Fevarin: instructions for use, analogues and reviews, prices in Russian pharmacies. Fevarin - instructions for use and composition, indications, form of release and cost Fevarin tablets reviews instructions for use

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 appearance of suicidal intentions in the patient. Therefore, psychotherapists insist on the need to combat this disease.

Modern medicine offers many fairly effective means to combat depression and obsessive-compulsive disorders, and one of them is the Fevarin drug, instructions for use of which will be brought to your attention.

The drug "Fevarin" helps to reduce the factor of suicidal activity

A clear advantage to the use of the described remedy is that it belongs to a new generation of drugs that do not worsen the patient's quality of life.

The drug "Fevarin" for depression

In the case of the treatment of mental disorders with antidepressants, as a rule, the fact that this process must take place in several stages is taken into account.

The main one is the treatment of depression.
After recovery, it is important to prevent the 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 the stages listed 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 the drug "Fevarin"

The drug "Fevarin" is a selective serotonin reuptake inhibitor (SSRI), in other words, a means of increasing the level of the mentioned substance in the human body.

Thanks to the named 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, and often completely impossible, to achieve emotional balance. In such cases, SSRIs are used.

In particular, the drug "Fevarin" is prescribed for depressive disorders, obsessive-compulsive disorders, manifestations of social phobia (avoidance of contact with people or fear of being in a crowd), as well as other mental disorders. Experts say that the first improvements in the patient's condition occur within a week after the start of treatment. This is manifested, as a rule, by a decrease in motor restlessness and anxiety of the patient.

It should be noted that when prescribing a dosage of 100 mg / day side effects in the form of drowsiness or apathy is practically not observed. At high level dosages (up to 300 mg / day), these manifestations usually 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 disorders in the digestive and autonomic systems were also noted.

In addition, as evidenced by the reviews, some patients experienced increased nervousness, insomnia, unreasonable anxiety, and even hallucinations. But, according to the instructions for use available for the Fevarin preparation, such manifestations should simply be experienced, because after a couple of weeks they pass. If improvement does not occur, the attending physician should be informed about this in order to review the dosage or discontinue this drug.

Contraindications to the use of the drug

The contraindications available for the drug "Fevarin" are not distinguished by anything special:

hypersensitivity to the elements that make up the drug;
liver disease;
age under 8 years;
period of pregnancy and lactation.

In addition to the above, experts insist on something else: if the patient is already taking any medicines, the described drug should be prescribed very carefully.

When using the drug "Fevarin", it is necessary to remember some features of its therapeutic effect.

Firstly, the anti-anxiety effect declared by the manufacturers of Fevarin does not appear immediately after the start of treatment. In order to see an improvement in the condition, the patient will have to be patient, since the first results will become noticeable only after 2-3 weeks. And in the beginning, there may even be an exacerbation of the disease that needs to be experienced.

If the patient feels very bad, then it is impossible to skip the medication on your own, and even more so to cancel the medication. The doctor should be informed about the deterioration of health, who, having objectively assessed the situation, will make a professional decision. By the way, the reviews of psychiatrists about the Fevarin drug 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 medicine is used to treat people with depression or anxiety, cases of overdose with this remedy are quite frequent.

It should be noted right away that an overdose does not pose a serious danger when taking Fevarin. Cases of death as a result of deliberate increase in doses are extremely rare. But (diarrhea, nausea, vomiting, drowsiness) and cardiac arrhythmias (tachycardia, bradycardia) in such patients are still noted, 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 Fevarin

There is a heated debate in psychiatry about the treatment of children and adolescents with antidepressants. The list of drugs allowed in pediatrics is rather narrow, but Fevarin is also included in it. 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 administration, they have a positive trend. Although in some cases an increase in doses is also required.

How to prescribe the drug "Fevarin" to the elderly

For the elderly, the described drug is also effective tool 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 given that this remedy not only helps to relieve the symptoms of depression or panic attacks, but also has a positive effect on the quality of life, then for the elderly it in some cases turns out to be completely indispensable.

Do not self-medicate!

As you can see, the reviews of psychiatrists about the drug "Fevarin" can be considered convincing evidence of its effectiveness. But it is very dangerous to prescribe this remedy for yourself, despite the above evidence of its low toxicity. After all, the human psyche is a subtle substance that can be easily broken. And this is especially true in cases where some disorders already exist. This drug can only be prescribed by a specialist, and it should be taken only in the prescribed doses and under the supervision of a doctor!

In this article, you can read the instructions for use medicinal product Fevarin. Reviews of site visitors - consumers of this medication, as well as opinions of specialist doctors on the use of Fevarin antidepressant in their practice are presented. A big request to actively add your reviews about the drug: did the medicine help or not help get rid of the disease, what complications and side effects were observed, perhaps not declared by the manufacturer in the annotation. Analogues of Fevarin in the presence of existing structural analogues. Use to treat depression and obsessive-compulsive disorders in adults, children, and pregnancy and lactation. Interaction of the drug with alcohol.

Fevarin- an antidepressant. Receptor binding studies have shown that fluvoxamine (the active ingredient in Fevarin) is a potent serotonin reuptake inhibitor with minimal affinity for serotonin receptor subtypes. Its ability to bind to alpha and beta adrenoreceptors, histamine, m-cholinergic receptors or dopamine receptors is negligible.

Fevarin has a high affinity for sigma-1 receptors, acting as an agonist at therapeutic doses.

Compound

Fluvoxamine maleate + excipients.

Pharmacokinetics

After oral administration, Fevarin is completely absorbed from the gastrointestinal tract. Absolute bioavailability is 53% after primary metabolism in the liver. Simultaneous administration of the drug with food does not affect the pharmacokinetics of fluvoxamine. 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. Fluvoxamine is excreted in the urine as metabolites. The metabolism of fluvoxamine is reduced in patients with liver disease.

Indications

depression of various origins;
obsessive-compulsive disorders.

Release forms

Film-coated tablets 50 mg and 100 mg.

Instructions for use and dosing regimen

In the treatment of depression in adults, the recommended initial dose is 50 mg or 100 mg 1 time per day, in the evening. Increasing the dose is recommended to be carried out gradually. An effective dose, usually 100 mg per day, is selected individually depending on the patient's response to treatment. The daily dose can reach 300 mg.

Doses greater than 150 mg per day should be divided into several doses.

To prevent recurrence of depression, Fevarin is recommended to be administered at a dose of 100 mg 1 time per day daily.

Due to lack of clinical experience, Fevarin is not recommended for the treatment of depression in children and adolescents under 18 years of age.

In the treatment of obsessive-compulsive disorders, the recommended starting dose for adults is 50 mg per day for 3-4 days. Increasing the dose should be carried out gradually until an effective daily dose is reached, which is usually 100-300 mg. The maximum effective dose is 300 mg per day. Doses up to 150 mg can be taken once a day, preferably in the evening. Doses of more than 150 mg per 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 taking the drug, then treatment with fluvoxamine should be reconsidered. So far, no systemic studies have been organized that could answer the question of how long fluvoxamine treatment can be carried out, however, obsessive-compulsive disorders are chronic, it can be considered appropriate to extend the course of treatment with Fevarin for more than 10 weeks in patients with adequate therapeutic effect. Selection of the minimum effective maintenance dose should be carried out individually and with caution. The need for treatment needs to be reassessed periodically. Some clinicians recommend concomitant psychotherapy for patients with good effect pharmacotherapy.

In case of hepatic or renal insufficiency, treatment should be started with the lowest dose under the strict supervision of a physician.

Fevarin tablets should be taken orally, without chewing and with water.

Side effect

increased excitability;
anxiety;
dizziness;
insomnia or drowsiness;
tremor;
headache;
convulsions;
a state of confused consciousness;
hallucinations;
mania;
abdominal pain;
constipation;
diarrhea;
dry mouth;
dyspepsia;
anorexia;
nausea, vomiting;
heartbeat;
tachycardia;
orthostatic hypotension;
increased sweating;
photosensitivity reactions;
skin hypersensitivity reactions (including rash, itching, angioedema);
arthralgia;
myalgia;
violation (delay) of ejaculation;
galactorrhea;
asthenia;
malaise;
hemorrhages (eg, gastrointestinal bleeding, ecchymosis, purpura);
weight gain;
weight loss;
paresthesia;
urinary disorders (including urinary retention, urinary incontinence, frequent urination, nocturia and enuresis);
anorgasmia;
menstrual irregularities (such as amenorrhea, hypomenorrhea, metrorrhagia, menorrhagia);
drug withdrawal syndrome, including neonatal withdrawal syndrome.

Contraindications

simultaneous reception with tizanidine and MAO inhibitors;
concomitant use with ramelteon;
hypersensitivity to the active substance or to any of the components of the drug.

Fevarin treatment can be started:

2 weeks after stopping an irreversible MAO inhibitor;
the next day after stopping the intake of a reversible MAO inhibitor.

The time interval between stopping fluvoxamine and starting therapy with any MAO inhibitor should be at least 1 week.

Use during pregnancy and lactation

Epidemiological data suggest that the use of selective serotonin reuptake inhibitors during pregnancy, especially during the last months of pregnancy, may increase the risk of persistent pulmonary hypertension(PLG) newborns.

The drug should be administered to pregnant women with caution. The potential risk to humans is unknown.

Isolated cases of withdrawal syndrome in newborns have been described after the use of Fevarin at the end of pregnancy.

Feeding and/or breathing difficulties, convulsive disorders, unstable body temperature, hypoglycemia, tremors, muscle tone disturbances, hyperexcitability syndrome and continuous crying have occurred in some newborns after exposure to selective serotonin reuptake inhibitors in the 3rd trimester of pregnancy, which may require longer hospital stay.

Fluvoxamine passes into breast milk. In this regard, the drug should not be used during lactation.

Use in elderly patients

With caution, the drug should be prescribed to elderly patients.

Use in children

Fevarin should not be used in children and adolescents under 18 years of age, except in patients with obsessive-compulsive disorder. Due to lack of clinical experience, Fevarin is not recommended for the treatment of depression in children. In clinical studies conducted in children and adolescents, suicidal behavior (suicidal attempts and thoughts) and hostility (mainly aggression, oppositional behavior and anger) were observed more frequently in patients treated with an antidepressant compared with placebo. If a treatment decision is made based on clinical need, the patient should be closely monitored for the occurrence of suicidal symptoms.

In addition, long-term safety data for children and adolescents regarding the growth, development and establishment of cognitive behavior are not available.

In the treatment of obsessive-compulsive disorders, the initial dose for children over 8 years of age and adolescents is 25 mg per day for 1 dose. Maintenance dose - 50-200 mg per day. Maximum daily dose is 200 mg. Doses of more than 100 mg per day are recommended to be divided into 2 or 3 doses.

special instructions

Depression is associated with an increased risk of suicidal thoughts or suicidal behavior (self-harm or suicide). This risk remains until a significant improvement in the condition. Because improvement may not occur during the first few weeks of treatment or longer, patients should be closely monitored until such improvement occurs.

In clinical practice, there is a widespread increase in the risk of suicide by early stages convalescence.

Obsessive-compulsive disorders may also be associated with an increased risk of suicidal events. In addition, these conditions may be accompanied by deep depression. Therefore, in the treatment of patients with obsessive-compulsive disorders, the same precautions should be observed as in the treatment of patients with major depression.

Patients with a history of suicidal events or who exhibit significant suicidal ideation are known to be at greater risk of suicidal thoughts or suicidal behavior before starting treatment and should be closely monitored during treatment.

Careful monitoring of patients, especially at high risk, should accompany drug therapy, especially in its early stages and after dose changes.

Patients (and their caregivers) should be warned to watch for any clinical deterioration, suicidal behavior or suicidal thoughts, unusual changes in behavior, and seek immediate specialist advice if such symptoms occur.

The development of fluvoxamine-associated akathisia is characterized by subjectively unpleasant and distressing anxiety. The need to move was often accompanied by an inability to sit or stand still. This condition is most likely to develop during the first few weeks of treatment. Increasing the dose of the drug in patients with such symptoms may worsen their condition.

Caution should be exercised when prescribing the drug to patients with a history of seizures. Fluvoxamine should be avoided in patients with unstable epilepsy, and patients with stable epilepsy should be closely monitored. Treatment with Fevarin should be discontinued if epileptic seizures occur or their frequency increases.

Rare cases of the development of a serotonergic syndrome or a condition similar to NMS have been described, which may be associated with the use of fluvoxamine, especially in combination with other serotonergic and / or antipsychotic drugs. These syndromes can lead to potentially life-threatening conditions manifested by hyperthermia, muscle rigidity, myoclonus, autonomic lability nervous system with possible rapid changes in vital parameters (including pulse, respiration, blood pressure), changes in mental status, including confusion, irritability, extreme agitation, reaching delirium or coma. Therefore, in such cases, Fevarin should be discontinued and appropriate symptomatic treatment initiated.

As with other selective serotonin reuptake inhibitors, in rare cases, hyponatremia may occur, which is reversed after fluvoxamine is discontinued. Some cases have been caused by ADH deficiency syndrome. Most of these cases were observed in elderly patients.

Blood glucose control (i.e. hyperglycemia, hypoglycemia, impaired glucose tolerance) may be impaired, especially in the early stages of treatment. In the case of prescribing the drug Fevarin to patients with diabetes in history, dose adjustment of hypoglycemic drugs may be required.

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 2 weeks of treatment.

There are reports of intradermal hemorrhages such as ecchymosis and purpura, as well as hemorrhagic manifestations (eg, gastrointestinal bleeding) observed with the use of selective serotonin reuptake inhibitors. Caution should be exercised when prescribing these drugs to elderly patients, as well as to patients simultaneously receiving drugs that act on platelet function (for example, atypical antipsychotics and phenothiazines, many tricyclic antidepressants, acetylsalicylic acid, NSAIDs) or drugs that increase the risk of bleeding, and also in patients with a history of bleeding or who are prone to bleeding (for example, with thrombocytopenia).

Increased risk of QT prolongation/paroxysmal ventricular tachycardia type "pirouette" in combination therapy with fluvoxamine with terfenadine or astemizole or cisapride, due to an increase in the concentration of the latter in the blood plasma. Therefore, fluvoxamine should not be administered with these drugs.

Fluvoxamine may cause a slight decrease in heart rate (by 2-6 bpm).

Discontinuation of fluvoxamine may lead to withdrawal symptoms, although available preclinical and clinical data have not shown dependence on fluvoxamine treatment. Symptoms noted in case of discontinuation of the drug: dizziness, paresthesia, headache, nausea, anxiety. Most of these symptoms are mild and stop on their own. When stopping treatment with the drug, a gradual dose reduction is recommended.

Treatment of patients with hepatic or kidney failure should begin with the appointment of the drug in a low dose, such patients require strict medical supervision. In rare cases, treatment with fluvoxamine can lead to an increase in liver enzymes, which is most often accompanied by corresponding clinical symptoms; in such cases, Fevarin should be canceled.

A meta-analysis of placebo-controlled clinical trials of antidepressants in adult patients with psychiatric disorders found an increased risk of suicidal behavior with antidepressants compared with placebo in patients younger than 25 years of age. When prescribing the drug Fevarin, the risk of suicide and the benefits of its use should be correlated.

Data obtained in the treatment of elderly patients and younger patients indicate that there are no clinically significant differences between their usual daily doses. However, dose escalation in elderly patients should always be done more slowly and with more caution.

As with the use of other psychotropic drugs, alcohol is not recommended during treatment with Fevarin.

Influence on the ability to drive vehicles and control mechanisms

When used in healthy volunteers, Fevarin in doses up to 150 mg did not affect or had a slight effect on the ability to drive a car and control machines. At the same time, there are reports of drowsiness observed during treatment with fluvoxamine. In this regard, until the final determination of the individual response to the drug, patients are advised to exercise caution when engaging in potentially hazardous activities.

drug interaction

Fevarin should not be used in combination with MAO inhibitors. Treatment with Fevarin can be started 2 weeks after stopping an irreversible MAO inhibitor; the next day after stopping the intake of a reversible MAO inhibitor; the time interval between stopping Fevarin and starting therapy with any MAO inhibitor should be at least 1 week.

Fluvoxamine significantly inhibits the CYP1A2 isoenzyme, and to a lesser extent - the CYP2C and CYP3A4 isoenzymes. Drugs that are largely metabolized by these isoenzymes are more slowly eliminated and may have higher plasma concentrations when used concomitantly with Fevarin. This is especially significant for drugs that have a narrow therapeutic window. Patients need careful monitoring, if necessary, it is recommended to adjust the doses of these drugs. Fluvoxamine has a minimal inhibitory effect on CYP2D6 and does not appear to affect non-oxidative metabolism and renal excretion.

With the simultaneous use of Fevarin, an increase in the concentration of tricyclic antidepressants (clomipramine, imipramine, amitriptyline) and neuroleptics (clozapine, olanzapine), which are largely metabolized by the CYP1A2 isoenzyme, was observed. In this regard, if treatment with Fevarin is started, the possibility of reducing the dose of these drugs should be considered.

Patients simultaneously taking Fevarin and drugs with a narrow therapeutic range metabolized by the CYP1A2 isoenzyme (including tacrine, theophylline, methadone, mexiletine) should be under close medical supervision. If necessary, it is recommended to adjust the doses of these drugs.

Isolated cases of cardiotoxicity have been reported while taking fluvoxamine and thioridazine.

When fluvoxamine interacted with propranolol, an increase in plasma propranolol concentrations was noted. In this regard, it can be recommended to reduce the dose of propranolol in the case of simultaneous administration with fluvoxamine.

Plasma concentrations of caffeine may increase while taking fluvoxamine. Thus, patients who consume large amounts of caffeinated beverages should reduce their intake while on fluvoxamine and when adverse effects of caffeine such as tremors, palpitations, nausea, restlessness, and insomnia are observed.

Simultaneous administration of fluvoxamine and ropinirole may increase the plasma concentration of ropinirole, thus increasing the risk of overdose. In such cases, it is recommended to control, or, if necessary, reduce the dose or cancel ropinirole for the duration of treatment with fluvoxamine.

Patients concomitantly taking fluvoxamine and drugs with a narrow therapeutic range, metabolized by cytochrome P450 2C isoenzyme (such as phenytoin), should be carefully monitored, and dose adjustment of these drugs is recommended if necessary.

When fluvoxamine was used in combination with warfarin, a significant increase in warfarin plasma concentrations and prolongation of prothrombin time were observed.

When combined therapy with fluvoxamine, plasma concentrations of terfenadine, astemizole or cisapride may increase, increasing the risk of prolongation of the QT interval / paroxysmal ventricular tachycardia of the "pirouette" type. Therefore, fluvoxamine should not be administered with these drugs.

Patients concomitantly taking fluvoxamine and drugs with a narrow therapeutic range that are metabolized by the CYP3A4 isoenzyme (such as carbamazepine, cyclosporine) should be carefully monitored, dose adjustment of these drugs is recommended.

With simultaneous administration of benzodiazepines undergoing oxidative metabolism, such as triazolam, midazolam, alprazolam and diazepam, with Fevarin, their plasma concentrations may increase. The dose of these benzodiazepines should be reduced while taking fluvoxamine.

Fluvoxamine does not affect the plasma concentration of digoxin.

Fevarin does not affect the plasma concentration of atenolol.

In the case of the combined use of fluvoxamine with serotonergic drugs (such as triptans, tramadol, selective serotonin reuptake inhibitors and St. John's wort preparations), the serotonergic effects of fluvoxamine may increase.

Fluvoxamine has been used in combination with lithium to treat critically ill patients with poor response to pharmacotherapy. It should be noted that lithium (and possibly also tryptophan) enhances the serotonergic effects of the drug, and therefore this kind of combined pharmacotherapy should be used with caution.

With the simultaneous use of oral anticoagulants and fluvoxamine, the risk of hemorrhage may increase. Such patients should be under medical supervision.

Analogues of the drug Fevarin

The drug Fevarin has no structural analogues for the active substance.

Analogues for pharmacological group(antidepressants):

Azaphen;
Azona;
Alventa;
Aleval;
Amizol;
Amitriptyline;
Anafranil;
Velaksin;
Venlaxor;
Heptor;
Heptral;
Deprim;
doxepin;
duloxetine;
Zoloft;
Ixel;
Clomipramine;
Coaxil;
Lenuxin;
Lerivon;
Maprotiline;
Miansan;
Mirzaten;
Mirtazapine (hemihydrate);
Negrustin;
Neuroplant;
Noxibel;
Oprah;
Paxil;
paroxetine;
Pipofezin;
pyrazidol;
Pleased;
Portal;
Prozac;
Sedopram;
selectra;
Seralyn;
Sertraline;
Tianeptine sodium;
Thorin;
fluoxetine;
Framex;
Citalon;
citalopram;
Cytol;
Elivel;
Efevelon.

In the absence of analogues of the drug for the active substance, you can follow the links below to the diseases that the corresponding drug helps with and see the available analogues for the therapeutic effect.

One tablet of Fevarin contains: fluvoxamine maleate - 100 or 50 mg.

Excipients: corn starch - 80 or 40 mg; - 303 or 152 mg; pregelatinized starch - 12 or 6 mg; sodium stearyl fumarate - 3.5 or 1.8 mg; colloidal silica - 1.5 or 0.8 mg.

Shell composition: macrogol 6000 - 2 or 1.5 mg; hypromellose - 5.6 or 4.1 mg; talc - 0.4 or 0.3 mg; titanium dioxide - 2.1 or 1.5 mg.

The drug does not contain lactose and sugar .

Release form

Tablets, regardless of dosage, are available in blisters of 15 and 20 pieces, in a cardboard bundle 4, 3, 2 or 1 such blister.

pharmachologic effect

The drug has antidepressant action .

Pharmacodynamics and pharmacokinetics

Pharmacodynamics

The drug selectively inhibits reuptake by brain cells and has minimal effect on noradrenergic transmission. Possesses poor ability to interact with histaminergic, cholinergic, alpha and beta-adrenergic, m-dopaminergic and serotonergic receptors .

Pharmacokinetics

When taken orally, it is completely adsorbed from the intestine. The maximum concentration is observed 4-8 hours after administration, the equilibrium concentration is reached after two weeks. Bioavailability - 53% after initial metabolism in the liver. Food does not affect the pharmacodynamics of Fevarin.

Approximately 80% of the molecules active substance bind to blood proteins.

The elimination half-life from the blood for a single dose is 13-15 hours, with multiple doses - 17-22 hours.

The metabolism of Fevarin is localized in the liver. The drug undergoes biotransformation by oxidative demethylation . Metabolites are excreted by the kidneys. Only 2 out of 9 metabolites have pharmacological activity.

Pharmacokinetics is the same regardless of age and the presence of renal insufficiency. Metabolism may be inhibited in individuals with liver disease.

Indications for use Fevarin

Indications for the use of Fevarin are reduced to the need for prevention and therapy, treatment obsessive-compulsive symptoms.

Contraindications

It is forbidden to prescribe Fevarin simultaneously with MAO inhibitors, or ramelteon . Treatment with the drug can be started only 14 days after the abolition of irreversible MAO inhibitors , and the next day after stopping the intake of reverse inhibitors MAO .

Therapy MAO inhibitors start 1 week after the abolition of Fevarin.

The drug is contraindicated in persons with fluvoxamine maleate or to any of the other components of the medicinal product, with severe liver disease and children under eight years of age.

Side effects

From the hematopoietic system: (gastrointestinal, gynecological, ecchymosis ).
From the side endocrine system: output imbalance , .
From the side of nutrition and metabolism:, hyponatremia , change in body weight.
From the side of the psyche: hallucinations, mania, suicidal thoughts and behavior.
From the nervous system: agitation, anxiety, nervousness, drowsiness, headache, ataxia , convulsions , serotonin syndrome , .
From the point of view: mydriasis , .
From the side of the cardiovascular system: hypotension .
From the digestive system: abdominal pain, nausea, impaired liver function.
From the skin: sweating, rash, itching, photosensitivity.
From the musculoskeletal system: muscle and joint pain, fractures.
From the side genitourinary system: various urination disorders (urinary retention, incontinence, enuresis and others), late ejaculation , Galactorrhea, anorgasmia, menstrual disorders.
General violations: asthenia, general weakness, withdrawal syndrome.

Termination of treatment often causes the development of a withdrawal syndrome. Cancellation of the drug is recommended to be done gradually.

Instructions for use Fevarin

According to the instructions for use of Fevarin, the dosing regimen is set individually in each individual case. Initially, the daily dose of the drug is 50-100 mg (1 or 2 tablets, depending on the dosage). The drug is recommended to be taken at night. If necessary, the daily dose is increased to 150-200 mg. The maximum daily dose is 300 mg. If the daily dose is more than 100 mg, then it should be taken in two or three doses.

Overdose

Overdose symptoms.

From the digestive system: nausea , impaired hepatic function.
From the nervous system: convulsions , drowsiness , dizziness .
Heart problems have also been reported: bradycardia, tachycardia, hypotension .

Fatalities due to overdose fluvoxamine occur extremely rarely. The highest recorded dose for overdose is 12 grams. The person who took this dose made a full recovery.

Treatment. There is no specific antidote. In case of an overdose, it is necessary to wash the stomach and prescribe symptomatic treatment. Recommended use. or forced diuresis ineffective.

Interaction

When taken together with MAO inhibitors there is a possibility of serotonin syndrome .
When used together with , the concentration of these drugs in the blood increases, and their negative effects intensify.
When taken concomitantly with , carbamazepine, trimipramine, theophylline their content in blood plasma increases.
When used together, c reduces its effectiveness; with valproic acid - its effects are activated; c - its concentration and the risk of bleeding increase; c - its negative effects are enhanced; c - increases the content of lithium in the blood.
The use of the drug together with increases the risk of extrapyramidal disorders.
When used together with quinidine its metabolism is inhibited and clearance is reduced.

Terms of sale

The drug is released only by prescription.

Storage conditions

Keep away from children. Store in a dry, dark place at temperatures below 20 degrees.

Shelf life

Three years.

special instructions

Patients with and other conditions need to be under the constant supervision of the attending physician until the condition improves.

In persons with hypofunction of the liver or kidneys, treatment should be started with small doses under the supervision of the attending physician.

Should be administered with caution fluvoxamine persons with convulsive syndrome in history. If the patient develops or becomes more frequent convulsions therapy should be discontinued.

Rarely when used fluvoxamine (and other selective serotonin reuptake blockers) may occur hyponatremia which disappears after discontinuation of the drug. The vast majority of episodes hyponatremia observed in elderly patients.

The most common adverse effect of treatment fluvoxamine is nausea and vomiting, but they disappear after the first two weeks of therapy.

Possible withdrawal syndrome when treatment is stopped fluvoxamine . Most common symptoms after withdrawal fluvoxamine : sensory disturbance, dizziness, sleep disturbances, irritability, agitation, confusion, headache, emotional instability, nausea, vomiting, sweating, anxiety. As a rule, these phenomena are mild and disappear on their own. They are observed in the first days after cessation of therapy. In this regard, it is advised to slowly reduce the dose of the consumed fluvoxamine .

Fevarin in a daily dose of 150 mg does not affect the ability to drive a car. However, drowsiness may develop during the treatment period, so care must be taken until the individual response to the drug is investigated.

Fevarin's analogs

Coincidence in the ATX code of the 4th level:

The most common are such analogues of Fevarin, containing fluvoxamine , as Deprivox and Fluvoxamine Sandoz .

children

The antidepressant Fevarin is contraindicated in children under 8 years of age.

During pregnancy and lactation

The use of drugs based on fluvoxamine , especially in the later stages, can increase the possibility of developing persistent pulmonary hypertension of the newborn . Therefore, Fevarin should not be used during pregnancy unless the patient's condition requires therapy with this drug.

The drug in a small amount can penetrate into breast milk, so the use of the drug in women during lactation is contraindicated.

Stress, difficult life problems, experiences, loss of loved ones and loved ones significantly affect the human nervous system. Sometimes external problems can drive you into a difficult situation. depression from which it is very difficult to find a way out.

Many people, unable to get out of the shackles of anxiety and sadness, see only one way - suicide. However, doctors have found a way to combat depression. Antidepressants can help the patient bring back the joy of life. Fevarin is one of those saviors of the human soul that can be found on pharmacy shelves.

But for many, it is out of reach in terms of acquisition - the price for a package of an antidepressant is more than high. Fortunately, a wide range pharmaceutical preparations allows you to find more affordable analogues of Fevarin, which have a similar method of influencing the human nervous system, while having an attractive cost.

Fevarin: basic information about the drug

The American-made drug belongs to the group of antidepressants listed on the B list (strong drugs dispensed from pharmacies strictly on prescription).

Let's pay attention to brief instructions on the use of Fevarin and prices in pharmacies.

Compound

The basis of the antidepressant is the substance fluvoxamine. Also, each tablet contains excipients - silicon dioxide, mannitol, sodium and starch.

Indications

An antidepressant is prescribed for severe forms of disorders of the psycho-emotional state of a person:

depressive syndrome;
feeling of anxiety, nervousness;
sleep disturbance (up to insomnia) against the background of stress;
compulsive disorder;
apathy, loss of interest in everything around.

It is used not only directly during the period of a nervous disorder, but also as preventive measure prevent relapse after treatment.

Contraindications

An antidepressant has a serious effect on a person's well-being, therefore in some cases, it is strictly prohibited to use it. The list of contraindications includes:

kidney failure;
disruption of the liver;
epileptic seizures;
tendency to thrombocytopenia;
convulsive state;
intolerance to the substance that is the basis of the drug.

During pregnancy and during breastfeeding the drug can be prescribed in extreme cases and treatment should be accompanied by close attention of the doctor.

Side effects

Antidepressant can cause a deterioration in the psycho-emotional state of a patient with suicidal tendencies. In this case, the attending physician may refrain from prescribing this drug to the patient or to appoint in the minimum dosage.

In addition, taking Fevarin can cause a number of side effects:

As can be seen from the impressive list of side effects, an antidepressant should not be taken as an easy and safe panacea for a bad mood. Even with strict adherence to all recommendations for use, the medication can have an extremely negative effect on human health.

Price

Fevarin is available in the form of tablets. The cost depends on the content of the main active ingredient in the tablet:

a package of tablets, each containing 50 milligrams of fluvoxamine, costs around 700 rubles (for 15 tablets);
a package of tablets, each containing 100 milligrams of the main active ingredient, can be purchased for an average of 910 rubles (for 15 tablets).

The antidepressant has a powerful effect not only on the human nervous system, but also on his financial condition. It must also be taken into account that treatment requires a full course, only in this case, you can count on a positive result. Since one package contains only 15 tablets, you will have to pay an impressive amount for the treatment of depression.

Cheap analogues

In order not to once again disturb your nervous system, shrouded in depression and anxiety, it is recommended to refrain from acquiring such an expensive drug.

And there is a weighty circumstance for this - in the vast stocks of any pharmacy you can find a number of drugs that are not inferior to Fevarin in terms of effectiveness, but at the same time paying a much smaller amount of money for them.

Deprivox

A German-made antidepressant that belongs to list B and is sold in pharmacies strictly on prescription.

Compound. The main active ingredient of the antidepressant is fluvoxamine.

Indications. It is prescribed for depressive syndrome and obsessive-compulsive states. Effective in removing panic attacks , anxiety and unreasonable fears.

Contraindications. The main contraindication is individual intolerance to the active ingredient that is part of the drug. Also, Deprivox should not be combined with other psychotropic drugs.

Price. The antidepressant comes in tablet form. For a package of the drug containing 20 tablets (100 milligrams of the active substance each), you will have to pay in the range of 500 rubles.

Comparison with the original. The two drugs have the same active substance contains fluvoxamine. Also, the indications for use are absolutely identical. The analog has much less contraindications, as well as a much more attractive cost (500 rubles for 20 tablets containing 100 milligrams of fluvoxamine, versus 910 rubles for 15 tablets of Fevarin).

Fluvoxin (Fluvoxamine)

An Indian-made antidepressant, it belongs to list B (strong drugs that are dispensed from pharmacies by prescription).

Compound. The basis of the drug is the substance fluvoxamine.

Indications. It is prescribed for mental disorders:

depressive syndrome;
anxiety state;
panic attacks;
stress;
phobias.

Contraindications. Taking the drug is contraindicated in:

diabetes mellitus;
epileptic seizures;
renal failure;
liver diseases;
hypersensitivity or absolute intolerance to the main active substance;
pregnancy;
breastfeeding;
children up to eight years of age.

Price. You can buy an antidepressant for an average of 400 rubles (10 tablets, each containing 100 milligrams of the active substance).

Comparison with the original. The two drugs are based on the substance fluvoxamine. In indications and contraindications, the two antidepressants are also very similar. The main difference is that the analogue is much cheaper.

fluoxetine

One of the most effective Russian antidepressants, which has a very long history existence. Refers to drugs from list B (strong drugs dispensed from pharmacies by prescription only).

Compound. The composition is based on the active substance of the same name - fluoxetine.

Indications. The antidepressant is aimed at combating such pathologies of the central nervous system as:

depression (including severe form);
neurosis;
bulimia (excessively active appetite in a nervous state, stress);
stress;
insomnia.

Contraindications. An antidepressant should not be taken when:

diseases of the liver and kidneys;
violation of the genitourinary system;
glaucoma;
oncological pathologies;
epilepsy;
pregnancy;
breastfeeding;
convulsions;
concomitant use with other psychotropic drugs;
individual intolerance to the components of the drug.

Price. You can buy Fluoxetine for an average of 60 rubles (20 capsules, each containing 20 milligrams of the main active ingredient). Of course, finding an analogue cheaper will not be easy!

Comparison with the original. In spite of different substances based drugs, both antidepressants have a similar focus. Significant difference in price. Despite the low cost, Fluoxetine is recognized as one of the most powerful antidepressants in the history of pharmacology.

If you overcame severe depression, do not give up and lose the colors of life. It is necessary to contact an experienced neurologist or psychotherapist who will select an effective drug and draw up a course of treatment.

It is important to remember that psychotropic drugs and drugs used to normalize the functioning of the nervous system, it is absolutely impossible to prescribe yourself on your own! Having arbitrarily diagnosed yourself with depression and illegally, without a doctor's prescription, having bought an antidepressant, you can significantly harm your health!

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Fluvoxamine maleate (fluvoxamine)

Composition and form of release of the drug

Coated tablets white, oval, biconvex, scored on one side, engraved with "313" on both sides of the score on one side of the tablet, and the letter "S" above the ∇ on the other side of the tablet.

Excipients: - 303 mg, corn starch - 80 mg, pregelatinized starch - 12 mg, sodium stearyl fumarate - 3.5 mg, colloidal silicon dioxide - 1.5 mg.

Shell composition: hypromellose - 5.6 mg, macrogol 6000 - 2 mg, talc - 0.4 mg, titanium dioxide (E171) - 2.1 mg.

15 pcs. - blisters (1) - packs of cardboard.
15 pcs. - blisters (2) - packs of cardboard.
15 pcs. - blisters (3) - packs of cardboard.
15 pcs. - blisters (4) - packs of cardboard.
20 pcs. - blisters (1) - packs of cardboard.
20 pcs. - blisters (2) - packs of cardboard.
20 pcs. - blisters (3) - packs of cardboard.
20 pcs. - blisters (4) - packs of cardboard.

pharmachologic effect

Antidepressant. The mechanism of action is associated with selective inhibition of reuptake by brain neurons and is characterized by a minimal effect on noradrenergic transmission. Fluvoxamine has a weak ability to bind to α- and β-adrenergic receptors, histamine, m-cholinergic receptors, dopamine and serotonin receptors.

Indications

Treatment and prevention of depression, treatment of symptoms of obsessive-compulsive disorders.

Contraindications

Severe liver dysfunction, simultaneous use of MAO inhibitors, childhood up to 8 years, hypersensitivity to fluvoxamine.

Dosage

Installed individually. At the beginning of treatment, the daily dose is 50-100 mg (it is recommended to take it at night). With insufficient effectiveness, the daily dose can be increased to 150-200 mg. The maximum daily dose is 300 mg. If the daily dose is more than 100 mg, then it should be divided into 2-3 doses.

Side effects

From the side digestive system: often - nausea, sometimes accompanied by vomiting (usually disappears in the first 2 weeks of treatment); possibly - constipation, anorexia, dyspepsia, diarrhea, discomfort in the epigastric region, dry mouth, discomfort; rarely - increased activity of liver enzymes, mainly in senile patients - transient hyponatremia (in some cases due to the syndrome of inadequate ADH secretion, disappears after fluvoxamine is discontinued).

From the side of the central nervous system: possible drowsiness, dizziness, headache, insomnia, anxiety, psychomotor agitation, fear, tremor, discomfort, asthenia; after the abrupt withdrawal of fluvoxamine, in rare cases, headache, nausea, dizziness, and a sense of fear were observed.

From the side of the cardiovascular system: perhaps a slight decrease in heart rate (by 2-6 bpm), palpitations, tachycardia.

Others: possible increased sweating, change in body weight.

Some of the above side effects may be symptoms of depression and are not due to fluvoxamine.

drug interaction

With simultaneous use with MAO inhibitors, there is a possibility of developing serotonin syndrome, especially with simultaneous use with irreversible non-selective MAO inhibitors.

With simultaneous use, the concentration in the blood of alprazolam, bromazepam, diazepam increases and their side effects increase due to the fact that fluvoxamine inhibits the metabolism of these benzodiazepines.

With simultaneous use, the concentration in the blood plasma of clomipramine, imipramine, maprotiline, trimipramine increases, which is apparently due to the fact that fluvoxamine is a non-competitive inhibitor of the CYP1A2 isoenzyme, with the participation of which the process of N-demethylation of these antidepressants occurs.

With simultaneous use with buspirone, its effectiveness may decrease; c - it is possible to enhance the effects of valproic acid; with warfarin - it is possible to increase the concentration of warfarin in the blood plasma and the risk of bleeding; c - increases the likelihood of increased side effects of galantamine; with haloperidol - the concentration of lithium in the blood plasma increases.

With simultaneous use, the concentration of carbamazepine in the blood plasma increases, which is due to the inhibition of its metabolism in the liver, mainly due to the suppression of the activity of the CYP2D6 isoenzyme under the influence of fluvoxamine.

With simultaneous use, the concentration of clozapine in the blood plasma increases significantly, which in some patients is accompanied by the development of toxic effects of clozapine.

With simultaneous use, it is possible to reduce the clearance of caffeine and enhance its effects. This interaction is due to the fact that fluvoxamine significantly inhibits the CYP1A2 isoenzyme, which is the main enzyme responsible for the metabolism of caffeine.

With simultaneous use with metoclopramide, a case of the development of extrapyramidal disorders has been described.

With simultaneous use with olanzapine, the concentration of olanzapine in the blood plasma increases; with propranolol - the concentration of propranolol in the blood plasma increases, which, apparently, is due to the inhibition of cytochrome P450 isoenzymes by fluvoxamine, which are involved in the metabolism of propranolol.

With simultaneous use with theophylline, the concentration of theophylline in the blood plasma increases, which leads to the development of toxic reactions. This interaction is due to the fact that fluvoxamine significantly inhibits the CYP1A2 isoenzyme, which is the main enzyme responsible for the metabolism of theophylline.

With simultaneous use, the clearance of tolbutamide and its metabolites decreases, which is due to inhibition of the CYP2C9 isoenzyme.

There are separate reports of reinforcement side effects phenytoin when used concomitantly with fluvoxamine.

With simultaneous use, metabolism slows down and the clearance of quinidine decreases.

special instructions

In depression, there is usually a high likelihood of suicide attempt, which may persist until sufficient remission is achieved.

Use with caution in patients with a history of seizures. With the development of an epileptic seizure, treatment with fluvoxamine should be discontinued.

In patients with hepatic or renal insufficiency, fluvoxamine should be administered at low doses at the beginning of treatment under the strict supervision of a physician.

There are reports of the development of ecchymosis and purpura with the use of selective serotonin reuptake inhibitors. Given this, such drugs should be prescribed with caution, especially concomitantly with drugs that affect platelet function (for example, with atypical antipsychotics and phenothiazines, many tricyclic antidepressants, NSAIDs, including), as well as patients with a history of bleeding.

During the treatment period, alcohol is not allowed.

Due to lack of clinical experience, fluvoxamine is not recommended for the treatment of depression in children.

Influence on the ability to drive vehicles and control mechanisms

In patients whose activities are associated with the need for concentration and high speed of psychomotor reactions, fluvoxamine should be used with caution until the final determination of the individual response to treatment.

Treatment with MAO inhibitors should be discontinued 2 weeks before the start of fluvoxamine.

Fluvoxamine can slow down the excretion of drugs metabolized with the participation of microsomal liver enzymes.