Introduction
Florest 50 is a type of antidepressant belonging to the selective serotonin reuptake inhibitor (SSRI) group of medicines. It is prescribed to treat depression, where it helps to make you feel better. This medicine is also used to treat people with obsessive-compulsive disorder.
Florest 50 can be taken with or without food. The dose and how often you need it will be decided by your doctor so that you get the right amount to control your symptoms. Your doctor may start you on a lower dose and increase it gradually. Do not change the dose or stop taking it without talking to your doctor, even if you feel well. Doing so may make your condition worse or you may suffer from unpleasant withdrawal symptoms (anxiety, restlessness, palpitations, dizziness, sleep disturbances etc).
To get the most benefit, take this medicine regularly at the same time each day. It may take a few weeks before you start feeling better. Let your doctor know if you do not see any improvement even after 4 weeks.
Florest 50 has been reported to have fewer side effects than older antidepressants. Some common side effects of this medicine include nausea, vomiting, fatigue, dry mouth, increased sweating, tremors, insomnia (difficulty in sleeping), decreased sexual drive, delayed ejaculation, and erectile dysfunction. Some people may experience sleepiness after taking this medicine. Let your doctor know straight away if you develop any sudden worsening of mood or any thoughts about harming yourself.
Before taking this medicine, you should tell your doctor if you have epilepsy (seizure disorder or fits), diabetes, liver or kidney disease, heart problems, or glaucoma. These may affect your treatment. Pregnant or breastfeeding women should also consult their doctor before taking it. Some other medicines may affect the way it works, especially other antidepressants and medicines called MAO inhibitors. Please tell your doctor about all the medicines you are taking to make sure you are safe.
Uses of Florest 50
- Depression
- Obsessive-compulsive disorder
Side effects of Florest 50
Common
- Delayed ejaculation
- Drowsiness
- Erectile dysfunction
- Low sexual desire
- Nausea
- Vomiting
- Dryness in mouth
- Fatigue
- Increased sweating
- Indigestion
- Insomnia (difficulty in sleeping)
- Loss of appetite
- Nervousness
- Tremor
How to use Florest 50
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Florest 50 may be taken with or without food, but it is better to take it at a fixed time.
How Florest 50 works
Florest 50 is a selective serotonin reuptake inhibitor (SSRI) antidepressant. It works by increasing the levels of serotonin, a chemical messenger in the brain. This improves mood and physical symptoms of depression and also relieves symptoms of obsessive-compulsive disorders.
What if you forget to take Florest 50?
If you miss a dose of Florest 50, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.
Indication
Major depressive disorder, Anxiety disorders, Depression, Panic disorder, Obsessive-compulsive disorder, Posttraumatic stress disorder
Administration
May be taken with or without food.
Adult Dose
Oral
Obsessive compulsive disorder
Adult: 50 mg once daily; may increase by 50 mg every 4-7 days. Daily doses >100 mg should be given in 2 divided doses. Max: 300 mg daily.
Elderly: Initial 25mg once daily.
Depression
Adult: Initially, 50-100 mg daily, may increase gradually up to 300 mg daily, if necessary. Doses >150 mg should be given in 2 or 3 divided doses.
Hepatic impairment: Decrease dose
Child Dose
Oral
Obsessive compulsive disorder
Child: >8 yr: 25 mg once daily, may increase by 25 mg every 4-7 days. Doses >50 mg should be given in 2 divided doses.
Reassess if no improvement after 10 wk of treatment. Max: 200 mg daily.
Contraindication
Hypersensitivity. Not to be used with thioridazine, terfenadine, astemizole, cisapride, pimozide, aloestron, tizanidine. Lactation.
Mode of Action
Fluvoxamine, derived from aralkylketone, inhibits the re-uptake of serotonin in brain neurons.
Precaution
History of mania or seizures; liver dysfunction; presence of depressive symptoms; smokers. Treatment with MAOI should only be started at least 2 wk after stopping fluvoxamine treatment. Increased risk of suicidal ideation and behaviour when used in children, adolescents and young adults <24 yr. Pregnancy, elderly; operating hazardous machinery; withdraw gradually. Monitor prothrombin time in patients who are taking oral anticoagulants concurrently.
Lactation
Present in breast milk; avoid
Side Effect
>10%
Nausea (40%),Headache (22-35%),Somnolence (22-27%),Weakness (14-26%),Insomnia (20-35%),Diarrhea (11-18%),Dizziness (11-15%),Xerostomia (10-14%),Anorexia (6-14%),Abnormal ejaculation (8-11%)
1-10%
Pain (10%),Dyspepsia (8-10%),Constipation (4-10%),Decreased libido (2-10%),Upper respiratory infections (9%),Anxiety (5-8%),Tremor (5-8%),Sweating (6-7%),Vomiting (4-6%),Abdominal pain (5%),Myalgia (5%),Abnormal taste (2-5%),Bruising (4%),Abnormal dreams (3%),Abnormal thinking (3%),Chest pain (3%),Palpitation (3%),Agitation (2-3%),Vasodilation (2-3%),Hypertension (1-2%),Increased LFTs (1-2%),Weight change (1-2%),Manic reaction
<1%
Activation of mania/hypomania, seizures (discontinue),Sinusitis
Frequency Not Defined
Edema,Amnesia,Apathy,Asthenia,Malaise,Nervousness,Dry mouth,Myoclonus,Cough
Pregnancy Category Note
Pregnancy
Prolonged experience with fluvoxamine in pregnant women over decades, based on published observational studies, have not identified a clear drug-associated risk of major birth defects or miscarriage; there are risks associated with untreated depression in pregnancy and risks of persistent pulmonary hypertension of newborn (PPHN) and poor neonatal adaptation with exposure to selective serotonin reuptake inhibitors (SSRIs), including fluvoxamine, during pregnancy
Women who discontinue antidepressants during pregnancy are more likely to experience a relapse of major depression than women who continue antidepressants; consider risk of untreated depression when discontinuing or changing treatment with antidepressant medication during pregnancy and postpartum
Neonates exposed to therapy and other SSRIs or SNRIs late in the third trimester have developed complications requiring prolonged hospitalization, respiratory support, and tube feeding; such complications can arise immediately upon delivery; reported clinical findings have included respiratory distress, cyanosis, apnea, seizures, temperature instability, feeding difficulty, vomiting, hypoglycemia, hypotonia, hypertonia, hyperreflexia, tremor, jitteriness, irritability, and constant crying; these features are consistent with either a direct toxic effect of SSRIs and SNRIs or, possibly, a drug discontinuation syndrome; it should be noted that, in some cases, the clinical picture is consistent with serotonin syndrome
Animal findings suggest fertility may be impaired while taking fluvoxamine
Lactation
Data from published literature report presence of drug in human milk; no adverse effects on breastfed infant have been reported in most cases of maternal use of fluvoxamine during breastfeeding; however, there are reports of diarrhea, vomiting, decreased sleep, and agitation; there are no data on effect of fluvoxamine on milk production
Developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for fluvoxamine and any potential adverse effects on breastfed child from drug or from the underlying maternal condition
Monitor infants exposed to fluvoxamine through breast milk for diarrhea, vomiting, decreased sleep, and agitation
Interaction
Co-admin with fluvoxamine may increase carbamazepine toxicity and serum levels of theophylline. Lithium enhances the serotonergic effects of fluvoxamine. Anticoagulants may require dosage adjustments. Diltiazem with fluvoxamine may lead to bradycardia. Avoid alcohol.
Potentially Fatal: Fluvoxamine should not be used in combination with MAOIs, or within 14 days of discontinuing treatment with MAOIs.