| Description | Fluvoxamine maleate is the most recent of the serotonin-specific antidepressants
to reach the market. In vitro and in vivo animal experiments have shown
fluvoxamine to have a marked effect on 5-HT mediated processes and little effect
on norepinephrine. Clinical trials suggest similar efficacy to imipramine and
clomipramine with a somewhat lower incidence of side effects, especially anticholinergic
effects. Fluvoxamine, in contrast to the tricyclic antidepressants,
does not appear to produce heart rate increase, postural hypotension or prolongation
of the intraventricular conduction time and QT interval. |
| Chemical Properties | Crystalline Solid |
| Originator | Duphar (Netherlands) |
| Uses | A selective serotonin reuptake inhibitor (SSRI) used as an anti-depressant. Antiobsessional. |
| Uses | estrogen |
| Uses | nonsteroidal anti-inflammatory reduces pain and inflammation in eyes |
| Uses | Anxiety disorder |
| Uses | Fluvoxamine maleate has been used as a test compound to determine the solubility and effective blood-brain barrier permeability.(2) |
| Definition | ChEBI: Fluvoxamine maleate is a member of (trifluoromethyl)benzenes. |
| Manufacturing Process | 20.4 mmol (5.3 g) of 5-methoxy-4'-trifluoromethylvalerophenone (MP 43°C to 44°C), 20.5 mmol (3.1 g) of 2-aminooxyethylamine dihydrochloride and 10 ml of pyridine were refluxed for 15 hr in 20 ml of absolute ethanol. After evaporating the pyridine and the ethanol in vacuo, the residue was dissolved in water. This solution was washed with petroleum ether and 10 ml of 50% sodium hydroxide solution were then added. Then three extractions with 40 ml of ether were carried out. The ether extract was washed successively with 20 ml of 5% sodium bicarbonate solution and 20 ml of water. After drying on sodium sulfate, the ether layer was evaporated in vacuo. Toluene was then evaporated another three times (to remove the pyridine) and the oil thus obtained was dissolved in 15 ml of absolute ethanol. An equimolar quantity of maleic acid was added to the solution and the solution was then heated until a clear solution was obtained. The ethanol was then removed in vacuo and the residue was crystallized from 10 ml of acetonitrile at +5°C. After sucking off and washing with cold acetonitrile, it was dried in air. The MP of the resulting compound was 120°C to 121.5°C. |
| Brand name | Luvox (Solvay Pharmaceuticals);FLOXYFRAL. |
| Therapeutic Function | Antidepressant |
| General Description | Pharmaceutical secondary standards for application in quality control provide pharma laboratories and manufacturers with a convenient and cost-effective alternative to the preparation of in-house working standards |
| Hazard | A poison by ingestion. Human systemic
effects. |
| Biological Activity | Selective serotonin reuptake inhibitor; antidepressant. Binds to the human 5-HT transporter with a K i of 1.6 nmol/l. Also available as part of the Serotonin Uptake Inhibitor Tocriset™ . |
| Biochem/physiol Actions | Fluvoxamine maleate is a selective neuronal serotonin reuptake inhibitor. It functions as an antidepressant and anti-obsessive agent. It is useful in treating obsessive compulsive disorder and panic disorder. |
| Clinical Use | SSRI antidepressant:DepressionObsessive compulsive disorder |
| Veterinary Drugs and Treatments | Fluvoxamine may be considered for use in treating a variety of behavior-
related diagnoses in dogs and cats, including aggression and
stereotypic behaviors (and other obsessive-compulsive behaviors). |
| Drug interactions | Potentially hazardous interactions with other drugsAminophylline and theophylline: increased
aminophylline and theophylline concentrations
- avoid; if not possible, halve aminophylline or
theophylline dose and monitor levels.Analgesics: increased risk of bleeding with aspirin
and NSAIDs; risk of CNS toxicity increased with
tramadol; concentration of methadone possibly
increased.Anti-arrhythmics: increased risk of toxicity with
mexiletine.Anticoagulants: effect of coumarins possibly
enhanced; possibly increased risk of bleeding with
dabigatran.Antidepressants: avoid with reboxetine, MAOIs,
moclobemide and St John’s wort; possibly enhanced
serotonergic effects with mirtazapine; fluvoxamine
inhibits metabolism of duloxetine - avoid; can
increase tricyclics concentration; metabolism of
agomelatine reduced; possible increased risk of
convulsions with vortioxetine.Antiepileptics: antagonise anticonvulsant threshold;
concentration of carbamazepine, fosphenytoin and
phenytoin increased.Antimalarials: avoid with artemether/lumefantrine
and piperaquine with artenimol.Antipsychotics: concentration of asenapine,
haloperidol, clozapine and olanzapine increased;
increased risk of ventricular arrhythmias with
droperidol and possibly pimozide - avoid.Antivirals: concentration possibly increased by
ritonavir.Ciclosporin: may increase ciclosporin concentration.Clopidogrel: possibly reduced antiplatelet effect.Cytotoxics: concentration of pomalidomide
increasedDapoxetine: possible increased risk of serotonergic
effects - avoid.Dopaminergics: increased risk of CNS toxicity with
rasagiline - avoid; hypertension and CNS excitation
with selegiline - avoid. 5HT1
agonists: risk of CNS toxicity increased with
sumatriptan; possibly increased risk of serotonergic
effects with naratriptan; inhibits metabolism
of frovatriptan; possibly inhibits metabolism of
zolmitriptan - reduce zolmitriptan dose.Linezolid: use with care, possibly increased risk of
side effects.Lithium: increased risk of CNS effects - monitor
levels.Melatonin: concentration of melatonin increased -
avoid.Methylthioninium: risk of CNS toxicity - avoid if
possible.Muscle relaxants: increased risk of toxicity with
tizanidine - avoidPirfenidone: concentration of pirfenidone increased
- avoid. |
| Metabolism | Fluvoxamine undergoes extensive hepatic transformation
by CYP2D6, mainly via oxidative demethylation, into
at least 9 metabolites. The 2 major metabolites showed
negligible pharmacological activity. The other metabolites
are not expected to be pharmacologically active.Excretion is mainly in the urine; about 2% of a dose is
excreted as unchanged drug. |
| storage | +4°C (desiccate) |
