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Fluvoxamine Extended-Release Capsules and Silenor

Determining the interaction of Fluvoxamine Extended-Release Capsules and Silenor and the possibility of their joint administration.

Check result:

Fluvoxamine Extended-Release Capsules <> Silenor

Relevance: 24.09.2023 Reviewer: Shkutko P.M., M.D., in

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:

Ask your doctor before using doxepin together with fluvoxaMINE this can increase your blood levels of doxepin. This combination may cause side effects such as drowsiness, dry mouth, blurred vision, constipation, or urinating less than usual. Talk with your doctor before using these medications together. You may need a dose adjustment or special tests to safely take 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:

GENERALLY AVOID: Coadministration with fluvoxamine may significantly increase the plasma concentrations of some tricyclic antidepressants (TCAs). The proposed mechanism is fluvoxamine inhibition of multiple hepatic microsomal enzymes involved in the metabolic clearance of TCAs. Mild to moderate increases in plasma levels have been reported for desipramine, while significant increases of several fold have been reported for clomipramine, imipramine, and trimipramine. Pharmacodynamically, the combination of fluvoxamine (or any other selective serotonin reuptake inhibitor) and a TCA may potentiate the risk of serotonin syndrome, which is a rare but serious and potentially fatal condition thought to result from hyperstimulation of brainstem 5HT1A receptors.

MANAGEMENT: In general, the use of fluvoxamine (or other SSRIs) with TCAs should be avoided if possible, or otherwise approached with caution if potential benefit is deemed to outweigh the risk. Pharmacologic response and plasma TCA levels should be monitored more closely whenever fluvoxamine is added to or withdrawn from therapy in patients stabilized on their existing antidepressant regimen, and the TCA dosage adjusted as necessary. Patients should be monitored closely for signs and symptoms of TCA toxicity (e.g., sedation, dry mouth, blurred vision, constipation, urinary retention) and/or excessive serotonergic activity (e.g., CNS irritability, altered consciousness, confusion, myoclonus, ataxia, abdominal cramping, hyperpyrexia, shivering, pupillary dilation, diaphoresis, hypertension, and tachycardia).

References

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Fluvoxamine Extended-Release Capsules

Generic Name: fluvoxamine

Brand name: Luvox, Luvox CR

Synonyms: Fluvoxamine

What is Fluvoxamine Extended-Release Capsules?

Silenor

Generic Name: doxepin

Brand name: Silenor, Sinequan, Sinequan

Synonyms: n.a.

What is Silenor?

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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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