Luvox CR Warnings and Precautions
Talk to your healthcare provider if you have liver disease, epilepsy, or bipolar disorder before taking Luvox CR. Warnings and precautions should also be discussed with your healthcare provider before starting treatment so you know how to use the drug safely. Precautions and warnings with Luvox CR also apply to people who are allergic to components of the medication or who have taken an MAOI recently.
You should talk with your healthcare provider prior to taking Luvox® CR (fluvoxamine CR) if you have:
- Bipolar disorder or a family history of bipolar disorder (manic depression)
- A history of suicide attempts or suicidal thoughts
- A recent history of heart attack or have unstable heart disease
- Seizures or epilepsy
- Liver disease, including liver failure or cirrhosis
- Any allergies, including allergies to food, dyes, or preservatives.
Also, let your healthcare provider know if you are:
- Pregnant or thinking of becoming pregnant
- Smoke cigarettes.
Make sure to tell your healthcare provider about all other medicines you are taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.
Some warnings and precautions to be aware of prior to taking Luvox CR include the following:
- Luvox CR can interact with many medicines (see Luvox CR Interactions). Many of these interactions are serious. Always check with your healthcare provider before taking any medications (including non-prescription medications) with Luvox CR.
- Even though Luvox CR is not licensed to treat depression, it is classified as an antidepressant based on how it works in the brain. Antidepressants (including Luvox CR) may increase the risk of suicidal thinking or behavior in children, teenagers, and adults (see Depression and Suicide for more information). Therefore, if you notice any changes in symptoms or new symptoms, talk to your healthcare provider immediately. Some of these symptoms may include:
- Extreme hyperactivity
- Suicidal thinking or behavior.
- Before prescribing Luvox CR off-label for depression, your healthcare provider should make sure you do not have bipolar disorder instead. Sometimes, the symptoms of bipolar disorder and depression are similar, and Luvox CR can cause problems in people with bipolar disorder.
- Smoking usually decreases the level of Luvox CR in your blood. If you start smoking (or quit smoking), your healthcare provider may need to adjust your Luvox CR dosage.
- If you have a seizure disorder, there is a possibility that taking Luvox CR may cause seizures. Talk to your healthcare professional before taking this medication if you have seizures.
- If you are stopping Luvox CR, you should be monitored by a healthcare professional for withdrawal symptoms. If you do develop any symptoms of Luvox CR withdrawal, such as irritability, anxiety, confusion, headache, lethargy, or insomnia, your healthcare provider may slow down the rate at which the medication is stopped.
- Luvox CR may cause bleeding in the stomach or intestines. This risk is increased in those taking aspirin or nonsteroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen. Symptoms of gastrointestinal bleeding may include:
- Bright red blood coating the stool
- Dark blood mixed with the stool
- Black or tarry stool
- Bright red blood in vomit
- Vomit that has the appearance of coffee grounds.
If you experience any of these symptoms, call your healthcare provider.
- Taking Luvox CR with other medications that affect serotonin can increase your risk of a dangerous group of symptoms called serotonin syndrome. These other medications include other antidepressants, triptans (migraine medications), and several other medications (see Luvox CR Interactions for more information). Contact your healthcare provider immediately if you have any possible symptoms of serotonin syndrome, including:
- Seeing or hearing things that are not really there (hallucinations)
- Fast heartbeat (tachycardia)
- Feeling faint
- Muscle spasms
- Difficulty walking
- If you are elderly or taking a diuretic, Luvox CR could cause low salt levels in the blood (hyponatremia). This generally returns to "normal" when Luvox CR is stopped.
- If you have liver problems, you may need a lower Luvox CR dosage (and your dose should be increased slowly and only if needed), since the liver helps to remove the medication from the blood.
- Luvox CR may affect your ability to perform complex tasks requiring mental and motor skills. Therefore, it is recommended that you become accustomed to its effect on you before becoming involved in activities requiring mental or motor concentration (such as driving a car or operating machinery). This effect may be greater if you are taking other medications that make you drowsy.
- Luvox CR is considered a pregnancy Category C medication. This means that it may not be safe for use during pregnancy. Talk to your healthcare provider about the risks and benefits of using the drug when pregnant (see Luvox CR and Pregnancy for more information).
- Luvox CR passes through breast milk. Therefore, if you are breastfeeding or plan to start, be sure to talk with your healthcare provider before using this drug (see Luvox CR and Breastfeeding).