Buy Fevarin (Fluvoxamine)

Strongly and specifically slows down the reuptake of serotonin by neurons, thereby increasing its concentration in the synapse and enhancing its action; while having little effect on the reuptake of dopamine and norepinephrine. According to the antidepressant effect, indications for use are similar to imipramine, amitriptyline, but are better tolerated, since it has a significantly lower anticholinergic activity.

It is used for depression of various etiologies and for obsessive-compulsive disorder.

• Nausea,
• vomiting,
• constipation,
• anorexia,
• dry mouth,
• drowsiness,
• feeling of anxiety and restlessness,
• visual disturbances,
• tremor,
• headache,
• various pains, s
• exual disorders (including decreased potency),
• convulsions,
• hypomanic and manic states,
• dyspepsia,
• tachycardia,
• arthralgia,
• allergic reactions,
• serotonin syndrome (in high doses),
• hepatotoxicity.

It is forbidden to take it simultaneously with tizanidine and monoamine oxidase inhibitors (MAO inhibitors). Treatment with fluvoxamine can be started:

• 2 weeks after stopping the irreversible MAO inhibitor;
• the day after stopping the use of reversible MAO inhibitors (for example, moclobemide, linezolid).

The time interval between stopping fluvoxamine and starting therapy with any MAO inhibitor should be at least 1 week.

Contraindications:

• concurrent use with pimozide and ramelteon;
• hypersensitivity to the active substance or to any of the components of the drug;
• age up to 18 years in the treatment of depression of various origins;
• age up to 8 years in the treatment of obsessive-compulsive disorders.

With caution:

• liver and kidney failure,
• history of convulsions,
• epilepsy,
• old age,
• patients with a tendency to bleeding (thrombocytopenia),
• pregnancy,
• breastfeeding period.

Pregnancy:

Epidemiological evidence suggests that the use of selective serotonin reuptake inhibitors (SSRIs) during pregnancy, especially in the last months of pregnancy, may increase the risk of developing persistent pulmonary hypertension (PLH) in newborns. The available data show that PLH occurs in about 5 per 1000 births (as opposed to 1-2 per 1000 births if the mother did not use SSRIs in the last stages of pregnancy). The use of fluvoxamine during pregnancy is not recommended, unless the clinical condition of the woman indicates the need for its use. Isolated cases of neonatal withdrawal syndrome have been described after the use of fluvoxamine at the end of pregnancy. Feeding and/or breathing difficulties, seizure disorders, unstable body temperature, hypoglycemia, tremors, impaired muscle tone, neuroreflex hyperexcitability syndrome, cyanosis, irritability, lethargy, drowsiness, vomiting, difficulty falling asleep and incessant crying, which may require a longer stay in hospital.

Breastfeeding Period:

Fluvoxamine passes into breast milk in small amounts. In this regard, the drug should not be used during breastfeeding. Fertility: Reproductive toxicity studies in animals have shown that fluvoxamine affects reproductive function in males and females, increases the risk of fetal death and reduces fetal body weight at doses higher than the maximum recommended human dose by about 2 times. In addition, pre- and postnatal studies show an increase in perinatal mortality in puppies. The relevance of these data to humans is unknown. Fluvoxamine should not be administered to patients planning pregnancy, unless the clinical condition of the patient warrants the administration of fluvoxamine.

The dosage regimen is set by the attending physician depending on the disease and its severity. Before use, be sure to consult a specialist.

Fluvoxamine tablets should be taken orally, without chewing, with water. The tablet can be divided into two equal parts. Depression: the recommended starting dose for adults is 50 or 100 mg (once, in the evening). After 3-4 weeks from the start of therapy, the dose should be reviewed and adjusted in accordance with clinical experience with the drug. It is recommended to gradually increase the dose to the effective level. The effective daily dose, which is usually 100 mg, is selected individually depending on the patient's response to treatment. The daily dose can reach 300 mg. Daily doses over 150 mg are recommended to be divided into 2 or 3 doses.

Withdrawal syndrome after discontinuation of fluvoxamine. Termination of the use of fluvoxamine (especially abrupt) often leads to the development of a withdrawal syndrome. The most common symptoms noted in case of discontinuation of the drug: dizziness, sensory disturbance (including paresthesia, visual disturbance and electric shock sensation), sleep disturbances (including insomnia and vivid dreams), agitation, irritability, confusion, emotional lability, headache, nausea and/or vomiting, diarrhea, sweating, palpitations, tremors, and anxiety. Most of these symptoms are mild to moderate and self-limiting, but in some patients they may be severe and/or prolonged. For this reason, if fluvoxamine treatment is no longer required, it is recommended to gradually reduce the dose until the drug is completely discontinued.

Fluvoxamine should not be taken concomitantly with MAO inhibitors, treatment with this group of drugs should be stopped 2 weeks before fluvoxamine is started in order to avoid the risk of serotonin syndrome. Between the abolition of fluvoxamine and the appointment of MAO inhibitors, an interval of one week should be maintained .

SSRIs should also be avoided in conjunction with other serotonergic drugs. In addition, serotonin syndrome can occur when SSRI antidepressants are combined with buspirone, levodopa, herbal antidepressants containing Hypericum, 5-hydroxytryptophan, adenosylmethionine (SAM, heptral) and tryptophan, dextromethorphan, tramadol and other opioid analgesics, carbamazepine, lithium preparations, metoclopramide and some other drugs.  It is dangerous to combine fluvoxamine with lithium preparations, as this increases the effect of neurotoxicity, and the side effects of lithium preparations increase.

The drug slows down the metabolism of haloperidol and other neuroleptics of the group of butyrophenone derivatives, increasing their concentration in the blood by 2 times (at the same time, the concentration of fluvoxamine increases by 2–10 times), as a result of which it can reach a toxic level. Combining fluvoxamine with the atypical antipsychotics olanzapine or clozapine also slows down the metabolism of this antipsychotic and increases its blood concentrations (several times when combined with clozapine).

Fluvoxamine also slows down the metabolism of some tricyclic antidepressants with a possible increase in their concentration in the blood and the development of intoxication; the combined use of fluvoxamine with beta-blockers, theophylline, caffeine, alprazolam, carbamazepine, phenytoin, warfarin leads to similar effects. Increases the blood concentration of immunosuppressants, some benzodiazepines, propranolol.

It is not recommended to combine fluvoxamine with amitriptyline, clomipramine, imipramine, desipramine, carbamazepine, theophylline.

The drug potentiates the action of alcohol, barbiturates. Enhances the side effects of cardiac glycosides, tryptophan. In combination with warfarin, it can lead to increased bleeding. In combination with benzodiazepines, fluvoxamine may increase the severity of psychomotor disorders.

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We guarantee a refund if your package has not been delivered to you for any reason, according to PayPal protection policy.

Due to Quarantine, delivery time may increase slightly, but still delivery remains within reasonable limits and does not exceed the delivery time during Christmas sales.

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Suicidal/suicidal thoughts or clinical deterioration: Depression is associated with an increased risk of suicidal thoughts, self-harm and suicide attempts (suicidal behaviour). This risk persists until a significant improvement in the condition. Since improvement may not occur during the first few weeks of treatment or longer, patients should be closely monitored until such improvement occurs.

Treatment of patients suffering from hepatic or renal insufficiency should begin with low doses, and such patients should be under strict medical supervision. In rare cases, treatment with fluvoxamine can lead to an increase in liver enzymes, most often accompanied by corresponding clinical symptoms, and in such cases, fluvoxamine should be canceled.

Disorders of the nervous system: care must be taken when prescribing the drug to patients with a history of seizures. Fluvoxamine should be avoided in patients with unstable epilepsy, and patients with stable epilepsy should be closely monitored. Treatment with the drug should be discontinued if epileptic seizures occur or their frequency increases.

Metabolic and nutritional disorders: Blood glucose control (i.e. hyperglycemia, hypoglycemia, impaired glucose tolerance) may be impaired, especially in the early stages of treatment. In the case of the appointment of fluvoxamine in patients with a history of diabetes mellitus, dose adjustment of antidiabetic drugs may be required.

Visual impairment: Cases of mydriasis have been reported with SSRIs such as fluvoxamine. Therefore, patients with elevated intraocular pressure or patients at increased risk of acute angle-closure glaucoma should be given fluvoxamine with caution.

Mania/Hypomania: Fluvoxamine should be used with caution in patients with a history of mania/hypomania. Fluvoxamine should be discontinued if the patient develops a manic phase.