fluvoxamine Indications/Contra | FAERs-F | FAERs-M | Orange Bk | BioActivity |

Stem definition	Drug id	CAS RN
	1230	54739-18-3

Description:

Molecule	Description
Molfile Inchi Smiles Synonyms: fluvoxamine fluvoxamine maleate depromel	A selective serotonin reuptake inhibitor that is used in the treatment of DEPRESSION and a variety of ANXIETY DISORDERS. Because of its high affinity at the sigma-1 receptor, the drug was evaluated whether could prevent clinical deterioration in patients with COVID-19. At the moment, there are insufficient data to recommend either for or against use of fluvoxamine for the treatment of COVID-19. Molecular weight: 318.34 Formula: C15H21F3N2O2 CLOGP: 3.03 LIPINSKI: 0 HAC: 4 HDO: 1 TPSA: 56.84 ALOGS: -4.64 ROTB: 10 Status: OFP Legend: OFP - off patent OFM - off market ONP - on patent

Molecule

Description

Molfile Inchi Smiles

Synonyms:

fluvoxamine
fluvoxamine maleate
depromel

A selective serotonin reuptake inhibitor that is used in the treatment of DEPRESSION and a variety of ANXIETY DISORDERS. Because of its high affinity at the sigma-1 receptor, the drug was evaluated whether could prevent clinical deterioration in patients with COVID-19. At the moment, there are insufficient data to recommend either for or against use of fluvoxamine for the treatment of COVID-19.

Molecular weight: 318.34
Formula: C15H21F3N2O2
CLOGP: 3.03
LIPINSKI: 0
HAC: 4
HDO: 1
TPSA: 56.84
ALOGS: -4.64
ROTB: 10

Status: OFP

Legend:
OFP - off patent
OFM - off market
ONP - on patent

Drug dosage:

Dose	Unit	Route
0.10	g	O

ADMET properties:

Property	Value	Reference
BDDCS (Biopharmaceutical Drug Disposition Classification System)	1	Benet LZ, Broccatelli F, Oprea TI
S (Water solubility)	14.87 mg/mL	Benet LZ, Broccatelli F, Oprea TI
EoM (Fraction excreted unchanged in urine)	2 %	Benet LZ, Broccatelli F, Oprea TI
MRTD (Maximum Recommended Therapeutic Daily Dose)	13.46 µM/kg/day	Contrera JF, Matthews EJ, Kruhlak NL, Benz RD
BA (Bioavailability)	53 %	Kim MT, Sedykh A, Chakravarti SK, Saiakhov RD, Zhu H
Vd (Volume of distribution)	23.50 L/kg	Lombardo F, Berellini G, Obach RS
CL (Clearance)	31.95 mL/min/kg	Lombardo F, Berellini G, Obach RS
fu (Fraction unbound in plasma)	0.20 %	Lombardo F, Berellini G, Obach RS
t_half (Half-life)	12.50 hours	Lombardo F, Berellini G, Obach RS

Approvals:

Date	Agency	Company	Orphan
Dec. 5, 1994	FDA

FDA Adverse Event Reporting System (Female)

MedDRA adverse event term	Likelihood ratio	Likelihood ratio threshold	Patients taking drug having adverse event	Patients taking drug not having adverse event	Patients not taking drug having adverse event	Patients not taking drug not having adverse event
Drug interaction	148.42	18.86	149	5371	202945	46477597
Suicide attempt	103.17	18.86	70	5450	54966	46625576
Intentional self-injury	93.31	18.86	49	5471	24117	46656425
Intentional overdose	88.32	18.86	68	5452	64876	46615666
Toxicity to various agents	72.60	18.86	106	5414	211660	46468882
Obsessive-compulsive disorder	67.71	18.86	22	5498	3193	46677349
Serotonin syndrome	65.83	18.86	39	5481	24181	46656361
Suicidal ideation	55.57	18.86	49	5471	56333	46624209
Drug abuse	54.45	18.86	51	5469	63357	46617185
Neuroleptic malignant syndrome	52.96	18.86	26	5494	11096	46669446
Anxiety	50.92	18.86	83	5437	181874	46498668
Somnolence	43.22	18.86	71	5449	156450	46524092
Oscillopsia	41.58	18.86	8	5512	130	46680412
Schizophrenia	40.70	18.86	20	5500	8548	46671994
Completed suicide	40.02	18.86	66	5454	145854	46534688
Mydriasis	36.77	18.86	20	5500	10533	46670009
Electrocardiogram QT prolonged	36.04	18.86	37	5483	51288	46629254
Drug level increased	33.41	18.86	23	5497	18418	46662124
Torsade de pointes	31.52	18.86	19	5501	12135	46668407
Depression	30.37	18.86	64	5456	170040	46510502
Blood creatine phosphokinase increased	29.11	18.86	25	5495	27699	46652843
Tremor	28.62	18.86	50	5470	115589	46564953
Galactorrhoea	27.89	18.86	12	5508	3785	46676757
Overdose	27.75	18.86	46	5474	101933	46578609
Sopor	27.42	18.86	21	5499	19807	46660735
Mental disorder	27.24	18.86	22	5498	22403	46658139
Drug screen false positive	26.88	18.86	8	5512	869	46679673
Personality disorder	26.68	18.86	11	5509	3122	46677420
Delirium	26.42	18.86	27	5493	37201	46643341
Activation syndrome	26.26	18.86	6	5514	230	46680312
Depersonalisation/derealisation disorder	25.76	18.86	8	5512	1002	46679540
Restlessness	24.75	18.86	22	5498	25502	46655040
Alice in wonderland syndrome	23.50	18.86	4	5516	31	46680511
Dysarthria	22.71	18.86	25	5495	37473	46643069
Depressed level of consciousness	22.61	18.86	28	5492	47541	46633001
Agitation	22.24	18.86	30	5490	55385	46625157
Akinesia	21.23	18.86	8	5512	1793	46678749
Anaemia folate deficiency	20.59	18.86	5	5515	250	46680292
Congestive cardiomyopathy	20.38	18.86	11	5509	5702	46674840
Dysphoria	19.69	18.86	10	5510	4579	46675963
Aspiration of gastric residual	19.30	18.86	3	5517	12	46680530
Psychotic disorder	19.01	18.86	18	5502	22603	46657939

FDA Adverse Event Reporting System (Male)

MedDRA adverse event term	Likelihood ratio	Likelihood ratio threshold	Patients taking drug having adverse event	Patients taking drug not having adverse event	Patients not taking drug having adverse event	Patients not taking drug not having adverse event
Loss of libido	120.05	20.49	33	4714	2009	29945722
Apathy	109.20	20.49	40	4707	6192	29941539
Drug interaction	107.25	20.49	144	4603	199424	29748307
Schizophrenia	104.85	20.49	43	4704	9005	29938726
Psychotic disorder	98.85	20.49	54	4693	21461	29926270
Serotonin syndrome	96.56	20.49	50	4697	17841	29929890
Neuroleptic malignant syndrome	95.08	20.49	48	4699	16247	29931484
Suicidal ideation	84.67	20.49	59	4688	36055	29911676
Obsessive-compulsive disorder	66.72	20.49	25	4722	4116	29943615
Persecutory delusion	53.86	20.49	18	4729	2122	29945609
Toxicity to various agents	51.83	20.49	97	4650	177086	29770645
Depression	50.95	20.49	67	4680	90370	29857361
Weight increased	46.10	20.49	58	4689	74855	29872876
Intentional overdose	42.60	20.49	42	4705	41439	29906292
Catatonia	41.32	20.49	18	4729	4362	29943369
Anxiety	40.75	20.49	60	4687	89811	29857920
Aggression	39.07	20.49	38	4709	36869	29910862
Completed suicide	38.88	20.49	62	4685	99430	29848301
Sopor	38.14	20.49	23	4724	10968	29936763
Salivary hypersecretion	34.73	20.49	19	4728	7547	29940184
Social avoidant behaviour	34.48	20.49	14	4733	2849	29944882
Hanging	34.32	20.49	7	4740	114	29947617
Agitation	33.44	20.49	42	4705	54031	29893700
Suicide attempt	31.94	20.49	34	4713	36663	29911068
Respiratory fatigue	31.61	20.49	6	4741	66	29947665
Obsessive thoughts	31.06	20.49	9	4738	662	29947069
Antipsychotic drug level above therapeutic	30.95	20.49	10	4737	1060	29946671
Akathisia	30.39	20.49	16	4731	5888	29941843
Cyclothymic disorder	30.27	20.49	6	4741	84	29947647
Neonatal behavioural syndrome	28.75	20.49	6	4741	110	29947621
Tic	28.18	20.49	11	4736	2021	29945710
Encephalitis toxic	27.84	20.49	6	4741	129	29947602
Sedation	27.66	20.49	22	4725	16351	29931380
Tremor	26.75	20.49	45	4702	75318	29872413
Heat stroke	24.63	20.49	8	4739	862	29946869
Blood creatine phosphokinase increased	23.88	20.49	32	4715	43816	29903915
Somnolence	23.38	20.49	49	4698	96714	29851017
Drug withdrawal syndrome	22.08	20.49	21	4726	19788	29927943
Impulsive behaviour	21.59	20.49	9	4738	1956	29945775
Mental impairment	21.33	20.49	15	4732	9262	29938469
Cerebellar atrophy	20.87	20.49	6	4741	429	29947302
Inappropriate antidiuretic hormone secretion	20.70	20.49	16	4731	11406	29936325

Pharmacologic Action:

Source	Code	Description
ATC	N06AB08	NERVOUS SYSTEM PSYCHOANALEPTICS ANTIDEPRESSANTS Selective serotonin reuptake inhibitors
FDA MoA	N0000000109	Serotonin Uptake Inhibitors
FDA EPC	N0000175696	Serotonin Reuptake Inhibitor
CHEBI has role	CHEBI:35469	thymoanaleptics
CHEBI has role	CHEBI:35474	minor tranquilisers
CHEBI has role	CHEBI:50949	serotonin reuptake inhibitor
MeSH PA	D014151	Anti-Anxiety Agents
MeSH PA	D000928	Antidepressive Agents
MeSH PA	D018687	Antidepressive Agents, Second-Generation
MeSH PA	D002491	Central Nervous System Agents
MeSH PA	D002492	Central Nervous System Depressants
MeSH PA	D065609	Cytochrome P-450 CYP1A2 Inhibitors
MeSH PA	D065689	Cytochrome P-450 CYP2C19 Inhibitors
MeSH PA	D065607	Cytochrome P-450 Enzyme Inhibitors
MeSH PA	D004791	Enzyme Inhibitors
MeSH PA	D049990	Membrane Transport Modulators
MeSH PA	D065606	Metabolic Side Effects of Drugs and Substances
MeSH PA	D018377	Neurotransmitter Agents
MeSH PA	D014179	Neurotransmitter Uptake Inhibitors
MeSH PA	D011619	Psychotropic Drugs
MeSH PA	D018490	Serotonin Agents
MeSH PA	D017367	Serotonin Uptake Inhibitors
MeSH PA	D014149	Tranquilizing Agents

Drug Use (View source of the data)

Disease	Relation	SNOMED_ID	DOID
Social phobia	indication	25501002	DOID:11257
Obsessive-compulsive disorder	indication	191736004	DOID:10933
Depressive disorder	off-label use	35489007
Posttraumatic stress disorder	off-label use	47505003	DOID:2055
Bipolar affective disorder, current episode depression	off-label use	191627008	DOID:3312
Suicidal thoughts	contraindication	6471006
Bipolar disorder	contraindication	13746004	DOID:3312
Neuroleptic malignant syndrome	contraindication	15244003	DOID:14464
Upper gastrointestinal hemorrhage	contraindication	37372002
Syndrome of inappropriate vasopressin secretion	contraindication	55004003	DOID:3401
Blood coagulation disorder	contraindication	64779008	DOID:1247
Epilepsy	contraindication	84757009	DOID:1826
Hyponatremia	contraindication	89627008
Mania	contraindication	231494001
Hypomania	contraindication	231496004
Disease of liver	contraindication	235856003	DOID:409
Serotonin syndrome	contraindication	371089000
Breastfeeding (mother)	contraindication	413712001
Poor metabolizer due to cytochrome p450 CYP2D6 variant	contraindication	423629005
Smokes tobacco daily	contraindication	449868002

Acid dissociation constants calculated using MoKa v3.0.0

Dissociation level	Dissociation constant	Type (acidic/basic)
pKa1	9.36	Basic

Orange Book patent data (new drug applications)

None

Orange Book exclusivity data (new drug applications)

None

Bioactivity Summary:

Target	Class	Pharos	UniProt	Action	Type	Activity value (-log[M])	Bioact source	MoA source
Sodium-dependent serotonin transporter	Transporter	P31645	SC6A4_HUMAN	INHIBITOR	Ki	8.51	WOMBAT-PK	CHEMBL
Sodium-dependent dopamine transporter	Transporter	Q01959	SC6A3_HUMAN		Ki	8.84	CHEMBL
Sigma non-opioid intracellular receptor 1	Membrane receptor	Q99720	SGMR1_HUMAN		Ki	7.44	CHEMBL
Cytochrome P450 1A2	Enzyme	P05177	CP1A2_HUMAN		Ki	5.07	WOMBAT-PK
Sodium-dependent noradrenaline transporter	Transporter	P23975	SC6A2_HUMAN		Ki	5.95	PDSP
Sigma non-opioid intracellular receptor 1	Membrane receptor		SGMR1_RAT		Ki	7.44	CHEMBL
Sodium-dependent serotonin transporter	Transporter		SC6A4_RAT	INHIBITOR	Ki	8.19	IUPHAR

External reference:

ID	Source
4023976	VUID
N0000021981	NUI
D00824	KEGG_DRUG
61718-82-9	SECONDARY_CAS_RN
4020892	VANDF
4023976	VANDF
C0085228	UMLSCUI
CHEBI:5138	CHEBI
FVX	PDB_CHEM_ID
CHEMBL814	ChEMBL_ID
CHEMBL1409	ChEMBL_ID
DB00176	DRUGBANK_ID
D016666	MESH_DESCRIPTOR_UI
9560989	PUBCHEM_CID
7189	IUPHAR_LIGAND_ID
3879	INN_ID
O4L1XPO44W	UNII
203143	RXNORM
40916	MMSL
4758	MMSL
d03804	MMSL
003633	NDDF
003634	NDDF
116522003	SNOMEDCT_US
372905008	SNOMEDCT_US
96213009	SNOMEDCT_US

Pharmaceutical products:

Product	Category	Ingredients	NDC	Form	Quantity	Route	Marketing	Label
Fluvoxamine Maleate	HUMAN PRESCRIPTION DRUG LABEL	1	0228-2848	CAPSULE, EXTENDED RELEASE	100 mg	ORAL	ANDA	21 sections
Fluvoxamine Maleate	HUMAN PRESCRIPTION DRUG LABEL	1	0228-2849	CAPSULE, EXTENDED RELEASE	150 mg	ORAL	ANDA	21 sections
Fluvoxamine maleate	HUMAN PRESCRIPTION DRUG LABEL	1	0832-1670	TABLET, FILM COATED	25 mg	ORAL	ANDA	34 sections
Fluvoxamine maleate	HUMAN PRESCRIPTION DRUG LABEL	1	0832-1671	TABLET, FILM COATED	50 mg	ORAL	ANDA	34 sections
Fluvoxamine maleate	HUMAN PRESCRIPTION DRUG LABEL	1	0832-1672	TABLET, FILM COATED	100 mg	ORAL	ANDA	34 sections
Fluvoxamine Maleate	HUMAN PRESCRIPTION DRUG LABEL	1	10370-175	CAPSULE, EXTENDED RELEASE	100 mg	ORAL	ANDA	30 sections
Fluvoxamine Maleate	HUMAN PRESCRIPTION DRUG LABEL	1	10370-176	CAPSULE, EXTENDED RELEASE	150 mg	ORAL	ANDA	30 sections
Fluvoxamine Maleate	HUMAN PRESCRIPTION DRUG LABEL	1	16590-270	TABLET	25 mg	ORAL	NDA	11 sections
fluvoxamine maleate	HUMAN PRESCRIPTION DRUG LABEL	1	33261-683	TABLET, COATED	50 mg	ORAL	NDA AUTHORIZED GENERIC	31 sections
Fluvoxamine Maleate	HUMAN PRESCRIPTION DRUG LABEL	1	60505-0164	TABLET	25 mg	ORAL	ANDA	32 sections
Fluvoxamine Maleate	HUMAN PRESCRIPTION DRUG LABEL	1	60505-0165	TABLET	50 mg	ORAL	ANDA	32 sections
Fluvoxamine Maleate	HUMAN PRESCRIPTION DRUG LABEL	1	60505-0166	TABLET	100 mg	ORAL	ANDA	32 sections
fluvoxamine maleate	HUMAN PRESCRIPTION DRUG LABEL	1	62559-158	TABLET, COATED	25 mg	ORAL	NDA authorized generic	31 sections
fluvoxamine maleate	HUMAN PRESCRIPTION DRUG LABEL	1	62559-159	TABLET, COATED	50 mg	ORAL	NDA authorized generic	31 sections
fluvoxamine maleate	HUMAN PRESCRIPTION DRUG LABEL	1	62559-160	TABLET, COATED	100 mg	ORAL	NDA authorized generic	31 sections
fluvoxamine maleate	HUMAN PRESCRIPTION DRUG LABEL	1	63629-8018	TABLET, COATED	25 mg	ORAL	NDA authorized generic	31 sections
fluvoxamine maleate	HUMAN PRESCRIPTION DRUG LABEL	1	68071-2337	TABLET, COATED	50 mg	ORAL	NDA authorized generic	31 sections
fluvoxamine maleate	HUMAN PRESCRIPTION DRUG LABEL	1	68151-0637	TABLET, COATED	50 mg	ORAL	NDA authorized generic	31 sections
fluvoxamine maleate	HUMAN PRESCRIPTION DRUG LABEL	1	68788-7219	TABLET, COATED	100 mg	ORAL	NDA authorized generic	31 sections
Fluvoxamine Maleate	HUMAN PRESCRIPTION DRUG LABEL	1	69452-182	CAPSULE, EXTENDED RELEASE	100 mg	ORAL	ANDA	22 sections
Fluvoxamine Maleate	HUMAN PRESCRIPTION DRUG LABEL	1	69452-183	CAPSULE, EXTENDED RELEASE	150 mg	ORAL	ANDA	22 sections
fluvoxamine maleate	HUMAN PRESCRIPTION DRUG LABEL	1	70518-1057	TABLET, COATED	100 mg	ORAL	NDA authorized generic	31 sections
fluvoxamine maleate	HUMAN PRESCRIPTION DRUG LABEL	1	70518-1643	TABLET, COATED	50 mg	ORAL	NDA authorized generic	31 sections
fluvoxamine maleate	HUMAN PRESCRIPTION DRUG LABEL	1	71335-0264	TABLET, COATED	100 mg	ORAL	NDA authorized generic	31 sections