Can't find Fluvoxamine XR? Here are 4 alternative medications your doctor may consider, plus how to switch safely during the ongoing shortage.
Being told your medication is unavailable is never easy — especially when it's a drug you depend on every day. If you've been unable to find Fluvoxamine XR due to the ongoing national shortage, you may be wondering what your options are.
The good news is that there are several effective alternatives in the same drug class that your doctor can consider. But before we get into those, let's quickly cover what Fluvoxamine XR is and how it works — because understanding that will help you have a more informed conversation with your prescriber.
Fluvoxamine XR (extended-release) is a generic medication formerly sold under the brand name Luvox CR. It belongs to a class of drugs called selective serotonin reuptake inhibitors, or SSRIs.
The FDA has approved Fluvoxamine XR for two conditions:
It's also prescribed off-label for depression, PTSD, panic disorder, and generalized anxiety. You can learn more in our full guide: What Is Fluvoxamine XR?
Like other SSRIs, Fluvoxamine works by blocking the reabsorption (reuptake) of serotonin in the brain. This makes more serotonin available, which helps improve mood, reduce anxiety, and decrease obsessive-compulsive symptoms.
What makes Fluvoxamine somewhat unique among SSRIs is its strong activity at the sigma-1 receptor, which may contribute additional anti-anxiety and neuroprotective effects. It's also one of the most potent inhibitors of the CYP1A2 liver enzyme, which is important to know because it affects how it interacts with other drugs — and even caffeine.
For a deeper dive, see: How Does Fluvoxamine XR Work?
If you and your doctor decide it's time to consider a different medication, here are four alternatives that are commonly prescribed for the same conditions. All of these are available as affordable generics.
Important: Never switch medications on your own. Always work with your prescriber, who can help you taper off Fluvoxamine safely and choose the right alternative for your specific situation.
Sertraline is one of the most widely prescribed SSRIs in the world. It's FDA-approved for OCD, social anxiety disorder, panic disorder, PTSD, major depression, and premenstrual dysphoric disorder (PMDD).
Why it's a good alternative: Sertraline covers all the same conditions Fluvoxamine is used for — and more. It's widely available as a generic, with prices as low as $4 to $10 per month with a coupon. It has fewer drug interactions than Fluvoxamine because it's a weaker CYP enzyme inhibitor.
Typical dose: 50 mg to 200 mg daily
Fluoxetine was the first SSRI approved in the United States and remains one of the most prescribed. It's FDA-approved for OCD, major depression, panic disorder, and bulimia nervosa.
Why it's a good alternative: Fluoxetine has a very long half-life (2-6 days), which means missed doses are less likely to cause withdrawal symptoms. It's extremely affordable — as low as $4 per month for generic. It's available in capsules, tablets, and liquid form.
Typical dose: 20 mg to 80 mg daily
Paroxetine is approved for OCD, social anxiety disorder, generalized anxiety disorder, panic disorder, PTSD, and major depression. It's available in both immediate-release and controlled-release (CR) formulations.
Why it's a good alternative: Paroxetine CR offers a similar once-daily extended-release option for patients who prefer that convenience. It's effective for social anxiety disorder, one of the key indications for Fluvoxamine XR. Generic Paroxetine is affordable at $10 to $20 per month with coupons.
Typical dose: 20 mg to 60 mg daily
Note: Paroxetine has a shorter half-life and may cause more withdrawal symptoms if stopped abruptly. It also has more anticholinergic side effects (dry mouth, constipation) than some other SSRIs.
Clomipramine is not an SSRI — it's a tricyclic antidepressant (TCA). However, it was the first drug ever FDA-approved specifically for OCD and remains one of the most effective options for treatment-resistant OCD.
Why it might be considered: If you've tried multiple SSRIs without adequate relief, Clomipramine may be more effective for OCD. It works on both serotonin and norepinephrine. Generic versions are available.
Typical dose: 25 mg to 250 mg daily
Important note: Clomipramine has more side effects than SSRIs, including drowsiness, weight gain, dry mouth, constipation, and cardiac effects. It requires careful monitoring and is generally reserved for cases where SSRIs haven't worked well enough.
Before trying a completely different medication, your doctor may suggest switching from the extended-release capsules to Fluvoxamine immediate-release (IR) tablets. The IR formulation is the same active ingredient, just in a different delivery system.
Fluvoxamine IR is significantly more available and more affordable — as low as $16 to $22 per month with a coupon, compared to $75 to $440 for the extended-release version. The main difference is that IR tablets are taken twice daily instead of once at bedtime.
This switch is often the easiest first step because it keeps you on the same medication with minimal adjustment.
Not being able to fill your Fluvoxamine XR prescription is stressful, but you do have options. Whether it's switching to the more widely available IR formulation or trying a different SSRI like Sertraline or Fluoxetine, your prescriber can help you find a treatment that works.
In the meantime, don't give up on finding Fluvoxamine XR. Use Medfinder to check pharmacy stock near you — availability changes frequently, and a tool that checks in real time can save you a lot of effort.
And remember: never stop taking your medication abruptly. Work with your doctor to taper safely and transition to a new treatment if needed.
You focus on staying healthy. We'll handle the rest.
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