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Luvox Tapering Guide

fluvoxamine

SSRIFDA 1994
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Boxed Warning

Suicidality risk in children, adolescents, and young adults under 25 during initial treatment.

Overview

Fluvoxamine is an SSRI primarily approved for obsessive-compulsive disorder (OCD). It is a potent inhibitor of CYP1A2 and CYP2C19 and also has sigma-1 receptor agonist activity, which may contribute to its anxiolytic properties.

Common Doses

25mg, 50mg, 100mg, 200mg

Formulations

Tablets: 25mg, 50mg, 100mg; Extended-release capsules (CR): 100mg, 150mg

Pregnancy

Category C (risk cannot be ruled out)

Mechanism of Action

Selective serotonin reuptake inhibitor (SSRI) that potently inhibits the serotonin transporter (SERT). Also acts as a sigma-1 receptor agonist, which may provide additional anti-anxiety and neuroprotective effects.

Taper Notes

Short half-life. CR formulation available. Tablets can be split for gradual reduction.

Hyperbolic Tapering Guidance

Shorter half-life than most SSRIs; slower taper pace recommended. Tablets can be dissolved in water for precise dosing.

Summary written by TaperCommunity, informed by the Maudsley Deprescribing Guidelines (Horowitz & Taylor) and related literature — see Sources & References below. Not affiliated with or endorsed by the Maudsley.

Common Withdrawal Symptoms

brain zapsdizzinessnauseainsomniairritability

Interactions & Safety

Drug Interactions

  • MAOIs — contraindicated (serotonin syndrome risk)
  • Thioridazine — contraindicated
  • Alosetron — contraindicated (CYP1A2 inhibition)

Food Interactions

  • No significant food effect on absorption
  • Caffeine levels may increase significantly due to CYP1A2 inhibition
  • Avoid alcohol during treatment

Contraindications

  • MAOIs within 14 days
  • Thioridazine
  • Alosetron

Toxicity

Serotonin syndrome with serotonergic combinations. Significant drug interactions due to CYP1A2 inhibition (e.g., with theophylline, clozapine, tizanidine).

Pharmacokinetics

ADME Profile

Absorption

Completely absorbed after oral administration. Bioavailability ~53% due to first-pass metabolism. Tmax 3–8 hours. Food does not significantly affect absorption.

Distribution

~25 L/kg

Metabolism

Extensively metabolized hepatically via CYP2D6 and CYP1A2. Potent inhibitor of CYP1A2 and CYP2C19, moderate inhibitor of CYP2C9 and CYP3A4. No active metabolites.

Elimination

Renal (~94% as metabolites, ~2% unchanged).

Protein Binding

~77–80%

Clearance

~1400 mL/min (apparent oral clearance)

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Sources & References

Luvox (fluvoxamine) information on this page is sourced from peer-reviewed research, regulatory bodies, clinical guidelines, and patient-advocacy organizations.

Encyclopedic & chemical databases

Neutral, high-authority entity references.

Deprescribing-specific resources

Clinician-facing references on tapering protocols.

Patient-advocacy & lived-experience

Long-running communities documenting withdrawal experience.

TaperCommunity does not provide medical advice. Always consult a qualified prescriber before adjusting psychiatric medication.