Fluvoxamine ER Capsules and Fosphenytoin Sodium
Determining the interaction of Fluvoxamine ER Capsules and Fosphenytoin Sodium and the possibility of their joint administration.
In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.
Consumer:Using fosphenytoin together with fluvoxaMINE may increase the effects of fosphenytoin. Contact your doctor if you experience twitching eye movements, slurred speech, loss of balance, tremor, muscle stiffness or weakness, nausea, vomiting, feeling light-headed, fainting, and slow or shallow breathing. If your doctor does prescribe these medications together, you may need a dose adjustment or special test to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Professional:MONITOR: Coadministration with fluvoxamine may increase the serum concentrations of phenytoin. The proposed mechanism is fluvoxamine inhibition of CYP450 2C9 and 2C19, the isoenzymes responsible for the metabolic clearance of phenytoin. In one case report, a patient developed ataxia in association with a phenytoin level of 49.1 mcg/mL approximately one month after fluvoxamine 50 mg/day was added to a stable regimen of phenytoin 300 mg/day. Her previous phenytoin level was 16.6 mcg/mL three months prior to addition of fluvoxamine. The patient progressively improved following gradual reduction of phenytoin dosage and fluvoxamine withdrawal. Genotyping of the patient did not show mutations for CYP450 2C9 or 2C19, further supporting the likelihood of an interaction with fluvoxamine. It is not known whether this interaction occurs with other hydantoins.
MANAGEMENT: Caution is advised if phenytoin must be used with fluvoxamine. Pharmacologic response and serum phenytoin levels should be monitored more closely whenever fluvoxamine is added to or withdrawn from therapy, and the phenytoin dosage adjusted as necessary. The same precaution may be applicable during therapy with other hydantoins, although clinical data are lacking. Patients should be advised to contact their physician if they experience symptoms of hydantoin toxicity such as nausea, vomiting, tremors, ataxia, lethargy, slurred speech, visual disturbances, or changes in mental status.
- Mamiya K, Kojima K, Yukawa E, Higuchi S, Ieiri I, Ninomiya H, Tashiro N "Phenytoin intoxication induced by fluvoxamine." Ther Drug Monit 23 (2001): 75-7
- "Product Information. Luvox (fluvoxamine)." Solvay Pharmaceuticals Inc, Marietta, GA.
Generic Name: fluvoxamine
Brand name: Luvox, Luvox CR
Synonyms: Fluvoxamine
Generic Name: fosphenytoin
Brand name: Cerebyx
Synonyms: Fosphenytoin
In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.
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