LIPOSTAT 10mg Price

Overview

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This medicine contains an important and useful components, as it consists of
Pravastatin sodiumis available in the market in concentration

Name

Fluvoxamine Maleate

Precaution

Fluvoxamine maleate is a selective serotonin reuptake inhibitor (SSRI) primarily used to treat conditions such as obsessive-compulsive disorder (OCD) and social anxiety disorder. Like other SSRIs, it carries a risk of side effects and requires careful consideration before use. Patients with a history of bipolar disorder should be monitored closely, as SSRIs can precipitate manic episodes in susceptible individuals. Fluvoxamine should also be used with caution in patients with a history of seizures, as it may lower the seizure threshold. Those with liver or kidney impairment may need dose adjustments, as fluvoxamine is metabolized in the liver and excreted in the urine. The medication should be used cautiously in elderly patients, as they may be more sensitive to the effects, particularly the sedative or anticholinergic effects. During pregnancy, fluvoxamine should only be used if absolutely necessary, as it is classified as Category C by the FDA, meaning there are potential risks to the fetus that should be weighed against the benefits. While fluvoxamine is excreted in breast milk, it may be safe for breastfeeding women, but they should consult their healthcare provider for guidance. As with other antidepressants, there is a risk of suicidal thoughts or behaviors, especially in children, adolescents, and young adults. Therefore, patients starting fluvoxamine should be closely monitored for any signs of worsening depression or unusual behavior. This medication can also interact with other drugs, so a full medication review is essential before starting treatment.

Indication

Fluvoxamine maleate is primarily used for the treatment of: - **Obsessive-compulsive disorder (OCD)**: It is FDA-approved to reduce the frequency and severity of obsessive thoughts and compulsive behaviors in patients with OCD. - **Social anxiety disorder (SAD)**: Fluvoxamine is commonly prescribed to reduce the symptoms of social anxiety, such as fear of social situations, embarrassment, and anxiety during public speaking or interactions. - **Depression and anxiety**: Although it is not FDA-approved for major depressive disorder (MDD) in some regions, fluvoxamine is sometimes prescribed off-label to treat depression and generalized anxiety disorder (GAD). - **Panic disorder**: Fluvoxamine is also sometimes used off-label for managing panic disorder, characterized by sudden and repeated attacks of intense fear or discomfort. It works by increasing serotonin levels in the brain, which helps improve mood, reduce anxiety, and alleviate obsessive thoughts and compulsive behaviors. The mechanism of action is similar to other SSRIs but is particularly effective for conditions like OCD and SAD. Fluvoxamine is typically used for long-term management, although it may also be prescribed for acute symptom relief in certain cases.

Contra indication

Fluvoxamine maleate is contraindicated in several conditions, and its use should be avoided in patients who have: - **Hypersensitivity**: Any patient who has a known hypersensitivity or allergic reaction to fluvoxamine or any of its ingredients should not take this medication. - **Concomitant use with monoamine oxidase inhibitors (MAOIs)**: Fluvoxamine should not be taken in combination with MAOIs or within 14 days of discontinuing an MAOI, due to the risk of serotonin syndrome, a potentially life-threatening condition caused by excessive serotonin activity in the brain. - **Severe liver impairment**: Since fluvoxamine is metabolized by the liver, it should not be used in patients with severe liver disease or hepatic impairment. Dose adjustments or alternative treatments may be necessary in patients with mild to moderate liver dysfunction. - **Severe renal impairment**: Although the drug is primarily excreted by the liver, its use should be approached with caution in patients with severe renal dysfunction, and dosage adjustments may be necessary. - **Pregnancy (if not necessary)**: While fluvoxamine is classified as Category C, indicating potential risks to the fetus, it should only be used during pregnancy if the benefits outweigh the risks. Alternative treatments may be considered if the condition being treated is mild or can be managed without medication. - **Children under 8 years of age**: Fluvoxamine is not recommended for use in children under the age of 8 years, as its safety and efficacy in this age group have not been established.

Side Effect

Common side effects of fluvoxamine include: - **Gastrointestinal disturbances**: Nausea, vomiting, and diarrhea are frequently reported side effects, especially during the early stages of treatment. - **Central nervous system effects**: Drowsiness, dizziness, and insomnia can occur. Some patients may also experience headache, fatigue, or agitation. In rare cases, fluvoxamine can cause sedation or somnolence. - **Sexual dysfunction**: Like many SSRIs, fluvoxamine can cause sexual side effects, including reduced libido, delayed orgasm, or erectile dysfunction. - **Weight changes**: Some individuals may experience weight gain or loss while on fluvoxamine, though these changes are generally minimal. - **Serotonin syndrome**: Although rare, serotonin syndrome is a potentially life-threatening condition caused by excessive serotonin levels. Symptoms include agitation, hallucinations, rapid heart rate, high blood pressure, fever, excessive sweating, shivering, muscle twitching, tremor, loss of coordination, nausea, vomiting, and diarrhea. Immediate medical attention is necessary if serotonin syndrome is suspected. - **Suicidal thoughts**: Especially in children, adolescents, and young adults, fluvoxamine and other antidepressants may increase the risk of suicidal thoughts or behaviors. Close monitoring is required during the first few months of treatment or when doses are adjusted.

Pregnancy Category ID

3

Mode of Action

Fluvoxamine maleate works by selectively inhibiting the reuptake of serotonin (5-HT) in the brain. It blocks the serotonin transporter (SERT), which is responsible for removing serotonin from the synaptic cleft and returning it to the presynaptic neuron. By inhibiting this reuptake, fluvoxamine increases the concentration of serotonin in the synaptic cleft, which is believed to enhance neurotransmission and help regulate mood, anxiety, and compulsive behavior. The exact mechanism through which fluvoxamine alleviates symptoms of OCD and social anxiety disorder is not fully understood, but it is thought that increased serotonin availability helps to reduce the overactivity of serotonin pathways that are dysregulated in these conditions. The medication also has some mild antagonistic effects on certain receptors (such as sigma-1 receptors) that may contribute to its therapeutic effects, particularly in reducing anxiety. Its selective action on serotonin makes it less likely to cause side effects commonly associated with older antidepressants that affect multiple neurotransmitter systems.

Interaction

Fluvoxamine maleate interacts with several other medications, which can alter its efficacy or increase the risk of side effects: - **Monoamine oxidase inhibitors (MAOIs)**: As mentioned earlier, fluvoxamine should never be used in combination with MAOIs or within 14 days of discontinuing them due to the risk of serotonin syndrome. - **Other SSRIs or SNRIs**: Combining fluvoxamine with other serotonin-reuptake inhibitors like sertraline or venlafaxine can lead to excessive serotonin levels in the brain, increasing the risk of serotonin syndrome. - **CYP450 enzyme inhibitors**: Fluvoxamine inhibits the cytochrome P450 1A2 and 2C19 enzymes, and drugs that also inhibit these enzymes (such as fluoxetine, cimetidine, and some antifungal medications) may increase fluvoxamine levels in the blood, potentially causing toxicity. On the other hand, drugs that induce these enzymes, such as rifampin or carbamazepine, may reduce the effectiveness of fluvoxamine. - **Warfarin**: Fluvoxamine can alter the effects of warfarin, a blood thinner, by affecting its metabolism, which could lead to either increased bleeding risk or reduced anticoagulant effect. Regular monitoring of INR (International Normalized Ratio) is recommended if these drugs are used together. - **Alcohol**: Alcohol can enhance the sedative effects of fluvoxamine, leading to increased drowsiness, dizziness, or difficulty concentrating. The combination of alcohol and fluvoxamine should be avoided or used with caution. - **Other sedatives or CNS depressants**: The use of fluvoxamine with other sedative medications, including benzodiazepines, may result in enhanced sedative effects, increasing the risk of drowsiness, dizziness, and impaired coordination.

Pregnancy Category Note

Information not available

Adult Dose

For most adult patients, the starting dose of fluvoxamine maleate is typically 50 mg once daily, usually taken in the evening. Depending on the patient's response and tolerance, the dose may be gradually increased to a typical therapeutic dose range of 100–300 mg per day, divided into one or two doses. The maximum recommended dose is 300 mg per day. The dose should be titrated slowly to minimize side effects, especially during the initiation phase. If the patient is elderly or has liver impairment, the dosage may need to be reduced. Treatment is generally long-term, as fluvoxamine is used for chronic conditions like OCD and social anxiety. The drug should be taken with food to reduce gastrointestinal upset.

Child Dose

For children aged 8 years and older, the typical starting dose of fluvoxamine is 25 mg once daily. This can be gradually increased based on clinical response, with the usual dose range being 50–200 mg per day, divided into one or two doses. The maximum dose for children is typically 200 mg per day. The dosing should be carefully managed, and children on fluvoxamine should be monitored for any signs of suicidal thoughts, behavioral changes, or other adverse effects. Fluvoxamine is generally not recommended for use in children under 8 years old, and its safety and efficacy in this age group have not been established.

Renal Dose

Fluvoxamine maleate should be used with caution in patients with renal impairment. While no formal renal dose adjustment is typically required for mild to moderate kidney dysfunction, patients with severe renal impairment (creatinine clearance < 30 mL/min) may require a dose reduction. It is important to monitor for side effects such as sedation, dizziness, or signs of excessive serotonergic effects, which could indicate the need for dose adjustments.

Administration

Information not available