Recently, the problem of mental disorders associated with a decrease in vitality and a change in mood has become more and more urgent. Psychiatrists call this condition depression. And it is dangerous because it can become the basis for the patient's suicidal intentions. Therefore, psychotherapists insist on the need to combat this ailment.
Modern medicine offers many quite effective means to combat both depression and obsessive-compulsive disorders, and one of them is the drug "Fevarin", the instructions for the use of which will be offered to your attention.
The drug "Fevarin" helps to reduce the factor of suicidal activity
A clear advantage to the use of the described agent is that it belongs to the new generation of drugs that do not worsen the patient's quality of life.
The drug "Fevarin" for depression
When treating mental disorders with antidepressants, it is usually taken into account that the process must take place in several stages.
- The main one is the treatment of depression.
- After recovery, it is important to prevent recurrence of the disease, which means that the second stage will include the prevention of this disease.
- And the last one is to improve the patient's quality of life, since taking antidepressants most often causes various side effects.
The reviews of psychiatrists available on the drug "Fevarin" just indicate that at all these stages it is better to use it, and not several different means, which can cause an undesirable reaction and even aggravate the patient's condition.
How does Fevarin work?
The drug "Fevarin" is a selective serotonin reuptake inhibitor (SSRI), in other words, a means that increases the level of the mentioned substance in the human body.
Thanks to this hormone of happiness, which is produced in the brain, a person's emotional background is leveled and stabilized. If its level is low, then it is extremely difficult to achieve emotional balance, and often completely impossible. In such cases, SSRIs are used.
In particular, the drug "Fevarin" is prescribed for depressive disorders, obsessions, manifestations of social phobia (avoidance of contact with people or fear of being in a crowd), as well as for other mental disorders. Experts say that the first improvements in the patient's condition occur within a week after the start of admission. This is manifested, as a rule, by a decrease in the patient's motor restlessness and anxiety.
It should be noted that when a dosage of 100 mg / day is prescribed, there are practically no side effects in the form of drowsiness or apathy. At a high dosage level (up to 300 mg / day), these manifestations, as a rule, disappear after the second week of drug treatment.
The drug "Fevarin": contraindications, side effects
Like most medicines, this drug has side effects. Most often, patients complain of drowsiness, apathy and nausea as a result of taking the medication we are considering. Fluctuations in body weight and manifestations of disturbances in the digestive and autonomic systems were also noticed.
In addition, according to reviews, some patients experienced increased nervousness, insomnia, causeless anxiety and even hallucinations. But, according to the instructions for use for the "Fevarin" preparation, such manifestations should simply be experienced, because in a couple of weeks they pass. If the improvement does not occur, you should inform the attending physician about this to revise the dosage or discontinue this drug.
Contraindications to the use of the drug
The contraindications available for the drug "Fevarin" do not stand out in any way:
- hypersensitivity to the elements that make up the drug;
- liver disease;
- age under 8;
- the period of pregnancy and lactation.
In addition to the above, experts insist on one more thing: if the patient is already taking any medications, the described drug should be prescribed very carefully.
Using the drug "Fevarin", you should definitely remember about some of the features of its therapeutic effects.
Firstly, the anti-anxiety effect declared by the manufacturers of the Fevarin drug does not appear immediately after the start of treatment. In order to see an improvement in the patient's condition, the patient will have to be patient, since the first results will become noticeable only after 2-3 weeks. And in the beginning, even an exacerbation of the disease may occur, which must be experienced.
If the patient feels very bad, then it is impossible to skip and even more so to cancel the medication intake. You need to inform the doctor about the deterioration of health, who, after objectively assessing the situation, will make a professional decision. By the way, the reviews of psychiatrists about the drug "Fevarin" emphasize that a negative attitude towards it is caused precisely by a lack of patience in some patients.
When a clear improvement occurs in the course of treatment, then in this case it is impossible to cancel the medication on your own. Cancellation is carried out under the supervision of a doctor and gradually, otherwise a relapse is possible, and sometimes the patient's condition becomes even more severe.
Drug overdose
Since the described drug is used to treat people with depression or anxiety, then cases of overdose with this drug are quite frequent.
It should be noted right away that overdose does not represent a serious danger when taking the drug "Fevarin". Deaths from intentional dose increases are extremely rare. But (diarrhea, nausea, vomiting, drowsiness) and cardiac arrhythmias (tachycardia, bradycardia) are still noted in such patients, which once again proves the danger of self-medication. The drug is classified as non-toxic, but in case of an overdose, the patient needs to rinse the stomach and take any sorbent.
Treatment of children and adolescents with the drug "Fevarin"
There are heated discussions in psychiatry about the treatment of children and adolescents with antidepressants. The list of drugs permitted in pediatrics is rather narrow, but it also includes Fevarin. Indications for use, reviews of specialists on the results of therapy with the named remedy - all this is still being discussed, but the effectiveness of the medication in question in the treatment of emotional and behavioral disorders in children over 8 years old seems to be no longer in doubt.
For young patients, the drug is prescribed, as a rule, at a dosage of 25 mg / day, and already on the third day after the start of admission, they have a positive trend. Although in some cases an increase in doses is required.
How the drug "Fevarin" is prescribed for the elderly
For the elderly, the described drug is also an effective remedy in the fight against depression.
By the way, tablets and capsules "Fevarin" against anxiety in elderly patients in psychiatric practice are used much more often than for the treatment of children. And if we consider that this remedy not only helps to relieve symptoms of depression or panic attacks, but also has a positive effect on the quality of life, then for older people, in some cases it turns out to be completely irreplaceable.
Do not self-medicate!
As you can see, the reviews of psychiatrists about the Fevarin drug can be considered convincing evidence of its effectiveness. But it is very dangerous to prescribe this remedy to yourself on your own, despite the above evidence of its low toxicity. After all, the human psyche is a subtle substance that can be easily disturbed. And this is especially true for those cases when some disorders are already present. This drug can only be prescribed by a specialist and should only be taken in prescribed doses and under medical supervision!
And also obsessive-compulsive disorder. Fluvoxamine is presented as an active ingredient in the preparation. This component allows you to reduce the reuptake of serotonin (better known as the "hormone of happiness"), and, as a result, increases its concentration in the blood. The scope of application of the drug Fevarin can be called not only treatment, but also the prevention of depressive and obsessive-compulsive disorders.
The preparation Fevarin is made in the form of tablets. Annotation to the drug recommends starting therapy with small doses, which can be gradually increased - thus, it is possible to select an actually individual treatment regimen. The use of "Fevarin" is not recommended for patients taking drugs belonging to the category of MAO inhibitors, as well as for people with severely impaired liver function, for children under eight years of age. Despite the encouraging results of studies that have been conducted in animals, the use of this drug in pregnant and lactating women is not recommended.
Side effects and overdose of Fevarin
Most often, patients who take Fevarin complain of a feeling of nausea - this symptom usually accompanies the start of treatment. In addition, there may be undesirable reactions from the central nervous and autonomic systems, as well as from the digestive system, cardiovascular system, such phenomena as hemorrhages, fluctuations in body weight.
Since Fevarin is used by those who are in a state of depression, you can find many reviews of a deliberate overdose of this drug. Its symptoms include dyspeptic disorders, as well as heart rhythm disturbances. At the very beginning of the provision of assistance, the patient's stomach should be flushed, after which he should be given activated charcoal or Enterosgel several times, and after that, the symptoms that appear should be observed and stopped. It should be emphasized separately that deliberately taking high doses of Fevarin will not be fatal. There is a known case when even a person who took 100 tablets of this drug at once survived.
Reviews about Fevarin
Reviews about Fevarin at first may just scare. Descriptions of some side effects are quite colorful: "I could not sleep until morning - I had nightmares", or "the feeling that you are going crazy - fears appear, even hallucinations", "the doctor said that you need to drink at least a couple of weeks to accumulate substance ... it is impossible to convey how I suffered all this time ”and much in the same vein. Therefore, in fairly frequent cases, this drug not only does not lead to improvements, but it can also seriously undermine mental health.
There are certainly other reviews. Some patients do not feel and do not notice any side effects, and are satisfied with the result of using Fevarin. For example, one patient described the progress of his condition as follows: "I began to gradually acquire armor - a course of this medicine was enough for me for at least six months."
It can be concluded that only a doctor can prescribe Fevarin and recommend it for treatment. As for the patient, he will have to carefully monitor his own condition, do not hesitate to contact a specialist again, in the event that the side effects of the drug may be stronger and more serious than its intended beneficial effect.
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Fevarin is a third generation antidepressant drug from the group of selective serotonin reuptake inhibitors (SSRIs for short). The active ingredient of the drug is fluvoxamine.
Like other antidepressants, it is widely used in the treatment of various neurological and psychiatric disorders, as well as a number of somatic, neuro-endocrine and other pathologies.
In this article, we will consider why doctors prescribe Fevarin, including instructions for use, analogues and prices for this drug in pharmacies. Real REVIEWS of people who have already used Fevarin can be read in the comments.
Composition and form of release
Tablets, regardless of dosage, are available in blisters of 15 and 20 pieces, in a cardboard box of 4, 3, 2 or 1 such blister.
- One Fevarin tablet contains: fluvoxamine maleate - 100 or 50 mg.
Pharmacological action: has an antidepressant effect.
Indications for use
The drug is used to treat patients with depression of various etiologies, as well as obsessive-compulsive disorders.
pharmachologic effect
Fevarin is a drug from the group of antidepressants that selectively inhibits serotonin reuptake. The active ingredient - fluvoxamine - selectively Fevarin in the package blocks the seizure of serotonin by the neurons of the brain.
The half-life of fluvoxamine after a single use is about 13-15 hours, after repeated use of the drug - 17-22 hours.
Fevarin practically does not affect the metabolic processes of norepinephrine, has a weak affinity for adrenergic receptors, serotonin, dopamine, histamine and cholinergic receptors. Reviews of Fevarin by neuropsychiatric specialists speak of the high effectiveness of this drug.
Instructions for use
Fevarin is intended for oral administration. The film-coated tablet is recommended to be swallowed whole, without chewing or crushing, with a sufficient amount of liquid. The drug is taken regardless of food intake.
Patients with depressive and other conditions need to be under constant supervision of the attending physician until the condition improves.
Depression:
- The recommended starting dose for adults is 50 mg or 100 mg once a day, in the evening. It is recommended to gradually increase the dose to the effective level. The effective daily dose, usually 100 mg, is selected individually depending on the patient's response to treatment. The daily dose can be as high as 300 mg. Daily doses over 150 mg should be divided into several doses.
- For the prevention of relapse of depression, Fevarin is recommended to be prescribed in a dose of 100 mg 1 time / day.
According to the official WHO guidelines, antidepressant treatment should be continued for at least 6 months of remission following a depressive episode.
Obsessive Compulsive Disorder (OCD):
- The dosage for the treatment of obsessive-compulsive disorders is 50mg. If the effect is insufficient, the dosage is increased after 2-3 days. The maximum dosage for this pathology is also 300 mg.
- The daily dosage of Fevarin for children 8-18 years old is 25 mg. With insufficient clinical effect, it is possible to increase the indicated dosage in 2-3 days. The maximum daily dosage is 200mg. If there is no effect after 10 weeks, the drug must be canceled.
If there is a good therapeutic response, treatment can be continued with an individually adjusted daily dose. If improvement is not achieved after 10 weeks of taking the drug, then fluvoxamine treatment should be reviewed.
In elderly patients, the dose of fluvoxamine should always be increased more slowly and with greater caution.
Contraindications
Direct contraindications to taking the drug:
- simultaneous use with tizanidine or MAO inhibitors;
- the presence of hypersensitivity (allergic reactions) to fluvoxamine or to any of the components that make up the drug;
- breastfeeding (due to the penetration of the drug into breast milk);
- children under 8 years of age (due to the lack of sufficient clinical studies).
Caution should be observed when using in the following cases:
- pregnancy;
- a history of organic convulsive syndrome, epilepsy;
- in the presence of hepatic or renal failure;
- in elderly and elderly patients;
- in the presence of thrombocytopenia, a tendency to bleeding.
Side effects
When taking this drug, a large number of side effects may develop, which often causes negative reviews about Fevarin from patients who have used this drug. The following side effects of Fevarin have been registered:
- From the side of vision: mydriasis, glaucoma.
- From the side of the cardiovascular system: tachycardia, hypotension.
- From the side of the psyche: hallucinations, mania, suicidal thoughts and behavior.
- On the part of the skin: sweating, rash, itching, Quincke's edema, photosensitivity.
- From the musculoskeletal system: pain in muscles and joints, fractures.
- From the hematopoietic system: bleeding (gastrointestinal, gynecological, ecchymosis).
- From the endocrine system: an imbalance in the production of antidiuretic hormone, hyperprolactinemia.
- From the side of nutrition and metabolism: anorexia, hyponatremia, changes in body weight.
- From the side of the central nervous system and peripheral nervous system: headache, weakness, dizziness, agitation, anxiety, tremor, ataxia, disturbance of sleep and wakefulness, extrapyramidal disorders;
- From the gastrointestinal tract: vomiting, nausea, epigastric pain, impaired appetite, dryness of the oral mucosa, impaired stool, increased levels of liver enzymes;
- From the genitourinary system: various disorders of urination (urinary retention, incontinence, enuresis and others), late ejaculation, galactorrhea, anorgasmia, menstrual disorders.
- General disorders: asthenia, general weakness, withdrawal syndrome.
It is necessary to avoid abrupt withdrawal of the drug. When discontinuing treatment with fluvoxamine, the dose should be gradually reduced over a period of at least 1–2 weeks to reduce the risk of withdrawal. In the event of intolerable symptoms after a dose reduction or after discontinuation of treatment, resumption of treatment at the previously recommended dose may be considered. Later, the doctor may start reducing the dose again, but more gradually.
Analogs
The most common analogs of Fevarin containing fluvoxamine are Deprivox and Fluvoxamine Sandoz.
Antidepressant.
Preparation: FEVARIN®
The active substance of the drug:
fluvoxamine
ATX encoding: N06AB08
KFG: Antidepressant
Registration number: P No. 013262/01
Date of registration: 11.08.06
Owner reg. ID: SOLVAY PHARMACEUTICALS B.V. (Netherlands)
Fevarin release form, drug packaging and composition.
White film-coated tablets, round, biconvex, scored and engraved with "291" on both sides of the marks on one side of the tablet and the letter "S" above the icon on the other side.
1 tab.
fluvoxamine maleate
50 mg
Excipients: mannitol (152 mg), corn starch, pregelatinized starch, sodium stearyl fumarate, colloidal silicon dioxide.
White film-coated tablets, oval, biconvex, scored and engraved with "313" on both sides of the notch on one side of the tablet and the letter "S" above the icon on the other side.
1 tab.
fluvoxamine maleate
100 mg
Excipients: mannitol (303 mg), corn starch, pregelatinized starch, sodium stearyl fumarate, colloidal silicon dioxide.
Composition of the tablet shell: hypromellose, macrogol 6000, talc, titanium dioxide (E171).
15 pcs. - blisters (1) - cardboard packs.
15 pcs. - blisters (2) - cardboard packs.
15 pcs. - blisters (3) - cardboard packs.
15 pcs. - blisters (4) - cardboard packs.
20 pcs. - blisters (1) - cardboard packs.
20 pcs. - blisters (2) - cardboard packs.
20 pcs. - blisters (3) - cardboard packs.
20 pcs. - blisters (4) - cardboard packs.
The description of the product is based on the officially approved instructions for use.
Pharmacological action Fevarin
Antidepressant. The mechanism of action is associated with selective inhibition of serotonin reuptake by neurons in the brain and is characterized by a minimal effect on noradrenergic transmission. Fevarin has a weak ability to bind to - and -adrenergic receptors, histamine, m-cholinergic receptors, dopamine and serotonin receptors.
Pharmacokinetics of the drug.
Suction
After oral administration, Fevarin is completely absorbed from the gastrointestinal tract. Cmax in blood plasma is achieved after 3-8 hours. The absolute bioavailability is 53% after primary metabolism in the liver. Simultaneous administration of the drug with food does not affect the pharmacokinetics of fluvoxamine.
Distribution
Css in blood plasma is reached, as a rule, in 10-14 days.
The degree of binding to blood plasma proteins is about 80% (in vitro). Vd - 25 l / kg.
Metabolism
Fluvoxamine is biotransformed in the liver (mainly by oxidative demethylation) to at least 9 metabolites. The two main metabolites have little pharmacological activity, the rest are pharmacologically inactive.
Although the isoenzyme 2D6 of cytochrome P450 is the main one in the metabolism of fluvoxamine, the concentration of the drug in the blood plasma in individuals with a reduced function of this isoenzyme is not much higher than in individuals with a normal metabolism.
Fluvoxamine significantly inhibits cytochrome P450 1A2, moderately inhibits cytochrome P450 2C and P450 3A4, and slightly inhibits cytochrome P450 2D6.
Withdrawal
After taking a single dose, the average T1 / 2 from blood plasma is 13-15 hours, with repeated administration, T1 / 2 slightly increases and is 17-22 hours.
Fluvoxamine is excreted in the urine as metabolites.
Pharmacokinetics of the drug.
in special clinical cases
Pharmacokinetics of the drug.
fluvoxamine is the same in healthy people, the elderly and patients with renal failure.
Fluvoxamine metabolism is reduced in patients with liver disease.
The steady-state plasma concentrations of fluvoxamine were twice as high in children (aged 6-11 years) than in adolescents (aged 12-17 years). Plasma concentrations of the drug in adolescents are similar to those in adults.
Indications for use:
Depression of various origins;
Obsessive-compulsive disorder.
Dosage and method of administration of the drug.
In the treatment of depression, the recommended starting dose is 50 mg or 100 mg 1 time / day, in the evening. The dose should be increased gradually. The effective dose, which is usually 100 mg / day, is selected individually, depending on the patient's response to treatment. The daily dose can be as high as 300 mg.
Doses over 150 mg / day should be divided into several doses.
For the prevention of relapse of depression, Fevarin is recommended to be prescribed in a dose of 100 mg 1 time / day.
In the treatment of obsessive-compulsive disorders, the recommended starting dose is 50 mg / day for 3-4 days. The dose should be increased gradually until an effective daily dose is reached, which is usually 100-300 mg. The maximum effective dose for adults is 300 mg / day. Doses up to 150 mg can be taken 1 time / day, preferably in the evening. Doses over 150 mg / day are recommended to be divided into 2 or 3 doses.
For children over 8 years old and adolescents, the initial dose is 25 mg / day per dose. The maintenance dose is 50-200 mg / day. The maximum daily dose is 200 mg. Doses over 100 mg / day are recommended to be divided into 2 or 3 doses.
With the development of an adequate therapeutic effect, treatment can be continued with an individually selected daily dose. If improvement is not achieved after 10 weeks of treatment, Fevarin should be canceled. Given that obsessive-compulsive disorders are chronic in nature, it can be considered appropriate to extend the course of treatment with Fevarin for more than 10 weeks in patients with an adequate therapeutic effect. The selection of the minimum effective maintenance dose should be carried out individually and with caution. Some clinicians recommend concomitant psychotherapy in patients with good pharmacotherapy response.
In hepatic or renal impairment, treatment should be started with the lowest dose under the strict supervision of a physician.
Fevarin tablets should be taken without chewing and with a little water.
Side effect of Fevarin:
The most commonly observed symptom associated with the use of Fevarin is nausea, sometimes accompanied by vomiting. This side effect usually disappears within the first two weeks of treatment.
Some of the side effects observed in clinical trials were often associated with symptoms of depression, and not with the treatment with Fevarin.
From the digestive system: often (1-10%) - abdominal pain, anorexia, constipation, diarrhea, dry mouth, dyspepsia; seldom (< 0.1%) — нарушение функции печени (повышение уровня печеночных трансаминаз).
From the side of the central nervous system and peripheral nervous system: often (1-10%) - asthenia, headache, malaise, nervousness, anxiety, agitation, dizziness, insomnia or drowsiness, tremor; sometimes (<1 %) — атаксия, спутанность сознания, экстрапирамидные нарушения, галлюцинации; редко (< 0.1%) — судороги, маниакальный синдром, серотонинергический синдром (состояние, подобное нейролептическому злокачественному синдрому, гипонатриемия и синдром недостаточной секреции антидиуретического гормона); очень редко — парестезии, извращение вкуса.
From the side of the cardiovascular system: often (1-10%) - palpitations, tachycardia; sometimes (<1 %) — постуральная гипотензия.
Dermatological reactions: often (1-10%) - increased sweating; seldom (< 0.1%) — фотосенсибилизация.
Allergic reactions: sometimes (<1%) — сыпь, зуд, ангионевротический отек.
From the musculoskeletal system: sometimes (<1 %) — артралгия, миалгия.
From the reproductive system: sometimes (<1%) — замедленная эякуляция; редко (< 0.1%) — галакторея; очень редко — аноргазмия.
From the side of the blood coagulation system: ecchymosis, purpura, gastrointestinal bleeding.
Others: rarely (< 0.1%) — изменение массы тела.
When you stop taking Fevarin fluvoxamine, withdrawal symptoms may develop, although preclinical and clinical studies have not revealed the emergence of dependence on treatment with fluvoxamine.
Symptoms observed in case of drug withdrawal: dizziness, paresthesia, headache, nausea, anxiety. Most of these symptoms are mild and self-limited. When discontinuing the drug, a gradual dose reduction is recommended.
Contraindications to the drug:
Simultaneous use with tizanidine;
Simultaneous use with MAO inhibitors;
Hypersensitivity to fluvoxamine maleate or to other components of the drug.
The drug should be prescribed with caution in case of hepatic and renal insufficiency, a history of seizures, epilepsy, patients with a tendency to bleeding (thrombocytopenia), during pregnancy, as well as elderly patients.
Application during pregnancy and lactation.
A small number of observations did not reveal any adverse effects of fluvoxamine on pregnancy. The potential risk is unknown. The drug should be administered with caution during pregnancy.
Isolated cases of withdrawal syndrome in newborns have been described after using fluvoxamine at the end of pregnancy.
Fluvoxamine is excreted in small amounts in breast milk. In this regard, the drug should not be used during lactation.
Special instructions for using Fevarin.
With depression, there is usually a high likelihood of attempting suicide, which may persist until sufficient remission is achieved. Such patients should be monitored.
Patients with hepatic or renal insufficiency at the beginning of treatment should be prescribed Fevarin in the minimum effective doses under the strict supervision of a physician. In rare cases, treatment with Fevarin can lead to an increase in the level of hepatic transaminases, most often accompanied by appropriate clinical symptoms. In such cases, Fevarin should be canceled.
Control over blood glucose levels may be impaired, especially in the early stages of treatment with Fevarin, and therefore, dose adjustment of hypoglycemic drugs may be required.
Use with caution in patients with a history of convulsions. Fevarin should be avoided in patients with unstable epilepsy, and patients with stable epilepsy should be under close medical supervision. Fevarin treatment should be discontinued if epileptic seizures occur or their frequency increases.
Rare cases of the development of serotonergic syndrome or a condition similar to neuroleptic malignant syndrome have been described, which may be associated with the intake of fluvoxamine, in combination with other serotonergic antidepressants and neuroleptic drugs. Since these syndromes can lead to potentially life-threatening conditions, manifested by hyperthermia, muscle rigidity, myoclonus, lability of the autonomic nervous system with possible rapid changes in vital functions, changes in the psyche, including increased irritability, agitation, confusion, delirious disorders and coma - Fevarin treatment should be discontinued. If necessary, appropriate symptomatic treatment should be carried out.
As with the use of other selective serotonin reuptake inhibitors, in rare cases, while taking Fevarin, hyponatremia may appear, which undergoes regression after discontinuation of the drug. Some cases were caused by the syndrome of insufficient secretion of antidiuretic hormone, which was observed mainly in elderly patients.
There are reports of the development of ecchymosis and purpura, as well as hemorrhagic manifestations (for example, gastrointestinal bleeding) when using selective serotonin reuptake inhibitors. Given this, caution should be exercised when prescribing such drugs, especially concurrently with drugs that affect platelet function (for example, with atypical antipsychotics and phenothiazines, many tricyclic antidepressants, NSAIDs, including acetylsalicylic acid), as well as patients with a history of bleeding and prone to to bleeding (for example, patients with thrombocytopenia).
The data obtained in the treatment of elderly patients and younger patients indicate that there are no clinically significant differences in the effectiveness of the drug used in usual daily doses. However, in elderly patients, the dose of the drug should always be increased more slowly and with greater caution.
Fevarin can lead to a slight decrease in heart rate (by 2-6 beats / min).
As with the use of other psychotropic drugs, alcohol is not recommended during treatment with Fevarin.
Use in pediatrics
Due to the lack of clinical experience, Fevarin is not recommended for the treatment of depression in children.
Influence on the ability to drive vehicles and use mechanisms
Fevarin in doses up to 150 mg, when administered to healthy volunteers, did not affect psychomotor functions associated with driving a car or controlling machines and mechanisms. At the same time, there are reports of drowsiness, noted with the use of the drug. Therefore, it is recommended to exercise caution before finally determining the individual response to treatment.
Drug overdose:
Symptoms: The most common are nausea, vomiting, diarrhea, drowsiness, dizziness. There are reports of cardiac abnormalities (tachycardia, bradycardia, arterial hypotension), liver dysfunction, seizures, coma.
Fluvoxamine has a wide therapeutic dose. To date, deaths associated with fluvoxamine overdose have been extremely rare. The highest recorded dose taken by one patient was 12 g (the patient was cured as a result of symptomatic therapy). More serious complications were observed in cases of deliberate overdose of Fevarin against the background of concomitant pharmacotherapy.
Treatment: gastric lavage, which should be carried out as early as possible after taking the drug; carry out symptomatic therapy. In addition, repeated intake of activated charcoal and, if necessary, the appointment of osmotic laxatives is recommended. There is no specific antidote. Forced diuresis or dialysis is not advisable.
Interaction of Fevarin with other drugs.
Fevarin should not be used in combination with MAO inhibitors. Fevarin treatment can be started 2 weeks after stopping the administration of an irreversible MAO inhibitor; the next day after stopping the intake of a reversible MAO inhibitor; the time interval between discontinuation of Fevarin and the start of therapy with any MAO inhibitor should be at least 1 week.
When combined therapy with Fevarin, plasma concentrations of terfenadine, astemizole or cisapride may increase, increasing the risk of prolongation of the QT interval. Therefore, Fevarin should not be administered concurrently with these drugs.
Fluvoxamine is a potent inhibitor of cytochrome P4501A2 and, to a lesser extent, P4502C and P4503A4. Drugs that are largely metabolized by these isoenzymes are excreted more slowly and may have higher concentrations in blood plasma, if used simultaneously with Fevarin. This is especially true for drugs that have a narrow therapeutic effect. Patients need careful monitoring, if necessary, it is recommended to adjust the dose of these drugs. Fluvoxamine has a minimal inhibitory effect on cytochrome P4502D6 and probably does not affect non-oxidative metabolism and renal excretion.
With the simultaneous use of Fevarin, an increase in previously stable levels of tricyclic antidepressants (clomipramine, imipramine, amitriptyline) and neuroleptics (clozapine, olanzapine), which are largely metabolized by cytochrome P4501A2, was observed. In this regard, a dose reduction of these drugs may be recommended.
Patients simultaneously taking Fevarin and drugs with a narrow therapeutic index metabolized by cytochrome P450 1A2 (tacrine, theophylline, methadone, mexiletine) metabolized by cytochrome P450 2C (phenytoin) and metabolized by cytochrome P4503A4 (carbamorospazepin) should be carefully monitored ... If necessary, it is recommended to adjust the doses of these drugs.
When using Fevarin in combination with warfarin, a significant increase in plasma concentrations of warfarin and an increase in prothrombin time were observed.
Reported isolated cases of cardiotoxicity, while taking Fevarin and thioridazine.
In studies examining the interactions of Fevarin, an increase in propranolol concentrations was noted after the administration of Fevarin. In this regard, it is possible to recommend a reduction in the dose of propranolol in the case of simultaneous administration with Fevarin.
While taking Fevarin, plasma levels of caffeine may increase. Thus, patients who consume large amounts of caffeine-containing drinks should reduce their intake during the period of taking Fevarin, and when adverse effects of caffeine are observed, such as tremors, palpitations, nausea, anxiety, and insomnia.
With the simultaneous administration of Fevarin and ropinirole, the concentration of ropinirole in plasma may increase, thus increasing the risk of overdose. In such cases, it is recommended to control, or, if necessary, reduce the dosage of ropinirole during treatment with Fevarin.
With the simultaneous administration of anxiolytics with fluvoxamine from the group of benzodiazepines that undergo oxidative metabolism, such as triazolam, midazolam, alprazolam and diazepam, their concentration in plasma may increase. The dosage of these drugs should be reduced while taking Fevarin.
Fluvoxamine has no effect on the concentration of digoxin and atenolol in plasma.
In the case of combined administration of Fevarin with serotonergic drugs (tryptans, serotonin reuptake inhibitors), tramadol may enhance the serotonergic effects of fluvoxamine.
Fevarin was used in combination with lithium preparations to treat critically ill patients who did not respond well to pharmacotherapy. It should be noted that lithium (and possibly also tryptophan) enhances the serotonergic effects of Fevarin, and therefore this kind of combination pharmacotherapy should be used with caution.
With the simultaneous administration of oral anticoagulants and fluvoxamine, the risk of hemorrhage may increase. Such patients should be under medical supervision.
Conditions of sale in pharmacies.
The drug is available by prescription.
Terms of storage conditions of the drug Fevarin.
List B. The drug should be stored in a dry, dark place, out of reach of children, at a temperature not exceeding 25 ° C. Shelf life - 3 years (if stored in undamaged original packaging).
Fevarin is one of the popular antidepressants. Like other drugs in this group, it is characterized not only by a strong effect in the fight against depression, anxiety, panic attacks and other disorders, but also by pronounced side effects. If you take it in excess, a serious overdose is possible, the symptoms of which sometimes force the patient to be admitted to a hospital.
What is Fevarin and its application
Fevarin is a drug that contains fluvoxamine. This active ingredient significantly slows down the reuptake of serotonin, while the drug does not bind other receptors similar to serotonin. Due to the selectivity of its action, many psychotherapists include it in the treatment of depression, neuroses, various disorders and the treatment of other mental problems.
Side effects
During the period of taking the drug and even after refusal from it, many side effects may develop. The mildest are negative reactions of the body from the stomach (nausea, vomiting, diarrhea). From the side of the central nervous system, weakness, drowsiness, headache, sometimes trembling, a feeling of inexplicable fear are observed. In rare cases, hallucinations, impaired limb mobility, manic syndrome, seizures and other problems, including increased blood pressure, allergies, muscle pain, and sexual dysfunction, are possible.
The most dangerous side effect of taking fluvoxamine is the development of dependence over time, as well as the onset of withdrawal syndrome if the pill is suddenly stopped.
Overdose reasons
There are three types of reasons for an overdose with Fevarin:
- The emergence of addiction in patients to the drug, which is why they drink it in a higher dosage. The desire to increase the dose does not help in the treatment of the disease, but the number and severity of side effects increases.
- A single use of a large amount of Fevarin, which causes a sharp deterioration in the condition.
- The use of the product for a long time (a month or more) even in the permitted doses. This can have the opposite effect, as fluvoxamine builds up in the body over time, also causing overdose.
Even if the patient has exceeded the dosage and has developed negative symptoms, it is impossible to abruptly stop drinking Fevarin. It must be canceled gradually, otherwise the consequences may be even more dire.
Poisoning symptoms
Signs of Fevarin poisoning include:
- dizziness;
- drowsiness;
- unstable emotional background (the patient wants to cry, laugh, he behaves inappropriately);
- nausea, vomiting;
- heart rhythm disturbances, liver problems;
- in extremely severe cases, convulsions and even coma are possible.
However, fluvoxamine is considered to be relatively safe. By itself, it is not fatal, even if taken in large quantities. The recorded maximum dose that caused the overdose was 12 g. Despite the stress experienced, the patient survived and got to his feet. But if you combine the remedy with other drugs, the mechanism of action becomes more complicated, which can even lead to death. Intoxication is especially difficult during pregnancy.
Treatment and recovery after poisoning
In case of intoxication with fluvoxamine, it is recommended to follow general and specific approaches to treatment. The first involves gastric lavage and symptomatic therapy (for example, if muscles, head or eyes hurt, take painkillers, if stomach problems are observed, drink enterosorbents).
There is no specific antidote to fluvoxamine. If general therapy does not help, it is recommended to move on to more serious measures. It is required that the patient go to the hospital, where he will receive full assistance.
In the hospital, regular cardiac monitoring is arranged and the following means are injected through catheters:
- Naloxone;
- Thiamine;
- glucose solution;
- oxygen.
In parallel with this, the stomach is washed more thoroughly to stop further absorption of the drug. Further, supportive therapy begins, eliminating the signs of arrhythmia and epileptic seizures. It is necessary to observe the patient not only during the day, but also at night - cardiac monitoring should be around the clock.
The consequences of using Fevarin
It is very important to choose the correct dosage of the medicine, for which you need to consult your doctor. This drug is not suitable for everyone. First of all, you need to find out the cause of depression or other mental disorders.
At the same time, it is important to ensure that the course of treatment is not long. It is optimal that it does not exceed a month. Scientists do not have sufficient information on how strongly fluvoxamine affects the body during long-term treatment, but it was noticed that the consequences of its use include serious dependence and addiction. It is then difficult for the patient to get rid of the desire to take the drug, and he even tries to increase the dosage.
After a while after the course of admission, it is necessary to reassess and understand whether it is worth continuing the treatment. If not, you can start smooth undo.
Cancellation of Fevarin
Cancellation of the drug is carried out gradually, first by reducing the dosage, then gradually increasing the intervals between doses. If the intake of fluvoxamine into the body is abruptly stopped, the following symptoms are possible:
- headache;
- lightheadedness;
- memory problems;
- loss of appetite;
- confusion of consciousness;
- violation of mobility, etc.
You should not stop taking the drug on your own - it is imperative to consult a doctor about this.
Poisoning prevention measures
- do not increase the dose yourself;
- keep the product away from children;
- do not practice long-term intake;
- do not combine Fevarin with alcohol, as well as with drugs that affect the liver.
