氟伏沙明
Fluvoxamine
Fluvoxamine maleate
別名: Luvox CR · Dumirox · Faverin · Fevarin · DU-23000 · desifluvoxamin · Dumyrox · Favoxil · Felixsan · Flox-ex · Floxyfral · Fluvohexal · Fluvoxadura · Fluvoxin · Maveral
由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
各物種劑量
🌎 NA — North America🌍 EU — Europe
狗
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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).
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
概覽
氟伏沙明 (Fluvoxamine) 是一種選擇性血清素再攝取抑制劑 (SSRI) 抗憂鬱藥，在獸醫學中用於治療犬貓的各種行為障礙，包括攻擊行為和刻板/強迫行為。
雖然不如氟西汀 (fluoxetine) 常用，但它可作為行為管理的替代療法。
臨床重點：
- 與所有 SSRI 一樣，氟伏沙明需要較長的試驗期（通常為 6-8 週）才能達到完全的臨床效果，這是因為神經受體向下調節需要時間。
- 不應突然停藥；建議在 3-5 週內逐漸減量以避免戒斷症狀。
- 食慾不振是犬隻常見的副作用（通常是暫時性的），有時可以透過手餵或增加食物的適口性來改善。
作用機制
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.
安全性與警告
禁忌症
- 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
不良反應
- 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
注意事項
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.
藥物相互作用
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.
監測
- 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)
藥物動力學
半衰期
吸收
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.
分佈
In humans, it is widely distributed in the body and about 80% bound to plasma proteins.
代謝
Extensively metabolized in the liver to non-active metabolites.
排除
Eliminated primarily in the urine. In dogs, only about 10% of a dose is excreted unchanged in the urine.
過量
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.
可用產品
劑型
- Oral tablets
- Oral extended-release capsules
人用標示
- Fluvoxamine Oral Tablets: 25 mg, 50 mg, & 100 mg (Luvox®, generic)
- Fluvoxamine Oral Extended-release Capsules: 100 mg & 150 mg (Luvox CR®)
各地核准狀態
暫無法規資料: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
Commercially available tablets should be stored in tight containers at room temperatures of 15-30°C (59-86°F) and protected from high humidity.
飼主須知
- 需要耐心：此藥物不會立即見效。通常需要持續使用 6 到 8 週才能看到行為的顯著改善。
- 行為訓練：當與專業的行為矯正計畫結合使用時，氟伏沙明最為有效。
- 副作用：請注意食慾下降、嗜睡、嘔吐或異常行為（如焦慮增加或攻擊性）。如果您的寵物完全停止進食，請聯繫您的獸醫。
- 安全存放：請將此藥物嚴格存放在兒童和其他寵物接觸不到的地方。
- 請勿突然停藥：如果需要停止治療，您的獸醫將指導您如何逐漸減少劑量以避免戒斷症狀。
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