thank you for that I fully understand what your saying........I agree but I also know Australia has more wanings about possable medication interaction extra. Australia takes longer to approve new medication, we dont have all the medication that america has, and even the really old medication that american's say are old are still the most commen meds to be given to Australian's.......
Our warning system for medications is very high....what I find interesting is and confusing is that when reading about luvox my main medication I read that zyprexa and diazepam is more likly to interact with luvox. The main interaction being something to with the way your body matbilizes thr=em together what ever than being, I'v also read from other web pages that carbanazeepine might interact with luvox. Yet I have been precribe all 3 by different Dr's.
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Drug interactions
Fluvoxamine has a low potential for the
drug interactions which are based on inhibition of enzyme
Cytochrome P450 CYP2D6. Fluvoxamine shows the least interaction of the SSRIs, in regard to this specific enzyme.
[21][22][23] Naturally the other SSRIs which are metabolized by CYP2D6 will have more CYP2D6-based interactions with TCAs, antiarrhythmics, B-blockers, phenytoin, opiates (eg. codeine, dextromethorphan, morphine, tramadol) and neuroleptics (eg. haloperidol, risperidone).
Fluvoxamine does, however, inhibit cytochrome P450 enzyme
CYP1A2, which metabolises
Agomelatine,
caffeine,
clozapine,
haloperidol,
phenacetin,
tacrine,
theophylline, and
olanzapine. These substances can cause increased serum levels when administered together with fluvoxamine. Of major concern is the fact that the
polycyclic aromatic hydrocarbons found in tobacco smoke are potent inducers of CYP1A2 so that smokers may require significant modification of medication dosage.
[24] A recent warning has been published regarding potentially serious interaction with
Tizanidine, based on CYP1A2 metabolism.
[25]
Fluvoxamine inhibits metabolism of
diazepam and
phenytoin via
CYP2C19 and inhibits metabolism of
aripiprazole,
chlorpromazine,
clozapine,
haloperidol,
olanzapine,
perphenazine,
risperidone,
thioridazine and
zuclopenthixol via
CYP2D6 as well as inhibiting metabolism of
aripiprazole,
clozapine,
haloperidol,
quetiapine,
risperidone and
ziprasidone via
CYP3A4.
[26]
The plasma protein binding of fluvoxamine is about 77%. Drugs with low protein binding are less likely to displace other protein bound drugs, and therefore have a lower potential to cause protein binding-related drug interactions.
Fluvoxamine also inhibits: CYP3A4, CYP2C9, and CYP2C19
[19] [27]
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I think in australia we have medication that CANT be mix EVA together and other medication that are negotable but require lots of monitoring by Drs to check for reaction, or changes. I think luvox is very suseptable to reduced effectiveness with other medication. Specially with caffine I cant drink caffine with out feeling like I have not taken my medication properly. If can take zyprexa, diazepam, carbamazeepine, at different times over the corse of using luvox than I dont see why I cant use amitriptyline now. In australia the warning are there to protect people and keep them at ther PECK health if the posiable side effect out way the problem that is causeing serious lack of quality of life then a Dr has to decide which is the better option living with the med of trying the med and watching for posable symtoms. I think I'm at my bracking point and after taking the med the first night with out the Dr knowing that there posible interaction I felt so great the next day I already felt so much better.....I'm hoping I get this Dr let me take it and I'll stop if anything negative happens.......I cant keep on trying to get threw my day the way I have been feeling and if insomnia is causeing these problem which I kinda feel in at part that is true, insomnia is making my symtoms worse, I've always had issues but I could tolerate them now I struggling to tolerate any thing cause it gotten to bad......I just want to sleep....I get more side effect from nitrazepam than I did from Amitriptyline......Notrazepam makes me apear drunk the next day mainly due to sluring of speach. I have to keep explaining it my medication. The night after amitriptyline I had no slured speach I felt heavey eyes but my partner was saying i was specking clear and I felt so alert but on to anxiety triggers alert and responcive in conversation I did not feel I had to concetrate on just keeping my self upright. I think the benifits out weight any risk of posiable interaction it may even mean i wont need nitrazepam much or at all if I can do things easier I should be able to control panic better.