Luvox (Fluvoxamine) Dose Increment Recommendations
For adults, increase Luvox by 50 mg increments every 4-7 days; for pediatric patients (ages 8-17), increase by 25 mg increments every 4-7 days. 1
Adult Dosing Titration
- Start at 50 mg once daily at bedtime 1
- Increase in 50 mg increments every 4 to 7 days as tolerated until maximum therapeutic benefit is achieved 1
- Maximum dose is 300 mg/day 1
- Doses above 100 mg/day should be split into two divided doses, with the larger dose given at bedtime 1
Pediatric Dosing Titration (Ages 8-17)
- Start at 25 mg once daily at bedtime 1
- Increase in 25 mg increments every 4 to 7 days as tolerated 1
- Maximum dose for children up to age 11: 200 mg/day 1
- Maximum dose for adolescents: 300 mg/day 1
- Doses above 50 mg/day should be split into two divided doses, with the larger dose given at bedtime 1
Important Gender and Age Considerations
- Female children may achieve therapeutic effect at lower doses 1
- Steady-state plasma concentrations are 2-3 times higher in children (ages 6-11) compared to adolescents, justifying the lower maximum dose 2, 3
Special Populations
Elderly or Hepatically Impaired Patients
- Use slower titration and lower increments due to decreased clearance 1
- Consider modifying both initial dose and subsequent titration schedule 1
Clinical Pearls
- The 4-7 day interval between dose increases allows assessment of tolerability before further escalation 1
- Therapeutic trials typically require 10 weeks at adequate dosing to assess efficacy 1
- Nausea is the most common adverse effect (occurring in >10% of patients), but is generally mild to moderate 4, 5
- When discontinuing, taper gradually rather than stopping abruptly to minimize withdrawal symptoms 1