Fluvoxamine Maleate and Tol-Tab

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.

Using fluvoxaMINE together with TOLBUTamide can increase the effects of TOLBUTamide, which can lead to hypoglycemia (low blood sugar). Watch for signs and symptoms of low blood sugar (hypoglycemia), which include hunger, headache, drowsiness, weakness, dizziness, fast heartbeat, sweating, tremor, and nausea. You may need a dose adjustment and you may need to check your blood sugar more often 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.

MONITOR: The coadministration with fluvoxamine may increase the plasma concentrations of tolbutamide. The mechanism is decreased clearance of tolbutamide due to inhibition of the CYP450 2C9 enzymatic pathway by fluvoxamine. In an open-label, randomized study consisting of 14 healthy subjects, fluvoxamine (75 mg orally daily for 5 days) decreased the median total clearance of tolbutamide (500 mg oral dose) by 19%. Fluvoxamine (150 mg orally daily for 5 days) also decreased the total clearance of tolbutamide, but the difference was not statistically significant. The clearance by means of 4-hydroxylation, which is facilitated by CYP450 2C9, was significantly reduced by 40% and 60% in the 75 mg and 150 mg fluvoxamine group, respectively.

MANAGEMENT: Patients treated concomitantly with fluvoxamine may require a lower dosage of tolbutamide to control hyperglycemia. Pharmacologic response to tolbutamide should be monitored more closely whenever fluvoxamine is added to or withdrawn from therapy in patients stabilized on their existing antidiabetic regimen, and the tolbutamide dosage adjusted as necessary.

Fluvoxamine Maleate

Generic Name: fluvoxamine

Brand name: Luvox, Luvox CR

Synonyms: Fluvoxamine

What is Fluvoxamine Maleate?

Tol-Tab

Generic Name: tolbutamide

Brand name: Orinase, Orinase Diagnostic, Tol-Tab

Synonyms: Tol-Tab (Oral)

What is Tol-Tab?