플루복사민
Fluvoxamine
Fluvoxamine maleate
다른 이름: Luvox CR · Dumirox · Faverin · Fevarin · DU-23000 · desifluvoxamin · Dumyrox · Favoxil · Felixsan · Flox-ex · Floxyfral · Fluvohexal · Fluvoxadura · Fluvoxin · Maveral
VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
동물 종별 용량
🌎 NA — North America🌍 EU — Europe
개
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| For treatment of compulsive disorders | 0.5-2 mg/kg PO twice daily | PO | q12h | — | 🌎 NA |
| For treatment of behavioral diagnoses | 1-3 mg/kg PO once daily (q24h) | PO | q24h | allow 8 weeks for initial trial | 🌎 NA |
| For treatment of behavioral diagnoses | 1 mg/kg PO q12-24h | PO | q12-24h | Treat for 3-5 weeks minimum to assess effects; then treat until 'well' (minimum another 1-2 months). Continue for another 1-2 months minimum. | 🌎 NA |
- For treatment of behavioral diagnoses: Treatment should last for a minimum 4-6 months once initiating therapy. If weaning off, do so over 3-5 weeks (or longer).
고양이
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| For treatment of compulsive disorders | 0.25-0.5 mg/kg PO once daily | PO | q24h | — | 🌎 NA |
| For treatment of behavioral diagnoses | 0.25-0.5 mg/kg PO q24h | PO | q24h | Treat for 3-5 weeks minimum to assess effects; then treat until 'well' (minimum another 1-2 months). Continue for another 1-2 months minimum. | 🌎 NA |
| For spraying | 0.25 mg/kg PO q12h | PO | q12h | — | 🌎 NA |
| For treatment of behavioral diagnoses | 0.5-1 mg/kg PO once daily (q24h) | PO | q24h | allow 8 weeks for initial trial | 🌎 NA |
- For treatment of behavioral diagnoses: Treatment should last for a minimum 4-6 months once initiating therapy. If weaning off, do so over 3-5 weeks (or longer).
- For spraying: Avoid use with benzodiazepines
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
개요
플루복사민(Fluvoxamine)은 선택적 세로토닌 재흡수 억제제(SSRI) 항우울제로, 개와 고양이의 공격성 및 상동증(강박 행동)을 포함한 다양한 행동 장애를 치료하는 데 사용됩니다.
플루옥세틴만큼 흔하게 처방되지는 않지만 행동 관리를 위한 대안으로 활용될 수 있습니다.
임상 요점:
- 다른 SSRI와 마찬가지로 신경 수용체의 하향 조절에 시간이 필요하므로 완전한 임상 효과를 얻으려면 충분한 시험 기간(일반적으로 6-8주)이 필요합니다.
- 갑자기 투여를 중단해서는 안 됩니다. 금단 증상을 피하기 위해 3-5주에 걸쳐 점진적으로 용량을 줄이는 것이 권장됩니다.
- 식욕 부진은 개에서 흔한 부작용(대개 일시적임)이며, 손으로 직접 먹이를 주거나 음식의 기호성을 높여 관리할 수 있습니다.
작용 기전
Fluvoxamine acts by highly selective inhibition of the serotonin transporter (SERT) in the central nervous system.
Mechanism: Blockade of presynaptic reuptake → increased concentration of serotonin (5-HT) in the synaptic cleft → prolonged receptor stimulation. Over time, this chronic elevation leads to the down-regulation and desensitization of post-synaptic 5-HT receptors, which correlates with the delayed onset of clinical behavioral improvement. It has minimal to no effect on dopamine or norepinephrine reuptake.
안전성·주의사항
금기사항
- Patients with known hypersensitivity to fluvoxamine or other SSRIs
- Concurrent use of Monoamine Oxidase Inhibitors (MAOIs) such as selegiline or amitraz
- Concurrent use of cisapride
부작용
- Anorexia/decreased appetite (common)
- Lethargy or sedation
- Gastrointestinal upset (vomiting, diarrhea)
- Anxiety, irritability, or agitation
- Insomnia or hyperactivity
- Panting (dogs)
- Changes in elimination patterns (cats)
- Paradoxical aggressive behavior in previously non-aggressive dogs
주의
Caution: Use with care in patients with severe cardiac, renal, or hepatic disease. Dosages may need to be reduced in patients with severe renal or hepatic impairment, or in geriatric patients.
- Pregnancy: FDA Category C. Animal studies in rats showed increased pup mortality at birth and decreased birth weights.
- Lactation: Fluvoxamine enters maternal milk, though it appears unlikely to be of significant clinical concern.
약물 상호작용
Fluvoxamine may paradoxically decrease the clinical efficacy of buspirone.
Fluvoxamine may increase plasma levels of cisapride, leading to toxicity. Concurrent use is contraindicated.
May decrease or reverse the effects of SSRIs (useful in treating serotonin syndrome).
Fluvoxamine may increase diazepam (and other benzodiazepine) levels.
Fluvoxamine may increase the effects of diltiazem; bradycardia has been reported in humans.
High risk for serotonin syndrome; contraindicated. A 5-week washout is required after stopping fluvoxamine, and a 2-week washout if stopping the MAOI first.
Fluvoxamine may increase plasma levels of methadone, leading to toxicity.
Increased plasma levels of phenytoin possible.
Fluvoxamine may increase these beta-blockers' plasma levels; atenolol may be safer.
Fluvoxamine may increase plasma levels of theophylline.
SSRIs can inhibit the metabolism of tramadol to active metabolites, decreasing efficacy and increasing toxicity risk (serotonin syndrome, seizures).
Fluvoxamine may increase TCA blood levels and increase the risk for serotonin syndrome.
Fluvoxamine may increase the risk for bleeding.
모니터링
- Clinical efficacy (behavioral improvement)
- Adverse effects, particularly appetite and body weight
- Baseline liver function tests (consider re-testing as needed)
- ECG (consider baseline and re-test as needed)
약동학
반감기
흡수
In dogs, fluvoxamine appears to be completely absorbed. In humans, it is absorbed after oral administration with a bioavailability of around 50%. Food does not appear to affect absorption.
분포
In humans, it is widely distributed in the body and about 80% bound to plasma proteins.
대사
Extensively metabolized in the liver to non-active metabolites.
배설
Eliminated primarily in the urine. In dogs, only about 10% of a dose is excreted unchanged in the urine.
과다투여
Limited data exists for animals. Any dosage over 10 mg/kg can reportedly cause tremors and lethargy.
Clinical Signs of Overdose: Vomiting, somnolence/coma, tremors, diarrhea, hypotension, heart rate/rhythm disturbances (bradycardia/tachycardia, ECG changes), and seizures. Fatalities have been reported in human overdoses.
Treatment:
- Standard protocols for GI decontamination (drug adsorption/removal) for potentially dangerous overdoses.
- Symptomatic and supportive therapy.
- Serotonin Syndrome Management: Cyproheptadine (1.1 mg/kg PO or rectally) may be used as an adjunctive treatment to negate serotonin effects.
- Seizure Control: Diazepam may be used to treat seizures or other severe neurologic signs.
제품
제형
- Oral tablets
- Oral extended-release capsules
인용의약품
- Fluvoxamine Oral Tablets: 25 mg, 50 mg, & 100 mg (Luvox®, generic)
- Fluvoxamine Oral Extended-release Capsules: 100 mg & 150 mg (Luvox CR®)
규제 현황
규제 데이터 없음: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
보관·안정성
Commercially available tablets should be stored in tight containers at room temperatures of 15-30°C (59-86°F) and protected from high humidity.
보호자 정보
- 인내심이 필요합니다: 이 약은 즉각적인 효과를 나타내지 않습니다. 행동의 뚜렷한 개선을 보려면 일반적으로 6-8주 동안 꾸준히 투여해야 합니다.
- 행동 교정: 플루복사민은 전문적인 행동 교정 프로그램과 함께 사용할 때 가장 효과적입니다.
- 부작용: 식욕 감소, 무기력, 구토 또는 비정상적인 행동(불안 증가 또는 공격성)이 나타나는지 관찰하십시오. 반려동물이 먹이를 완전히 거부하면 수의사에게 연락하십시오.
- 안전한 보관: 어린이와 다른 반려동물의 손이 닿지 않는 곳에 엄격히 보관하십시오.
- 갑자기 중단하지 마십시오: 치료를 중단해야 하는 경우, 금단 증상을 피하기 위해 수의사가 점진적으로 용량을 줄이는 방법을 안내할 것입니다.
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