Lovan

Lovan - Indications | Dosage | Side Effects

This article was medically reviewed by M.Pharm, Marko Tanaskovic on August 12, 2018. To read more about an author, click here.

Lovan is a medicine that is registered in Australia and contains active ingredient called fluoxetine. It belongs to a family of medicines called selective serotonin uptake inhibitors (SSRIs).

It is believed that the mechanism of action of Lovan is based on the desensitization of somatodendritic serotonin 1A receptors in the mid-brain, because these parts of the brain are thought to be involved in numerous disorders and that the increase in serotonin levels in these brain parts leads to an improvement in symptoms.

Serotonin is also known as the "hormone of happiness", and an increase in its blood levels leads to an improvement of symptoms in depressed and anxiety patients.

Indications

Lovan is indicated in the treatment of the following conditions:

  • Major depressive episodes characterized by severe depressive disorders that disable normal life of the patient.
  • Obsessive-compulsive disorders characterized by the presence of the feeling that an action must be performed in a certain way, because otherwise something bad will happen (e.g. the person thinks he/she must open and close the door exactly five times, otherwise he / she or his/her family will die). Obsessive-compulsive disorders are also characterized by the presence of irrational fear (e.g. a person believes that the sand is too dirty and don't want to touch it).
  • Bulimia nervosa - a disorder characterized by excessive intake of food with followed by vomiting (which is self-induced), excessive exercise or abuse of laxatives, and occurs most often due to the fear of gaining weight.

Lovan can also be used in the treatment of major depression in children aged 8-18 years, if psychotherapeutic measures have not yielded adequate results.

Precautions

Like all other SSRIs, Lovan can also lead to the serotonin syndrome when administered in combination with other drugs. Serotonin syndrome can lead to severe heart problems and can endanger the patient's life. For this reason, it is very important that you inform the doctor about all the medicines you are using before starting the therapy.

Interactions

The risk of serotonin syndrome increases if Lovan is administered concurrently with the following drugs:

  • Monoamine oxidase inhibitors used in the treatment of depression, such as: phenelzine, tranylcypromine, isocarboxazide, and moclobemide.
  • Monoamine oxidase inhibitors used in the treatment of Parkinson's disease, such as: selegiline and rasagiline.
  • Linezolid (also a monoamine oxidase inhibitor) used as an antibiotic in the treatment of numerous infections.
  • Medicines used in the treatment of migraine, such as: zolmitriptan, almotriptan, sumatriptan, eletriptan, frovatriptan, naratriptan, rizatriptan and dihydroergotamine.
  • Medicines used for the prevention of chemo-induced nausea, such as: granisetron and ondansetron.
  • 5-hydroxytryptophan and tryptophan used in the treatment of depression and fibromyalgia.
  • Opioid analgesics, such as: pentazocine, codeine, hydrocodone, oxycodone, oxymorphone, hydromorphone, morphine, tramadol, fentanyl, and alfentanil.
  • Buspirone - anxiolytic agent used in the treatment of generalized anxiety disorder.
  • Other selective serotonin reuptake inhibitors, such as: citalopram, escitalopram, sertraline, fluvoxamine, and paroxetine.
  • Cyclobenzaprine - medicine used to treat chronic musculoskeletal disease.

Lovan should not be used concomitantly with the following medicines:

  • Dextromethorphan - non-opioid antitussive used in the treatment of non-productive cough. Concomitant use may increase the risk of side effects of dextromethorphan, such as: restlessness, confusion, drowsiness, nervousness and difficulty breathing.
  • Bedaquiline - a new medicine for the treatment of tuberculosis. Bedaquiline can cause serious arrhythmias and this risk increases if bedaquiline is administered concurrently with Lovan.
  • Bepridil - calcium blocker used to treat angina pectoris. Concomitant use may increase the risk of arrhythmias.
  • Bupropion - medicine used to help quit smoking as well as in the therapy of depression. Bupropion and Lovan can cause seizures, and concomitant use increases the risk of seizures.
  • Eliglustat - medicine used to treat Gaucher disease. Concomitant use increases the risk of heart failure.
  • Clopidogrel - antithrombotic agent used for secondary prevention of heart attack and stroke. Lovan reduces the effectiveness of clopidogrel, which increases the risk of heart attack and stroke.
  • Tricyclic antidepressants, such as: amitriptyline, clomipramine, nortriptyline, imipramine, and desimipramine. Concomitant use increases the risk of urinary retention, constipation, and visual disturbances.
  • Cisapride - medicine used to treat gastroesophageal reflux. Concomitant use increases the risk of arrhythmias.

This is not a list of all medicines that may interact with Lovan. You should inform your doctor about all the medicines you are taking.

Lovan, Pregnancy and Breastfeeding

The FDA classifies this drug in group C. The European Network of Teratology Information Services conducted a prospective cohort study that showed an increased risk of cardiovascular malformations in the fetus whose mothers had taken Lovan during pregnancy. For this reason, Lovan should be used only if the benefit to the mother outweighs the risk to the fetus.

Given that Lovan is excreted in breast milk, breastfeeding must be avoided while taking this medicine.

Dosage

Adults

The recommended dose in the treatment of major depression and obsessive-compulsive disorder is 20-80 mg per day. A dose of 20 mg achieves a therapeutic effect in most patients. The recommended starting dose is 20 mg once a day, in the morning.

The recommended starting dose for panic disorder therapy is 10 mg per day. The dose may be gradually increased to a maximum of 60 mg per day.

The recommended dose for bulimia nervosa therapy is 60 mg per day. The therapy should start with lower doses and gradually be increased.

The duration of therapy depends on the severity of the condition. Your doctor will tell you how long you need to take this medicine.

Side Effects

Lovan may cause the following side effects:

  • Asthenia - chronic feeling of tiredness.
  • Nausea.
  • Vomiting.
  • Dry mouth.
  • Dyspepsia.
  • Anorexia and decreased appetite.
  • Decreased libido.
  • Insomnia.
  • Nightmares.
  • Disorders of antidiuretic hormone secretion.
  • Involuntary and excessive grinding of teeth (called bruxism).
  • Suicidal thoughts and ideation.
  • Serotonin syndrome.
  • Blurred vision.
  • Low blood pressure.
  • Difficulty swallowing.
  • Muscle pain.
  • Urinary retention.
  • Feeling cold.
  • Feeling hot.
  • Lethargy.
  • Decrease in sodium concentration in the blood.
  • Allergic reactions.

Tell your doctor if you are experiencing any side effects.

References

  1. FDA
  2. NCBI link

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