FLUVOXAMINE MALEATE 50MG FILM-COATED TABLETS
Active substance(s): FLUVOXAMINE MALEATE
• muscle weakness (asthenia)
Uncommon side effects:
• allergic skin reactions (including swelling of face, lip or tongue, rash or
• delayed ejaculation
• dizziness when standing up too quickly
• lack of co-ordination
• muscle or joint pain
Rare side effects:
• liver complaints
• mania (a feeling of elation or over-excitement)
• sensitivity to sunlight
• unexpected milk flow
Other side effects reported:
• akathisia (restlessness)
• abnormal taste
• anorgasmy (failure to achieve orgasm)
• for female patients: disorders with menstruation (monthly bleeding)
• micturition disorders (such as the need to urinate frequently during the day
and/or the night, the sudden lack of control over urination during the day
and/or the night, or the lack of ability to urinate)
• paraesthesia (tingling or numbness)
• glaucoma (increased pressure in eye)
• dilated pupils
• increase in the hormone prolactin (a hormone that supports milk production
in a nursing mother)
• weight changes
An increased risk of bone fractures has been observed in patients taking this
type of medicine.
Side effects related to the treatment for OCD, in chiIdren and
adolescents, no frequencies are given:
• Hypomania (a feeling of elation and over excitement)
• Difficulty sleeping (insomnia)
• Lack of energy (asthenia)
• Hyperactivity (hyperkinesia)
• Feeling drowsy (somnolence)
Reporting of side effects
If you get any side effects, talk to your doctor or pharmacist. This includes
any possible side effects not listed on this leaflet. You can also report side
effects directly via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard
or search for MHRA Yellow Card in the Google Play or Apple App Store. By
reporting side effects, you can help provide more information on the
safety of this medicine.
How to store Fluvoxamine
• Keep out of the sight and reach of children.
• Do not store above 25°C. Protect from light.
• Do not use this medicine after the expiry date (EXP) which is printed on the
carton and blister pack.
Fluvoxamine maleate 50mg film-coated tablets
• If your doctor tells you to stop using this medicine, return any unused
medicine to your pharmacist for safe disposal. Only keep this medicine, if
your doctor tells you to.
• If your medicine becomes discoloured or shows any other signs of
deterioration, consult your pharmacist who will tell you what to do.
• Medicines should not be disposed of via wastewater or household waste.
These measures will help to protect the environment.
What Fluvoxamine 50 mg contains
The active substance is fluvoxamine maleate. Each tablet contains 50 mg of
The other ingredients are: mannitol (E421), maize starch, pregelatinized
starch, sodium stearyl fumarate, colloidal anhydrous silica, hypromellose,
macrogol 6000, talc and titanium dioxide (E171).
What Fluvoxamine Iooks like and contents of the pack
The Fluvoxamine 50 mg tablet is fiIm-coated, white to off-white, round and
marked "291" on both sides of the score line and plain on the revese.
Fluvoxamine 50 mg is available in blister packs of 60 tablets.
Product Licence Holder and Manufacturer
This medicines is manufactured by Mylan Laboratories SAS, Route de
Belleville Lieu dit Maillard, 01400 Châtillon sur Chalaronne, France and
procured from within the EU and repackaged by the Product Licence Holder:
Lexon (UK) Limited, Unit 18, Oxleasow Road, East Moons Moat, Redditch,
Worcestershire, B98 0RE.
PL 15184/1655 Fluvoxamine maleate 50mg film-coated tablets
Revision date: 07/03/18
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Patient Information Leaflet
• Fluvoxamine treats depression and Obsessive Compulsive
Disorder (OCD). Like all medicines it can have unwanted effects. It is
therefore important that you and your doctor weigh up the benefits of
treatment against the possible unwanted effects, before starting treatment.
• Fluvoxamine should not be used to treat depression in children and
adolescents under 18. See section 2, Use in Children and adolescents
• Fluvoxamine won't work straight away. Some people taking
antidepressants feel worse before feeling better. Your doctor should see
you regularly during your course of treatment. Tell your doctor if you
haven't started feeling better.
• Some people who are depressed or anxious think of harming or
killing themselves. If you start to feel worse, or think of harming or killing
yourself, see your doctor or go to a hospital straight away.
• Don't stop taking Fluvoxamine without talking to your doctor.
If you stop taking Fluvoxamine suddenly or miss a dose, you may
get withdrawal effects. See Section 3, How to take Fluvoxamine.
• If you feel restless and feel like you can't sit or stand still, tell your
doctor. Increasing the dose of Fluvoxamine may make these feelings
• Taking some other medicines with Fluvoxamine can cause
problems. You may need to talk to your doctor. See section 2, Are you
taking any other medicines.
• If you are pregnant or planning to get pregnant, talk to your doctor.
See section 2, Pregnancy and breastfeeding.
Read all of this leaflet carefully before you start taking this medicine
Keep this leaflet. You may need to read it again.
If you have any further questions, ask your doctor or pharmacist.
This medicine has been prescribed for you. Do not pass it on to others.
It may harm them, even if their symptoms are the same as yours.
If any of the side effects become serious, or if you notice any side effects not
listed in this leaflet, please tell your doctor or pharmacist.
Your medicine is called Fluvoxamine maleate 50mg film-coated tablets and
will be referred to as Fluvoxamine throughout the rest of this leaflet.
Please note that other strength of the medicine are also available:
Fluvoxamine maleate 100mg fim-coated tablets.
In this leaflet:
1 What Fluvoxamine is and what it is used for
2 Before you take Fluvoxamine
3 How to take Fluvoxamine
4 Possible side-effects
5 How to store Fluvoxamine
6 Further information
What Fluvoxamine is and what it is used for
Fluvoxamine belongs to a group of medicines called selective serotonin
re-uptake inhibitors (SSRI). Fluvoxamine tablets contain a substance called
fluvoxamine maleate. This is an antidepressant. It is used to treat depression
(major depressive episode).
Fluvoxamine can also treat people who have obsessive compulsive disorder
Before you take Fluvoxamine
Do not take Fluvoxamine if any of the following applies to you:
• You are allergic (hypersensitive) to fluvoxamine or any of the other tablet
ingredients (see section 6 ‘Further information’)
• You are taking medicines called monoamine oxidase inhibitors (MAOI)
sometimes prescribed to treat depression or anxiety, including Iinezolid
(an antibiotic which is also an MAOI). Treatment with fluvoxamine should
only be started at least 2 weeks after discontinuation of an irreversible
MAOI. However treatment with fluvoxamine after discontinuation of certain
reversible MAOIs can be started the foIlowing day. In exceptional cases
linezolid (an antibiotic MAOI) may be used with fluvoxamine provided the
doctor can monitor you closely. Your doctor will advise you how you should
begin taking Fluvoxamine once you have stopped taking the MAOI.
• You are taking tizanidine, a medicine often used as a muscle relaxant
• You are breast-feeding
If any of the above apply to you, do not take Fluvoxamine and talk to your
Take special care
Talk to your doctor or a pharmacist before taking your medicine if:
• you recently had a heart attack
• you are pregnant, or could be pregnant
• you have epilepsy
• you have a history of bleeding problems or if you regularly use medicines
which increase the risk of bleeding, such as common pain killers
• you have diabetes
• you are having treatment with electroconvulsive therapy (ECT)
• you ever had mania (a feeling of elation or over-excitement)
• you have liver or kidney problems
• you have high pressure in your eyes (glaucoma)
• you are less than 18 years old (See also section 3 'How to take
If any of the above applies to you, your doctor will tell you whether it is safe
for you to start taking Fluvoxamine.
Occasionally, thoughts of restlessness, for example you cannot sit or stand
still (akathisia) may occur or may increase during the first few weeks of
treatment with Fluvoxamine, until the antidepressant effect has worked.
Tell your doctor immediately if you experience these symptoms. Then a
dosage adjustment may be helpful.
Thoughts of suicide and worsening of your depression or anxiety
If you are depressed and/or have anxiety disorders you can sometimes have
thoughts of harming or killing yourself. These may be increased when first
starting antidepressants, since these medicines all take time to work, usually
about two weeks but sometimes longer.
You may be more likely to think like this:
- If you have previously had thoughts about killing or harming yourself.
- If you are a young adult. Information from clinical trials has shown an
increased risk of suicidal behaviour in adults aged less than 25 years with
psychiatric conditions who were treated with an antidepressant.
If you have thoughts of harming or killing yourself at any time, contact your
doctor or go to a hospital straight away.
You may find it helpful to tell a relative or close friend that you are
depressed or have an anxiety disorder and ask them to read this leaflet.
You might ask them to tell you if they think your depression or anxiety is
getting worse, or if they are worried about changes in your behaviour.
Tell your doctor immediately if you have any distressing thoughts or
Use in children and adolescents under 18 years of age
Children and adolescents under 18 years should not take this medicine,
unless they are being treated for obsessive compulsive disorder (OCD).
This is because Fluvoxamine is not used to treat depression in people aged
under 18 years.
When taking this type of medicine, people under 18 have an increased risk of
side effects such as attempting suicide, thoughts about suicide and hostility,
such as aggression, oppositional behaviour and anger.
If your doctor has prescribed Fluvoxamine for someone under 18 years and
you want to discuss this, pIease go back to your doctor. You should tell your
doctor if any of the symptoms listed above develop or worsen when patients
under 18 are taking Fluvoxamine.
Also, it is not known whether taking Fluvoxamine under the age of 18 years
can affect growth, maturation or development of intelligence or behaviour in
the long term.
Are you taking any other medicines?
• You should not start to take the herbal remedy St John's Wort while you are
being treated with Fluvoxamine since this may result in an increase
of undesirable effects. If you are already taking St John's Wort when you
start on Fluvoxamine, stop taking the St John's Wort and tell your doctor at
your next visit.
• If you have been taking a medicine to treat depression or anxiety within the
last two weeks, or you suffer from schizophrenia, check with your doctor or
Your doctor or pharmacist will check if you are taking other medicines to treat
your depression or related conditions, these may include:
• tricyclic antidepressants
• neuroleptic or anti-psychotics
• monoamine oxidase inhibitor (MAOI) such as moclobemide.
• Selective serotonin reuptake inhibitor (SSRI) such as citalopram
Your doctor will tell you if it is safe for you to start taking Fluvoxamine.
You should also tell your doctor or pharmacist if you have been taking any of
the medicines listed below:
• aspirin (acetylsalicylic acid) or aspirin-like medicines, used to treat pain and
• ciclosporin, used to reduce the activity of the immune system
• methadone, used to treat pain and withdrawal symptoms
• mexiletine, used to treat abnormal heart rhythms
• phenytoin or carbamazepine, used to treat epilepsy
• propranolol, used to treat high blood pressure and heart conditions
• ropinirole, for Parkinson's disease.
• a ‘triptan’, used to treat migraines, such as sumatriptan
• terfenadine, used to treat allergies. Fluvoxamine should not be taken
together with terfenadine.
• sildenafil, used to treat erectile dysfunction
• theophylline, used to treat asthma and bronchitis
• tramadol, a pain-killer
• clopidogrel, warfarin, nicoumalone or any other drug used to prevent blood
If you are taking or have recently taken any of the medicines in the above list
and you have not already discussed these with your doctor, go back to your
doctor and ask what you should do. Your dose may need to be changed or
you may need to be given a different medicine.
Taking Fluvoxamine with food and drink
• Do not drink alcohol if you are taking this medicine. This is because alcohol
works together with Fluvoxamine and will make you sleepy and unsteady.
• If you normally drink a lot of tea, coffee and soft drinks with caffeine in
them, you may have symptoms such as your hands shaking, feeling sick,
fast heart rate (palpitations), restlessness and difficulty sleeping (insomnia).
If you lower how much caffeine you drink, these symptoms might
Pregnancy and breast-feeding
Ask your doctor or pharmacist for advice before taking any medicine.
There is only Iimited experience concerning the use of fluvoxamine during
pregnancy. Do not take fluvoxamine if you are pregnant unless your
doctor considers it absolutely necessary. If you are currently taking
fluvoxamine and are planning to become pregnant or to father a child,
please consult with your physician to decide if an alternative
medication is necessary or appropriate. Fluvoxamine has been shown to
reduce the quality of sperm in animal studies. Theoretically, this could affect
fertility, but impact on human fertility has not been observed as yet.
Make sure your midwife and/or doctor know you are on fluvoxamine. When
taken during pregnancy, particularly in the last 3 months of pregnancy,
medicines like fluvoxamine may increase the risk of a serious condition in
babies, called persistent pulmonary hypertension of the newborn (PPHN),
making the baby breathe faster and appear bluish. These symptoms usually
begin during the first 24 hours after the baby is born. If this happens to your
baby you should contact your midwife and/or doctor immediately.
You should not discontinue treatment with fluvoxamine abruptly. If you are
taking fluvoxamine in the last 3 months of pregnancy, your baby might have
some other symptoms when it is born in addition to having trouble breathing
or bluish skin, such as not being able to sleep or feed properly, being too hot
or cold, being sick, crying a lot, stiff or floppy muscles, lethargy, drowsiness,
tremors, jitters or fits. If your baby has any of these symptoms when it is born
contact your doctor immediately.
Fluvoxamine passes into breast milk. There is a risk of an effect on the baby.
Therefore, you should discuss the matter with your doctor, and he/she will
decide whether you should stop breast-feeding or stop the therapy with
Driving and using machines
You can drive and use machines while you are taking this treatment, so long
as this medicine does not make you sleepy.
How to take Fluvoxamine
How much Fluvoxamine to take
Always take Fluvoxamine as your doctor has told you to.
You should check with your doctor or pharmacist if you are not sure.
If your doctor advises you to take more than 50 mg per day, do not take
them all at once; ask your doctor when you should take them. If the dose is
not divided equally, the larger dose should be taken at night.
Children and adolescents under the age of 18 should not take this medicine
to treat depression. This medicine should be prescribed for children or
adolescents for Obsessive Compulsive Disorder (OCD) only.
How to take Fluvoxamine
• Swallow the tablets with water. Do not chew them.
You can break the tablets in half if your doctor has advised you to
How long does it take to work?
Fluvoxamine may take a little time to start working. Some patients do not feel
better in the first 2 or 3 weeks of treatment
Keep taking your tablets until your doctor tells you to stop. Even when you
start feeling better, your doctor may want you to carry on taking the tablets
for some time, for at least six months to make sure that the medication has
Do not stop taking Fluvoxamine too quickly.
You may suffer from withdrawal symptoms such as:
• difficulty sleeping / intense dreams
• emotional instability
• nausea and/or vomiting
• palpitation (faster heartbeats)
• sensory disturbance (such as electric shock sensations or visual
When stopping Fluvoxamine your doctor will help you to reduce your dose
slowly over a number of weeks or months, this should help reduce the
chance of withdrawal effects. Most people find that any symptoms on
stopping Fluvoxamine are mild and go away on their own within two weeks.
For some people, these symptoms may be more severe, or go on for longer.
Usual starting dose for adults (18 years and oIder):
If you get withdrawal effects when you are coming off your tablets your
doctor may decide that you should come off them more slowly. If you get
severe withdrawal effects when you stop taking Fluvoxamine, please see
your doctor. He or she may ask you to start taking your tablets again and
come off them more slowly (see section 4 'Possible Side Effects').
The treatment for depression:
• Start with 50 or 100 mg daily, taken in the evening.
If you experience any symptoms on stopping the treatment, contact your
The treatment for obsessive compulsive disorder:
• Start with 50 mg daily, preferably in the evening.
If you take more Fluvoxamine than you should
If you or someone else takes too much Fluvoxamine (an overdose), talk to a
doctor or go to a hospital straight away. Take the medicine pack with you.
If you don’t start to feel better after a couple of weeks, talk to your doctor,
who will advise you. He or she may decide to increase the dose gradually.
The highest daily dose that is recommended is 300 mg.
Please tell your doctor or pharmacist if you are taking or have taken any
other medicines, including medicines obtained without a prescription. This
includes herbal medicines.
The usual dose for children and adolescents with obsessive
compulsive disorder - OCD (8 years and older is):
Start with 25 mg (half a tablet) per day. Your doctor may increase the
dose every 4 - 7 days in 25 mg increments as tolerated until an effective
dose is achieved.
The highest daily dose is 200 mg.
If your doctor advises you to take more than 150 mg per day, do not take
them all at once; ask your doctor when you should take them.
Symptoms of overdose include, but are not limited to, nausea, vomiting,
diarrhoea and feeling drowsy or dizzy, Cardiac events (slow or fast heartbeat,
low blood pressure), liver problems, convulsions (fits) and coma have also
If you forget to take Fluvoxamine
If you miss a tablet, wait until the next dose is due. Do not try to make up for
the dose you have missed.
If you have any further questions on the use of this product, ask your doctor
4 Possible side effects
Like all medicines Fluvaxamine can cause side effects (unwanted effects or
reactions), but not everyone gets them.
Frequencies of the observed side effects are defined as:
affects more than 1 user in 10
affects 1 to 10 users in 100
affects 1 to 10 users in 1,000
affects 1 to 10 users in 10,000
affects less than 1 user in 10,000
frequency cannot be estimated from
the available data
Side effects reIated to this type of medicine
Occasionally, thoughts of suicide or self harm may occur or may increase
in the first few weeks of treatment with Fluvoxamine, until the antidepressant
effect has worked.
Tell your doctor immediately if you have any distressing thoughts or
If you have several symptoms at the same time you might have one of the
following rare conditions:
• Serotonin syndrome: if you have sweating, muscle stiffness or spasms,
instability, confusion, irritability or extreme agitation.
• Neuroleptic malignant syndrome: if you have stiff muscles, high
temperature, confusion and other related symptoms.
• SIADH: if you feel tired, weak or confused and have achy, stiff or
Stop taking Fluvoxamine and contact your doctor immediately.
If unusual bruising or purple patches appear on your skin or you vomit blood
or pass blood in your stool, contact your doctor for advice.
Stopping of fluvoxamine (particularly when abrupt) commonly leads to
withdrawal symptoms (see section 3 withdrawal symptoms).
Sometimes patients feel slightly sick as Fluvoxamine begins to work.
Although the feeling of sickness is unpleasant, it should soon pass if you
keep taking your tablets as prescribed. This may take a few weeks.
Side effects specifically related to Fluvoxamine
Common side effects
• difficulty sleeping
• dry mouth
• faster heart beat
• feeling drowsy (lethargy)
• feeling unwell (malaise)
• loss of appetite