up blood; hematuria; black, red, or tarry stools; bleeding from the gums; abnormal vaginal bleeding; bruises without a reason or that get bigger; or any severe or persistent bleeding agitation, irritability, panic attacks, behavioral changes, mood changes, excessive weight gain, excessive weight loss, polyuria, sexual dysfunction, decreased libido, seizures, menstrual changes, signs of serotonin syndrome dizziness, severe headache, agitation, hallucinations, tachycardia, abnormal heartbeat, flushing, tremors, sweating a lot, change in balance, severe nausea, or severe diarrhea or priapism HCAHPS.

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