Fluvoxamine interactions
Fluvoxamine (Luvox), an SSRI has 249 documented interactions across the FDA labels and fact sheets we index: 72 major, 158 moderate, 18 minor, and 1 where a label reports no significant interaction. Each entry below quotes the sentence behind it. This drug page is a starting point, not a verdict for your situation.
Major interactions (72)
As with other psychotropic medications, patients should be advised to avoid alcohol while taking Fluvoxamine Maleate Tablets. (Fluvoxamine label, Drug interactions)
- AlosetronMajor
Coadministration Coadministration of tizanidine, thioridazine, alosetron, or pimozide with Fluvoxamine Maleate Tablets is contraindicated [see Warnings and Precautions ( 5.4 , 5.5 , 5.6 , 5.7 )] . (Fluvoxamine label, Contraindications)
Anyone considering the use of Fluvoxamine Maleate Tablets or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. (Fluvoxamine label, Boxed warning)
Serotonin Syndrome: Increased risk when coadministered with serotonergic agents (e.g., selective serotonin reuptake inhibitors (SSRIs), serotonin norepinephrine reuptake inhibitors (SNRIs), triptans), but also during overdosage situations. (Amphetamine and dextroamphetamine label, Warnings and precautions)
Serotonergic Drugs : Concomitant use may result in serotonin syndrome. (Buprenorphine label, Drug interactions)
Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (Buprenorphine and naloxone label, Drug interactions)
Anyone considering the use of Fluvoxamine Maleate Tablets or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. (Fluvoxamine label, Boxed warning)
If concomitant use of Fluvoxamine Maleate Tablets with other serotonergic drugs is clinically warranted, patients should be made aware of a potential increased risk for serotonin syndrome, particularly during treatment initiation and dose increases. (Fluvoxamine label, Warnings and precautions)
- ButorphanolopioidMajor
…medical attention if they experience symptoms of hyperalgesia, including worsening pain, increased sensitivity to pain, or new pain [see WARNINGS ; ADVERSE REACTIONS ]. Serotonin Syndrome Inform patients that butorphanol tartrate could cause a rare but potentially life-threatening condition resulting from concomitant administration of serotonergic drugs. (Butorphanol label, Precautions)
Known hypersensitivity to tricyclic antidepressants ( 4 ) (Carbamazepine label, Contraindications)
Anyone considering the use of Fluvoxamine Maleate Tablets or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. (Fluvoxamine label, Boxed warning)
CYP2C19 inhibitors: Avoid concomitant use of omeprazole or esomeprazole. (Clopidogrel label, Warnings and precautions)
- CodeineopioidMajor
• Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (Codeine label, Drug interactions)
If concomitant use of Fluvoxamine Maleate Tablets with other serotonergic drugs is clinically warranted, patients should be made aware of a potential increased risk for serotonin syndrome, particularly during treatment initiation and dose increases. (Fluvoxamine label, Warnings and precautions)
- DesvenlafaxineSNRIMajor
Anyone considering the use of Fluvoxamine Maleate Tablets or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. (Fluvoxamine label, Boxed warning)
If concomitant use of Fluvoxamine Maleate Tablets with other serotonergic drugs is clinically warranted, patients should be made aware of a potential increased risk for serotonin syndrome, particularly during treatment initiation and dose increases. (Fluvoxamine label, Warnings and precautions)
- Dihydroergotamineergot alkaloidMajor
If concomitant use of Fluvoxamine Maleate Tablets with other serotonergic drugs is clinically warranted, patients should be made aware of a potential increased risk for serotonin syndrome, particularly during treatment initiation and dose increases. (Fluvoxamine label, Warnings and precautions)
Anyone considering the use of Fluvoxamine Maleate Tablets or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. (Fluvoxamine label, Boxed warning)
- DronedaroneantiarrhythmicMajor
…(12.3) ] • Concomitant use of drugs or herbal products that prolong the QT interval and might increase the risk of torsade de pointes, such as phenothiazine antipsychotics, tricyclic antidepressants, certain oral macrolide antibiotics, and Class I and III antiarrhythmics • Liver or lung toxicity related to the previous use of amiodarone • QTc interval >500 ms or… (Dronedarone label, Contraindications)
Anyone considering the use of Fluvoxamine Maleate Tablets or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. (Fluvoxamine label, Boxed warning)
- EdoxabananticoagulantMajor
Anticoagulants, Antiplatelets, Thrombolytics, and Selective Serotonin Reuptake Inhibitors (SSRIs)/Serotonin Norepinephrine Reuptake Inhibitors (SNRIs): Avoid concomitant use due to increased risk of bleeding. (Edoxaban label, Drug interactions)
- EletriptantriptanMajor
If concomitant use of Fluvoxamine Maleate Tablets with other serotonergic drugs is clinically warranted, patients should be made aware of a potential increased risk for serotonin syndrome, particularly during treatment initiation and dose increases. (Fluvoxamine label, Warnings and precautions)
Anyone considering the use of Fluvoxamine Maleate Tablets or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. (Fluvoxamine label, Boxed warning)
• Serotonin Syndrome : Potentially life-threatening condition could result from concomitant serotonergic drug administration. (Fentanyl label, Warnings and precautions)
- FlibanserinCNS depressantMajor
If concomitant use of Fluvoxamine Maleate Tablets with other serotonergic drugs is clinically warranted, patients should be made aware of a potential increased risk for serotonin syndrome, particularly during treatment initiation and dose increases. (Fluvoxamine label, Warnings and precautions)
Anyone considering the use of Fluvoxamine Maleate Tablets or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. (Fluvoxamine label, Boxed warning)
- GranisetronQT-prolonging drugMajor
If concomitant use of Fluvoxamine Maleate Tablets with other serotonergic drugs is clinically warranted, patients should be made aware of a potential increased risk for serotonin syndrome, particularly during treatment initiation and dose increases. (Fluvoxamine label, Warnings and precautions)
Serotonin Syndrome Inform patients that hydrocodone bitartrate and acetaminophen tablets could cause a rare but potentially life-threatening condition resulting from concomitant administration of serotonergic drugs. (Hydrocodone and acetaminophen label, Precautions)
• Serotonergic Drugs : Concomitant use may result in serotonin syndrome. (Hydromorphone label, Drug interactions)
- IsoniazidantibioticMajor
Serotonin Syndrome and Monoamine Oxidase Inhibitors (MAOIs) The use of MAOIs intended to treat psychiatric disorders with Fluvoxamine Maleate Tablets or within 14 days of stopping treatment with Fluvoxamine Maleate Tablets is contraindicated because of an increased risk of serotonin syndrome. (Fluvoxamine label, Contraindications)
- LevomilnacipranSNRIMajor
Anyone considering the use of Fluvoxamine Maleate Tablets or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. (Fluvoxamine label, Boxed warning)
- LevorphanolopioidMajor
Serotonin Syndrome Inform patients that opioids could cause a rare but potentially life-threatening condition resulting from concomitant administration of serotonergic drugs. (Levorphanol label, Precautions)
- LinezolidantibioticMajor
Starting Fluvoxamine Maleate Tablets in a patient who is being treated with MAOIs such as linezolid or intravenous methylene blue is also contraindicated because of an increased risk of serotonin syndrome [see Dosage and Administration ( 2.5 ), Warnings and Precautions ( 5.2 )] . (Fluvoxamine label, Contraindications)
• Serotonin Syndrome: Increased risk when co-administered with serotonergic agents (e.g., SSRIs, SNRIs, triptans), but also during overdosage situations. (Lisdexamfetamine label, Warnings and precautions)
If concomitant use of Fluvoxamine Maleate Tablets with other serotonergic drugs is clinically warranted, patients should be made aware of a potential increased risk for serotonin syndrome, particularly during treatment initiation and dose increases. (Fluvoxamine label, Warnings and precautions)
LOREEV XR should not be used in such patients without adequate antidepressant therapy. (Lorazepam label, Warnings and precautions)
- MeperidineopioidMajor
If concomitant use of Fluvoxamine Maleate Tablets with other serotonergic drugs is clinically warranted, patients should be made aware of a potential increased risk for serotonin syndrome, particularly during treatment initiation and dose increases. (Fluvoxamine label, Warnings and precautions)
Serotonin Syndrome : Potentially life-threatening condition could result from concomitant serotonergic drug administration. (Methadone label, Warnings and precautions)
Anyone considering the use of Fluvoxamine Maleate Tablets or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. (Fluvoxamine label, Boxed warning)
• Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (Morphine label, Drug interactions)
- Naltrexone and bupropionopioid antagonistMajor
Anyone considering the use of Fluvoxamine Maleate Tablets or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. (Fluvoxamine label, Boxed warning)
Anyone considering the use of Fluvoxamine Maleate Tablets or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. (Fluvoxamine label, Boxed warning)
- OliceridineopioidMajor
Serotonergic Drugs : Concomitant use may result in serotonin syndrome. (Oliceridine label, Drug interactions)
If concomitant use of Fluvoxamine Maleate Tablets with other serotonergic drugs is clinically warranted, patients should be made aware of a potential increased risk for serotonin syndrome, particularly during treatment initiation and dose increases. (Fluvoxamine label, Warnings and precautions)
Serotonergic Drug s: Concomitant use may result in serotonin syndrome. (Oxycodone label, Drug interactions)
- OxymorphoneopioidMajor
Serotonergic Drugs : Concomitant use may result in serotonin syndrome. (Oxymorphone label, Drug interactions)
Anyone considering the use of Fluvoxamine Maleate Tablets or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. (Fluvoxamine label, Boxed warning)
- Pentazocine and naloxoneopioidMajor
Serotonin Syndrome Inform patients that opioids could cause a rare but potentially life-threatening condition resulting from concomitant administration of serotonergic drugs. (Pentazocine and naloxone label, Precautions)
- PhenelzineMAO inhibitorMajor
Anyone considering the use of Fluvoxamine Maleate Tablets or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. (Fluvoxamine label, Boxed warning)
- PirfenidoneMajor
Use of fluvoxamine or other strong CYP1A2 inhibitors should be discontinued prior to administration of ESBRIET and avoided during ESBRIET treatment. (Pirfenidone label, Drug interactions)
…prolong, or intensify the sedative action of other central-nervous-system depressants, such as alcohol, sedatives/hypnotics (including barbiturates), narcotics, narcotic analgesics, general anesthetics, tricyclic antidepressants, and tranquilizers; therefore, such agents should be avoided or administered in reduced dosage to patients receiving promethazine HCl. (Promethazine label, Drug interactions)
- Prucaloprideserotonergic drugMajor
If concomitant use of Fluvoxamine Maleate Tablets with other serotonergic drugs is clinically warranted, patients should be made aware of a potential increased risk for serotonin syndrome, particularly during treatment initiation and dose increases. (Fluvoxamine label, Warnings and precautions)
- Ramelteonsedative-hypnoticMajor
Ramelteon: Should not be used in combination with fluvoxamine ( 5.8 ). (Fluvoxamine label, Warnings and precautions)
- RasagilineMAO inhibitorMajor
Serotonin Syndrome and Monoamine Oxidase Inhibitors (MAOIs) The use of MAOIs intended to treat psychiatric disorders with Fluvoxamine Maleate Tablets or within 14 days of stopping treatment with Fluvoxamine Maleate Tablets is contraindicated because of an increased risk of serotonin syndrome. (Fluvoxamine label, Contraindications)
If concomitant use of Fluvoxamine Maleate Tablets with other serotonergic drugs is clinically warranted, patients should be made aware of a potential increased risk for serotonin syndrome, particularly during treatment initiation and dose increases. (Fluvoxamine label, Warnings and precautions)
- SelegilineMAO inhibitorMajor
Serotonin Syndrome and Monoamine Oxidase Inhibitors (MAOIs) The use of MAOIs intended to treat psychiatric disorders with Fluvoxamine Maleate Tablets or within 14 days of stopping treatment with Fluvoxamine Maleate Tablets is contraindicated because of an increased risk of serotonin syndrome. (Fluvoxamine label, Contraindications)
Anyone considering the use of Fluvoxamine Maleate Tablets or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. (Fluvoxamine label, Boxed warning)
- SolriamfetolCNS stimulantMajor
If concomitant use of Fluvoxamine Maleate Tablets with other serotonergic drugs is clinically warranted, patients should be made aware of a potential increased risk for serotonin syndrome, particularly during treatment initiation and dose increases. (Fluvoxamine label, Warnings and precautions)
Combining St. John's wort with antidepressants and other serotonergic drugs increases the risk of serotonin syndrome. (NCCIH, St. John's Wort)
If concomitant use of Fluvoxamine Maleate Tablets with other serotonergic drugs is clinically warranted, patients should be made aware of a potential increased risk for serotonin syndrome, particularly during treatment initiation and dose increases. (Fluvoxamine label, Warnings and precautions)
- Sumatriptan and naproxentriptanMajor
If concomitant use of Fluvoxamine Maleate Tablets with other serotonergic drugs is clinically warranted, patients should be made aware of a potential increased risk for serotonin syndrome, particularly during treatment initiation and dose increases. (Fluvoxamine label, Warnings and precautions)
- TapentadolopioidMajor
If concomitant use of Fluvoxamine Maleate Tablets with other serotonergic drugs is clinically warranted, patients should be made aware of a potential increased risk for serotonin syndrome, particularly during treatment initiation and dose increases. (Fluvoxamine label, Warnings and precautions)
- Tasimelteonsedative-hypnoticMajor
Strong CYP1A2 inhibitors (e.g., fluvoxamine): Avoid use of HETLIOZ in combination with strong CYP1A2 inhibitors because of increased exposure ( 7.1 , 12.3 ) (Tasimelteon label, Drug interactions)
Coadministration Coadministration of tizanidine, thioridazine, alosetron, or pimozide with Fluvoxamine Maleate Tablets is contraindicated [see Warnings and Precautions ( 5.4 , 5.5 , 5.6 , 5.7 )] . (Fluvoxamine label, Contraindications)
If concomitant use of Fluvoxamine Maleate Tablets with other serotonergic drugs is clinically warranted, patients should be made aware of a potential increased risk for serotonin syndrome, particularly during treatment initiation and dose increases. (Fluvoxamine label, Warnings and precautions)
- TranylcypromineMAO inhibitorMajor
Anyone considering the use of Fluvoxamine Maleate Tablets or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. (Fluvoxamine label, Boxed warning)
Anyone considering the use of Fluvoxamine Maleate Tablets or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. (Fluvoxamine label, Boxed warning)
Anyone considering the use of Fluvoxamine Maleate Tablets or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. (Fluvoxamine label, Boxed warning)
Anyone considering the use of Fluvoxamine Maleate Tablets or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. (Fluvoxamine label, Boxed warning)
Anyone considering the use of Fluvoxamine Maleate Tablets or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. (Fluvoxamine label, Boxed warning)
• Serotonin Syndrome: Increased risk when co-administered with other serotonergic agents, but also when taken alone. (Ziprasidone label, Warnings and precautions)
- ZolmitriptantriptanMajor
If concomitant use of Fluvoxamine Maleate Tablets with other serotonergic drugs is clinically warranted, patients should be made aware of a potential increased risk for serotonin syndrome, particularly during treatment initiation and dose increases. (Fluvoxamine label, Warnings and precautions)
Moderate interactions (158)
- Acetazolamidecarbonic anhydrase inhibitorModerate
Also, patients taking diuretics or who are otherwise volume depleted may be at greater risk. (Fluvoxamine label, Warnings and precautions)
Monoamine oxidase inhibitors and tricyclic antidepressants: Use with extreme caution. (Albuterol label, Drug interactions)
Theophylline: Clearance decreased; reduce theophylline dose by one-third ( 5.8 ). (Fluvoxamine label, Warnings and precautions)
Alprazolam - When fluvoxamine maleate (100 mg q.d.) and alprazolam (1 mg q.i.d.) were coadministered to steady state, plasma concentrations and other pharmacokinetic parameters (AUC, C max , T ½ ) of alprazolam were approximately twice those observed when alprazolam was administered alone; oral clearance was reduced by about 50%. (Fluvoxamine label, Warnings and precautions)
- Amiloridepotassium-sparing diureticModerate
Also, patients taking diuretics or who are otherwise volume depleted may be at greater risk. (Fluvoxamine label, Warnings and precautions)
Potential Pimozide Interaction Pimozide is metabolized by the cytochrome P4503A4 isoenzyme, and it has been demonstrated that ketoconazole, a potent inhibitor of CYP3A4, blocks the metabolism of this drug, resulting in increased plasma concentrations of parent drug. (Fluvoxamine label, Warnings and precautions)
- ApixabananticoagulantModerate
Thus patients receiving oral anticoagulants and Fluvoxamine Maleate Tablets should have their prothrombin time monitored and their anticoagulant dose adjusted accordingly. (Fluvoxamine label, Warnings and precautions)
- AprepitantCYP3A4 inhibitorModerate
Potential Pimozide Interaction Pimozide is metabolized by the cytochrome P4503A4 isoenzyme, and it has been demonstrated that ketoconazole, a potent inhibitor of CYP3A4, blocks the metabolism of this drug, resulting in increased plasma concentrations of parent drug. (Fluvoxamine label, Warnings and precautions)
- AripiprazoleantipsychoticModerate
CNS Active Drugs Antipsychotics: See Warnings and Precautions ( 5.2 ) . (Fluvoxamine label, Drug interactions)
- ArmodafinilCNS stimulantModerate
The risk is increased with concomitant use of other serotonergic drugs (including triptans, tricyclic antidepressants, fentanyl, meperidine, methadone, lithium, tramadol, tryptophan, buspirone, amphetamines, and St. (Fluvoxamine label, Warnings and precautions)
- AsenapineantipsychoticModerate
CNS Active Drugs Antipsychotics: See Warnings and Precautions ( 5.2 ) . (Fluvoxamine label, Drug interactions)
- AspirinNSAIDModerate
Other Drugs Affecting Hemostasis: Increased risk of bleeding with concomitant use of NSAIDs, aspirin, or other drugs affecting coagulation ( 5.8 , 5.10 ). (Fluvoxamine label, Warnings and precautions)
- Aspirin and dipyridamoleantiplatelet agentModerate
Other Drugs Affecting Hemostasis: Increased risk of bleeding with concomitant use of NSAIDs, aspirin, or other drugs affecting coagulation ( 5.8 , 5.10 ). (Fluvoxamine label, Warnings and precautions)
- Atenololbeta blockerModerate
Propranolol and Other Beta-Blockers: Coadministration of fluvoxamine maleate 100 mg per day and propranolol 160 mg per day in normal volunteers resulted in a mean five-fold increase (range 2 to 17) in minimum propranolol plasma concentrations. (Fluvoxamine label, Drug interactions)
- Bisoprololbeta blockerModerate
Propranolol and Other Beta-Blockers: Coadministration of fluvoxamine maleate 100 mg per day and propranolol 160 mg per day in normal volunteers resulted in a mean five-fold increase (range 2 to 17) in minimum propranolol plasma concentrations. (Fluvoxamine label, Drug interactions)
- Bisoprolol and hydrochlorothiazidebeta blockerModerate
Also, patients taking diuretics or who are otherwise volume depleted may be at greater risk. (Fluvoxamine label, Warnings and precautions)
- BrexpiprazoleantipsychoticModerate
CNS Active Drugs Antipsychotics: See Warnings and Precautions ( 5.2 ) . (Fluvoxamine label, Drug interactions)
- Brimonidinealpha-adrenergic agonistModerate
Caution is advised in patients taking tricyclic antidepressants which can affect the metabolism and uptake of circulating amines. (Brimonidine label, Drug interactions)
- Budesonide and formoterolcorticosteroidModerate
Monoamine oxidase inhibitors and tricyclic antidepressants: Use with extreme caution. (Budesonide and formoterol label, Drug interactions)
- Bumetanideloop diureticModerate
Also, patients taking diuretics or who are otherwise volume depleted may be at greater risk. (Fluvoxamine label, Warnings and precautions)
- Butalbital, acetaminophen, and caffeinebarbiturateModerate
Theophylline: Clearance decreased; reduce theophylline dose by one-third ( 5.8 ). (Fluvoxamine label, Warnings and precautions)
- CariprazineantipsychoticModerate
CNS Active Drugs Antipsychotics: See Warnings and Precautions ( 5.2 ) . (Fluvoxamine label, Drug interactions)
- Carisoprodolmuscle relaxantModerate
Since the sedative effects of carisoprodol and other CNS depressants (e.g., alcohol, benzodiazepines, opioids, tricyclic antidepressants) may be additive, appropriate caution should be exercised with patients who take more than one of these CNS depressants simultaneously. (Carisoprodol label, Warnings and precautions)
- Carvedilolbeta blockerModerate
Propranolol and Other Beta-Blockers: Coadministration of fluvoxamine maleate 100 mg per day and propranolol 160 mg per day in normal volunteers resulted in a mean five-fold increase (range 2 to 17) in minimum propranolol plasma concentrations. (Fluvoxamine label, Drug interactions)
- CelecoxibNSAIDModerate
Other Drugs Affecting Hemostasis: Increased risk of bleeding with concomitant use of NSAIDs, aspirin, or other drugs affecting coagulation ( 5.8 , 5.10 ). (Fluvoxamine label, Warnings and precautions)
- CenobamateanticonvulsantModerate
Potential Pimozide Interaction Pimozide is metabolized by the cytochrome P4503A4 isoenzyme, and it has been demonstrated that ketoconazole, a potent inhibitor of CYP3A4, blocks the metabolism of this drug, resulting in increased plasma concentrations of parent drug. (Fluvoxamine label, Warnings and precautions)
- ChlordiazepoxidebenzodiazepineModerate
Benzodiazepines: Use with caution. (Fluvoxamine label, Warnings and precautions)
- ChlorpromazineantipsychoticModerate
CNS Active Drugs Antipsychotics: See Warnings and Precautions ( 5.2 ) . (Fluvoxamine label, Drug interactions)
- Chlorthalidonethiazide diureticModerate
Also, patients taking diuretics or who are otherwise volume depleted may be at greater risk. (Fluvoxamine label, Warnings and precautions)
- Cilostazolantiplatelet agentModerate
Strong and moderate CYP3A4 and CYP2C19 inhibitors: Increase exposure to cilostazol. (Cilostazol label, Drug interactions)
- CimetidineH2 blockerModerate
Potential Pimozide Interaction Pimozide is metabolized by the cytochrome P4503A4 isoenzyme, and it has been demonstrated that ketoconazole, a potent inhibitor of CYP3A4, blocks the metabolism of this drug, resulting in increased plasma concentrations of parent drug. (Fluvoxamine label, Warnings and precautions)
- CiprofloxacinfluoroquinoloneModerate
…syndrome, uncorrected electrolyte imbalance, such as hypokalemia or hypomagnesemia and cardiac disease, such as heart failure, myocardial infarction, or bradycardia), and patients receiving Class IA antiarrhythmic agents (quinidine, procainamide), or Class III antiarrhythmic agents (amiodarone, sotalol), tricyclic antidepressants, macrolides, and antipsychotics. (Ciprofloxacin label, Warnings and precautions)
- Clarithromycinmacrolide antibioticModerate
Potential Pimozide Interaction Pimozide is metabolized by the cytochrome P4503A4 isoenzyme, and it has been demonstrated that ketoconazole, a potent inhibitor of CYP3A4, blocks the metabolism of this drug, resulting in increased plasma concentrations of parent drug. (Fluvoxamine label, Warnings and precautions)
- ClobazambenzodiazepineModerate
Benzodiazepines: Use with caution. (Fluvoxamine label, Warnings and precautions)
- ClonazepambenzodiazepineModerate
Benzodiazepines: Use with caution. (Fluvoxamine label, Warnings and precautions)
- Clonidinealpha-adrenergic agonistModerate
Tricyclic antidepressants Clinical Implication Concomitant use of tricyclic antidepressants with clonidine can increase blood pressure and may counteract the hypotensive effects of clonidine. (Clonidine label, Drug interactions)
- ClozapineantipsychoticModerate
Clozapine: Clozapine levels may be increased and produce orthostatic hypotension or seizures ( 5.8 ). (Fluvoxamine label, Warnings and precautions)
- CyclosporineimmunosuppressantModerate
Potential Pimozide Interaction Pimozide is metabolized by the cytochrome P4503A4 isoenzyme, and it has been demonstrated that ketoconazole, a potent inhibitor of CYP3A4, blocks the metabolism of this drug, resulting in increased plasma concentrations of parent drug. (Fluvoxamine label, Warnings and precautions)
- DabigatrananticoagulantModerate
Thus patients receiving oral anticoagulants and Fluvoxamine Maleate Tablets should have their prothrombin time monitored and their anticoagulant dose adjusted accordingly. (Fluvoxamine label, Warnings and precautions)
- Daridorexantsedative-hypnoticModerate
Co-administration with other CNS depressants (e.g., benzodiazepines, opioids, tricyclic antidepressants, alcohol) increases the risk of CNS depression, which can cause daytime impairment. (Daridorexant label, Warnings and precautions)
- DarifenacinanticholinergicModerate
Caution should be taken when darifenacin extended-release tablets is used concomitantly with medications that are predominantly metabolized by CYP2D6 and which have a narrow therapeutic window, such as flecainide, thioridazine and tricyclic antidepressants ( 7.2 ) (Darifenacin label, Drug interactions)
- DesmopressinModerate
…that may Increase Risk of Hyponatremia Concomitant administration of DESMODA with other drugs that may increase the risk of water intoxication with hyponatremia, (e.g., tricyclic antidepressants, selective serotonin re-uptake inhibitors, chlorpromazine, opiate analgesics, thiazide diuretics, NSAIDs, lamotrigine, sulfonylureas, particularly chlorpropamide, oxybutynin… (Desmopressin label, Drug interactions)
- DexmethylphenidateCNS stimulantModerate
The risk is increased with concomitant use of other serotonergic drugs (including triptans, tricyclic antidepressants, fentanyl, meperidine, methadone, lithium, tramadol, tryptophan, buspirone, amphetamines, and St. (Fluvoxamine label, Warnings and precautions)
- DiazepambenzodiazepineModerate
Because fluvoxamine reduces the clearance of both diazepam and its active metabolite, N-desmethyldiazepam, there is a strong likelihood of substantial accumulation of both species during chronic coadministration. (Fluvoxamine label, Warnings and precautions)
- DiclofenacNSAIDModerate
Other Drugs Affecting Hemostasis: Increased risk of bleeding with concomitant use of NSAIDs, aspirin, or other drugs affecting coagulation ( 5.8 , 5.10 ). (Fluvoxamine label, Warnings and precautions)
- DicyclomineanticholinergicModerate
…drugs including dicyclomine hydrochloride: amantadine, antiarrhythmic agents of Class I (e.g., quinidine), antihistamines, antipsychotic agents (e.g., phenothiazines), benzodiazepines, MAO inhibitors, narcotic analgesics (e.g., meperidine), nitrates and nitrites, sympathomimetic agents, tricyclic antidepressants, and other drugs having anticholinergic activity. (Dicyclomine label, Drug interactions)
- Diltiazemcalcium channel blockerModerate
Potential Pimozide Interaction Pimozide is metabolized by the cytochrome P4503A4 isoenzyme, and it has been demonstrated that ketoconazole, a potent inhibitor of CYP3A4, blocks the metabolism of this drug, resulting in increased plasma concentrations of parent drug. (Fluvoxamine label, Warnings and precautions)
- DofetilideantiarrhythmicModerate
Inhibitors of this isoenzyme (e.g., macrolide antibiotics, azole antifungal agents, protease inhibitors, serotonin reuptake inhibitors, amiodarone, cannabinoids, diltiazem, grapefruit juice, nefazadone, norfloxacin, quinine, zafirlukast) should be cautiously co-administered with dofetilide as they can potentially increase dofetilide levels. (Dofetilide label, Drug interactions)
- Dorzolamide and timololcarbonic anhydrase inhibitorModerate
Propranolol and Other Beta-Blockers: Coadministration of fluvoxamine maleate 100 mg per day and propranolol 160 mg per day in normal volunteers resulted in a mean five-fold increase (range 2 to 17) in minimum propranolol plasma concentrations. (Fluvoxamine label, Drug interactions)
- DronabinolcannabinoidModerate
Concomitant use of other drugs that cause dizziness, confusion, sedation, or somnolence such as CNS depressants may increase this effect (e.g., barbiturates, benzodiazepines, lithium, opioids, buspirone, scopolamine, antihistamines, tricyclic antidepressants, other anticholinergic agents, and muscle relaxants). (Dronabinol label, Warnings and precautions)
- EluxadolineopioidModerate
Methadone: Significantly increased methadone (plasma level:dose) ratios have been reported when fluvoxamine maleate was administered to patients receiving maintenance methadone treatment, with symptoms of opioid intoxication in one patient. (Fluvoxamine label, Warnings and precautions)
- EnoxaparinanticoagulantModerate
Thus patients receiving oral anticoagulants and Fluvoxamine Maleate Tablets should have their prothrombin time monitored and their anticoagulant dose adjusted accordingly. (Fluvoxamine label, Warnings and precautions)
- EpinephrinesympathomimeticModerate
• Drugs that potentiate the effects of epinephrine include sympathomimetics, beta blockers, tricyclic antidepressants, MAO inhibitors, COMT inhibitors, clonidine, doxapram, oxytocin, levothyroxine sodium, and certain antihistamines. (Epinephrine label, Drug interactions)
- Eplerenonealdosterone antagonistModerate
Also, patients taking diuretics or who are otherwise volume depleted may be at greater risk. (Fluvoxamine label, Warnings and precautions)
- Erythromycinmacrolide antibioticModerate
Potential Pimozide Interaction Pimozide is metabolized by the cytochrome P4503A4 isoenzyme, and it has been demonstrated that ketoconazole, a potent inhibitor of CYP3A4, blocks the metabolism of this drug, resulting in increased plasma concentrations of parent drug. (Fluvoxamine label, Warnings and precautions)
- EslicarbazepineanticonvulsantModerate
CYP2C19 Substrates APTIOM can inhibit CYP2C19, which can cause increased plasma concentrations of drugs that are metabolized by this isoenzyme (e.g., phenytoin, clobazam, and omeprazole) [see Clinical Pharmacology ( 12.3 )]. (Eslicarbazepine label, Drug interactions)
- Esmololbeta blockerModerate
Propranolol and Other Beta-Blockers: Coadministration of fluvoxamine maleate 100 mg per day and propranolol 160 mg per day in normal volunteers resulted in a mean five-fold increase (range 2 to 17) in minimum propranolol plasma concentrations. (Fluvoxamine label, Drug interactions)
- Eszopiclonesedative-hypnoticModerate
Additive effects occur with concomitant use of other CNS depressants (e.g., benzodiazepines, opioids, tricyclic antidepressants, alcohol), including daytime use. (Eszopiclone label, Warnings and precautions)
- Ethacrynic acidloop diureticModerate
Also, patients taking diuretics or who are otherwise volume depleted may be at greater risk. (Fluvoxamine label, Warnings and precautions)
- EtodolacNSAIDModerate
Other Drugs Affecting Hemostasis: Increased risk of bleeding with concomitant use of NSAIDs, aspirin, or other drugs affecting coagulation ( 5.8 , 5.10 ). (Fluvoxamine label, Warnings and precautions)
- EverolimusimmunosuppressantModerate
Potential Pimozide Interaction Pimozide is metabolized by the cytochrome P4503A4 isoenzyme, and it has been demonstrated that ketoconazole, a potent inhibitor of CYP3A4, blocks the metabolism of this drug, resulting in increased plasma concentrations of parent drug. (Fluvoxamine label, Warnings and precautions)
- FamotidineH2 blockerModerate
Tizanidine (CYP1A2 Substrate) Although not studied clinically, famotidine is considered a weak CYP1A2 inhibitor and may lead to substantial increases in blood concentrations of tizanidine, a CYP1A2 substrate. (Famotidine label, Drug interactions)
- Febuxostatxanthine oxidase inhibitorModerate
Theophylline: Clearance decreased; reduce theophylline dose by one-third ( 5.8 ). (Fluvoxamine label, Warnings and precautions)
- Fluconazoleazole antifungalModerate
Potential Pimozide Interaction Pimozide is metabolized by the cytochrome P4503A4 isoenzyme, and it has been demonstrated that ketoconazole, a potent inhibitor of CYP3A4, blocks the metabolism of this drug, resulting in increased plasma concentrations of parent drug. (Fluvoxamine label, Warnings and precautions)
- Fluticasone and salmeterolcorticosteroidModerate
Monoamine oxidase inhibitors and tricyclic antidepressants: Use with extreme caution. (Fluticasone and salmeterol label, Drug interactions)
- FondaparinuxanticoagulantModerate
Thus patients receiving oral anticoagulants and Fluvoxamine Maleate Tablets should have their prothrombin time monitored and their anticoagulant dose adjusted accordingly. (Fluvoxamine label, Warnings and precautions)
- Formoterolbeta-adrenergic agonistModerate
• MAO inhibitors, tricyclic antidepressants and drugs that prolong QTc interval may potentiate effect on the cardiovascular system. (Formoterol label, Drug interactions)
- FosfomycinantibioticModerate
Avoid co-administration of CONTEPO with drugs known to prolong the QT interval, such as class IA or class III antiarrhythmic medications, tricyclic antidepressants, macrolides, and antipsychotics [see Warnings and Precautions ( 5.2 )] . (Fosfomycin label, Drug interactions)
- Furosemideloop diureticModerate
Also, patients taking diuretics or who are otherwise volume depleted may be at greater risk. (Fluvoxamine label, Warnings and precautions)
- GlycopyrrolateanticholinergicModerate
Other Anticholinergic Drugs There is potential for an additive interaction between glycopyrrolate and concomitantly used anticholinergic drugs (e.g., tricyclic antidepressants, anti-epileptics, class I antiarrhythmics, anti-spasmodics, amantadine) resulting in increased anticholinergic adverse reactions. (Glycopyrrolate label, Drug interactions)
- HaloperidolantipsychoticModerate
CNS Active Drugs Antipsychotics: See Warnings and Precautions ( 5.2 ) . (Fluvoxamine label, Drug interactions)
- HeparinanticoagulantModerate
Thus patients receiving oral anticoagulants and Fluvoxamine Maleate Tablets should have their prothrombin time monitored and their anticoagulant dose adjusted accordingly. (Fluvoxamine label, Warnings and precautions)
- Hydrochlorothiazidethiazide diureticModerate
Also, patients taking diuretics or who are otherwise volume depleted may be at greater risk. (Fluvoxamine label, Warnings and precautions)
- IbuprofenNSAIDModerate
Other Drugs Affecting Hemostasis: Increased risk of bleeding with concomitant use of NSAIDs, aspirin, or other drugs affecting coagulation ( 5.8 , 5.10 ). (Fluvoxamine label, Warnings and precautions)
- IloperidoneantipsychoticModerate
CNS Active Drugs Antipsychotics: See Warnings and Precautions ( 5.2 ) . (Fluvoxamine label, Drug interactions)
- ImatinibCYP3A4 inhibitorModerate
Potential Pimozide Interaction Pimozide is metabolized by the cytochrome P4503A4 isoenzyme, and it has been demonstrated that ketoconazole, a potent inhibitor of CYP3A4, blocks the metabolism of this drug, resulting in increased plasma concentrations of parent drug. (Fluvoxamine label, Warnings and precautions)
- Indapamidethiazide diureticModerate
Also, patients taking diuretics or who are otherwise volume depleted may be at greater risk. (Fluvoxamine label, Warnings and precautions)
- IndomethacinNSAIDModerate
Other Drugs Affecting Hemostasis: Increased risk of bleeding with concomitant use of NSAIDs, aspirin, or other drugs affecting coagulation ( 5.8 , 5.10 ). (Fluvoxamine label, Warnings and precautions)
- Itraconazoleazole antifungalModerate
Potential Pimozide Interaction Pimozide is metabolized by the cytochrome P4503A4 isoenzyme, and it has been demonstrated that ketoconazole, a potent inhibitor of CYP3A4, blocks the metabolism of this drug, resulting in increased plasma concentrations of parent drug. (Fluvoxamine label, Warnings and precautions)
- IvacaftorCYP3A4 inhibitorModerate
Potential Pimozide Interaction Pimozide is metabolized by the cytochrome P4503A4 isoenzyme, and it has been demonstrated that ketoconazole, a potent inhibitor of CYP3A4, blocks the metabolism of this drug, resulting in increased plasma concentrations of parent drug. (Fluvoxamine label, Warnings and precautions)
- Ketoconazoleazole antifungalModerate
Potential Pimozide Interaction Pimozide is metabolized by the cytochrome P4503A4 isoenzyme, and it has been demonstrated that ketoconazole, a potent inhibitor of CYP3A4, blocks the metabolism of this drug, resulting in increased plasma concentrations of parent drug. (Fluvoxamine label, Warnings and precautions)
- KetorolacNSAIDModerate
Other Drugs Affecting Hemostasis: Increased risk of bleeding with concomitant use of NSAIDs, aspirin, or other drugs affecting coagulation ( 5.8 , 5.10 ). (Fluvoxamine label, Warnings and precautions)
- Labetalolbeta blockerModerate
Propranolol and Other Beta-Blockers: Coadministration of fluvoxamine maleate 100 mg per day and propranolol 160 mg per day in normal volunteers resulted in a mean five-fold increase (range 2 to 17) in minimum propranolol plasma concentrations. (Fluvoxamine label, Drug interactions)
- Lemborexantsedative-hypnoticModerate
Co-administration with other CNS depressants (e.g., benzodiazepines, opioids, tricyclic antidepressants, alcohol) increases the risk of CNS depression, which can cause daytime impairment. (Lemborexant label, Warnings and precautions)
- Levalbuterolbeta-adrenergic agonistModerate
Monoamine oxidase inhibitors (MAOs) or tricyclic antidepressants : May potentiate effect of albuterol on the cardiovascular system. (Levalbuterol label, Drug interactions)
- Levothyroxinethyroid hormoneModerate
Antidepressant Therapy Concurrent use of tricyclic (e.g., amitriptyline) or tetracyclic (e.g., maprotiline) antidepressants and levothyroxine may increase the therapeutic and toxic effects of both drugs, possibly due to increased receptor sensitivity to catecholamines. (Levothyroxine label, Drug interactions)
- Lidocainelocal anestheticModerate
Clinically Significant Drug Interactions The administration of local anesthetic solutions containing epinephrine or norepinephrine to patients receiving monoamine oxidase inhibitors or tricyclic antidepressants may produce severe, prolonged hypertension. (Lidocaine label, Drug interactions)
- Liothyroninethyroid hormoneModerate
Antidepressant Therapy Concurrent use of tricyclic (e.g., amitriptyline) or tetracyclic (e.g., maprotiline) antidepressants and liothyronine sodium may increase the therapeutic and toxic effects of both drugs, possibly due to increased receptor sensitivity to catecholamines. (Liothyronine label, Drug interactions)
- Lisinopril and hydrochlorothiazideACE inhibitorModerate
Also, patients taking diuretics or who are otherwise volume depleted may be at greater risk. (Fluvoxamine label, Warnings and precautions)
- Losartan and hydrochlorothiazideangiotensin II receptor blocker (ARB)Moderate
Also, patients taking diuretics or who are otherwise volume depleted may be at greater risk. (Fluvoxamine label, Warnings and precautions)
- LumateperoneantipsychoticModerate
CNS Active Drugs Antipsychotics: See Warnings and Precautions ( 5.2 ) . (Fluvoxamine label, Drug interactions)
- LurasidoneantipsychoticModerate
CNS Active Drugs Antipsychotics: See Warnings and Precautions ( 5.2 ) . (Fluvoxamine label, Drug interactions)
- MeloxicamNSAIDModerate
Other Drugs Affecting Hemostasis: Increased risk of bleeding with concomitant use of NSAIDs, aspirin, or other drugs affecting coagulation ( 5.8 , 5.10 ). (Fluvoxamine label, Warnings and precautions)
- MethylphenidateCNS stimulantModerate
The risk is increased with concomitant use of other serotonergic drugs (including triptans, tricyclic antidepressants, fentanyl, meperidine, methadone, lithium, tramadol, tryptophan, buspirone, amphetamines, and St. (Fluvoxamine label, Warnings and precautions)
- Metolazonethiazide diureticModerate
Also, patients taking diuretics or who are otherwise volume depleted may be at greater risk. (Fluvoxamine label, Warnings and precautions)
- Metoprololbeta blockerModerate
Propranolol or metoprolol : Reduce dose if coadministered and titrate more cautiously ( 7.3 ). (Fluvoxamine label, Drug interactions)
- MidazolambenzodiazepineModerate
Benzodiazepines: Use with caution. (Fluvoxamine label, Warnings and precautions)
- Mirabegronbeta-adrenergic agonistModerate
Potential Pimozide Interaction Pimozide is metabolized by the cytochrome P4503A4 isoenzyme, and it has been demonstrated that ketoconazole, a potent inhibitor of CYP3A4, blocks the metabolism of this drug, resulting in increased plasma concentrations of parent drug. (Fluvoxamine label, Warnings and precautions)
- ModafinilCNS stimulantModerate
The risk is increased with concomitant use of other serotonergic drugs (including triptans, tricyclic antidepressants, fentanyl, meperidine, methadone, lithium, tramadol, tryptophan, buspirone, amphetamines, and St. (Fluvoxamine label, Warnings and precautions)
- MoxifloxacinfluoroquinoloneModerate
Pharmacokinetic studies between moxifloxacin and other drugs that prolong the QT interval such as cisapride, erythromycin, antipsychotics, and tricyclic antidepressants have not been performed. (Moxifloxacin label, Warnings and precautions)
- NabumetoneNSAIDModerate
Other Drugs Affecting Hemostasis: Increased risk of bleeding with concomitant use of NSAIDs, aspirin, or other drugs affecting coagulation ( 5.8 , 5.10 ). (Fluvoxamine label, Warnings and precautions)
- Nadololbeta blockerModerate
Propranolol and Other Beta-Blockers: Coadministration of fluvoxamine maleate 100 mg per day and propranolol 160 mg per day in normal volunteers resulted in a mean five-fold increase (range 2 to 17) in minimum propranolol plasma concentrations. (Fluvoxamine label, Drug interactions)
- NalbuphineopioidModerate
Methadone: Significantly increased methadone (plasma level:dose) ratios have been reported when fluvoxamine maleate was administered to patients receiving maintenance methadone treatment, with symptoms of opioid intoxication in one patient. (Fluvoxamine label, Warnings and precautions)
- NaproxenNSAIDModerate
Other Drugs Affecting Hemostasis: Increased risk of bleeding with concomitant use of NSAIDs, aspirin, or other drugs affecting coagulation ( 5.8 , 5.10 ). (Fluvoxamine label, Warnings and precautions)
- Nebivololbeta blockerModerate
Propranolol and Other Beta-Blockers: Coadministration of fluvoxamine maleate 100 mg per day and propranolol 160 mg per day in normal volunteers resulted in a mean five-fold increase (range 2 to 17) in minimum propranolol plasma concentrations. (Fluvoxamine label, Drug interactions)
- OlanzapineantipsychoticModerate
CNS Active Drugs Antipsychotics: See Warnings and Precautions ( 5.2 ) . (Fluvoxamine label, Drug interactions)
- Omeprazoleproton pump inhibitorModerate
…Warnings and Precautions ( 5 ) ] and limited in vitro data for CYP3A4, it appears that fluvoxamine inhibits several cytochrome P450 isoenzymes that are known to be involved in the metabolism of other drugs such as: CYP1A2 (e.g., warfarin, theophylline, propranolol, tizanidine), CYP2C9 (e.g., warfarin), CYP3A4 (e.g., alprazolam), and CYP2C19 (e.g., omeprazole). (Fluvoxamine label, Drug interactions)
- Oxycodone and acetaminophenopioidModerate
Methadone: Significantly increased methadone (plasma level:dose) ratios have been reported when fluvoxamine maleate was administered to patients receiving maintenance methadone treatment, with symptoms of opioid intoxication in one patient. (Fluvoxamine label, Warnings and precautions)
- PalbociclibCYP3A4 inhibitorModerate
Potential Pimozide Interaction Pimozide is metabolized by the cytochrome P4503A4 isoenzyme, and it has been demonstrated that ketoconazole, a potent inhibitor of CYP3A4, blocks the metabolism of this drug, resulting in increased plasma concentrations of parent drug. (Fluvoxamine label, Warnings and precautions)
- PaliperidoneantipsychoticModerate
CNS Active Drugs Antipsychotics: See Warnings and Precautions ( 5.2 ) . (Fluvoxamine label, Drug interactions)
- PentoxifyllinemethylxanthineModerate
Theophylline: Clearance decreased; reduce theophylline dose by one-third ( 5.8 ). (Fluvoxamine label, Warnings and precautions)
- PerampanelanticonvulsantModerate
Potential Pimozide Interaction Pimozide is metabolized by the cytochrome P4503A4 isoenzyme, and it has been demonstrated that ketoconazole, a potent inhibitor of CYP3A4, blocks the metabolism of this drug, resulting in increased plasma concentrations of parent drug. (Fluvoxamine label, Warnings and precautions)
- PhentermineCNS stimulantModerate
The risk is increased with concomitant use of other serotonergic drugs (including triptans, tricyclic antidepressants, fentanyl, meperidine, methadone, lithium, tramadol, tryptophan, buspirone, amphetamines, and St. (Fluvoxamine label, Warnings and precautions)
- Phentermine and topiramateCNS stimulantModerate
The risk is increased with concomitant use of other serotonergic drugs (including triptans, tricyclic antidepressants, fentanyl, meperidine, methadone, lithium, tramadol, tryptophan, buspirone, amphetamines, and St. (Fluvoxamine label, Warnings and precautions)
- PhenylephrinedecongestantModerate
Agonistic Effects (increase in BIORPHEN blood pressure effect) can occur with monoamine oxidase inhibitors (MAOI), oxytocin and oxytocic drugs, tricyclic antidepressants, angiotensin and aldosterone, atropine, steroids, norepinephrine transporter inhibitors, ergot alkaloids. (Phenylephrine label, Drug interactions)
- PhenytoinanticonvulsantModerate
…Ethosuximide, felbamate, oxcarbazepine, methsuximide, topiramate Azoles Fluconazole, ketoconazole, itraconazole, miconazole, voriconazole Antineoplastic agents Capecitabine, fluorouracil Antidepressants Fluoxetine, fluvoxamine, sertraline Gastric acid reducing agents H 2 antagonists (cimetidine), omeprazole Sulfonamides Sulfamethizole, sulfaphenazole, sulfadiazine,… (Phenytoin label, Drug interactions)
- PimavanserinantipsychoticModerate
CNS Active Drugs Antipsychotics: See Warnings and Precautions ( 5.2 ) . (Fluvoxamine label, Drug interactions)
- Pindololbeta blockerModerate
Propranolol and Other Beta-Blockers: Coadministration of fluvoxamine maleate 100 mg per day and propranolol 160 mg per day in normal volunteers resulted in a mean five-fold increase (range 2 to 17) in minimum propranolol plasma concentrations. (Fluvoxamine label, Drug interactions)
- Posaconazoleazole antifungalModerate
Potential Pimozide Interaction Pimozide is metabolized by the cytochrome P4503A4 isoenzyme, and it has been demonstrated that ketoconazole, a potent inhibitor of CYP3A4, blocks the metabolism of this drug, resulting in increased plasma concentrations of parent drug. (Fluvoxamine label, Warnings and precautions)
- ProchlorperazineantipsychoticModerate
CNS Active Drugs Antipsychotics: See Warnings and Precautions ( 5.2 ) . (Fluvoxamine label, Drug interactions)
- Propranololbeta blockerModerate
Propranolol or metoprolol : Reduce dose if coadministered and titrate more cautiously ( 7.3 ). (Fluvoxamine label, Drug interactions)
- QuetiapineantipsychoticModerate
CNS Active Drugs Antipsychotics: See Warnings and Precautions ( 5.2 ) . (Fluvoxamine label, Drug interactions)
- RanolazineQT-prolonging drugModerate
Potential Pimozide Interaction Pimozide is metabolized by the cytochrome P4503A4 isoenzyme, and it has been demonstrated that ketoconazole, a potent inhibitor of CYP3A4, blocks the metabolism of this drug, resulting in increased plasma concentrations of parent drug. (Fluvoxamine label, Warnings and precautions)
- RifampinantibioticModerate
…5-HT3 Receptor Antagonists Ondansetron Decrease exposure Statins Metabolized by CYP3A4 Simvastatin Decrease exposure Thiazolidinediones Rosiglitazone Decrease AUC by 66% Tricyclic Antidepressants Nortriptyline A tuberculosis treatment regimen including rifampin (600 mg/day), isoniazid (300 mg/day), pyrazinamide (500 mg 3× per day), and pyridoxine (25 mg) was… (Rifampin label, Drug interactions)
- RiluzoleModerate
Strong to moderate CYP1A2 inhibitors: Co-administration may increase TIGLUTIK-associated adverse reactions ( 7.1 ) (Riluzole label, Drug interactions)
- RisperidoneantipsychoticModerate
CNS Active Drugs Antipsychotics: See Warnings and Precautions ( 5.2 ) . (Fluvoxamine label, Drug interactions)
- RivaroxabananticoagulantModerate
Thus patients receiving oral anticoagulants and Fluvoxamine Maleate Tablets should have their prothrombin time monitored and their anticoagulant dose adjusted accordingly. (Fluvoxamine label, Warnings and precautions)
- RoflumilastPDE4 inhibitorModerate
Use with inhibitors of CYP3A4 or dual inhibitors of CYP3A4 and CYP1A2 (e.g., erythromycin, ketoconazole, fluvoxamine, enoxacin, cimetidine) will increase roflumilast systemic exposure and may result in increased adverse reactions. (Roflumilast label, Drug interactions)
- Ropiniroledopamine agonistModerate
Therefore, if therapy with a drug known to be a potent inducer or inhibitor of CYP1A2 is stopped or started during treatment with ropinirole, adjustment of the dose of ropinirole may be required. (Ropinirole label, Drug interactions)
- Salmeterolbeta-adrenergic agonistModerate
• Monoamine oxidase inhibitors and tricyclic antidepressants: Use with extreme caution. (Salmeterol label, Drug interactions)
- ScopolamineanticholinergicModerate
Concomitant use of other drugs that cause central nervous system (CNS) adverse reactions (e.g., alcohol, sedatives, hypnotics, opiates, and anxiolytics) or have anticholinergic properties (e.g., other belladonna alkaloids, sedating antihistamines, meclizine, tricyclic antidepressants, and muscle relaxants) may increase this effect [see Drug Interactions ( 7.1 )] . (Scopolamine label, Warnings and precautions)
- Sodium oxybateCNS depressantModerate
The concurrent use of Xyrem with other CNS depressants, including but not limited to opioid analgesics, benzodiazepines, sedating antidepressants or antipsychotics, sedating anti-epileptic drugs, general anesthetics, muscle relaxants, and/or illicit CNS depressants, may increase the risk of respiratory depression, hypotension, profound sedation, syncope, and… (Sodium oxybate label, Warnings and precautions)
- Sotalolbeta blockerModerate
Propranolol and Other Beta-Blockers: Coadministration of fluvoxamine maleate 100 mg per day and propranolol 160 mg per day in normal volunteers resulted in a mean five-fold increase (range 2 to 17) in minimum propranolol plasma concentrations. (Fluvoxamine label, Drug interactions)
- Spironolactonealdosterone antagonistModerate
Also, patients taking diuretics or who are otherwise volume depleted may be at greater risk. (Fluvoxamine label, Warnings and precautions)
- Spironolactone and hydrochlorothiazidealdosterone antagonistModerate
Also, patients taking diuretics or who are otherwise volume depleted may be at greater risk. (Fluvoxamine label, Warnings and precautions)
- Sulfamethoxazole and trimethoprimsulfonamideModerate
The efficacy of tricyclic antidepressants can decrease when coadministered with sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim label, Drug interactions)
- Suvorexantsedative-hypnoticModerate
Potential Pimozide Interaction Pimozide is metabolized by the cytochrome P4503A4 isoenzyme, and it has been demonstrated that ketoconazole, a potent inhibitor of CYP3A4, blocks the metabolism of this drug, resulting in increased plasma concentrations of parent drug. (Fluvoxamine label, Warnings and precautions)
- TemazepambenzodiazepineModerate
Benzodiazepines: Use with caution. (Fluvoxamine label, Warnings and precautions)
- Terbutalinebeta-adrenergic agonistModerate
Monoamine Oxidase Inhibitors and Tricyclic Antidepressants Terbutaline sulfate should be administered with extreme caution to patients being treated with monoamine oxidase inhibitors or tricyclic antidepressants, or within 2 weeks of discontinuation of such agents, since the action of terbutaline sulfate on the vascular system may be potentiated. (Terbutaline label, Precautions)
- TheophyllinemethylxanthineModerate
Theophylline: Clearance decreased; reduce theophylline dose by one-third ( 5.8 ). (Fluvoxamine label, Warnings and precautions)
- Ticagrelorantiplatelet agentModerate
Potential Pimozide Interaction Pimozide is metabolized by the cytochrome P4503A4 isoenzyme, and it has been demonstrated that ketoconazole, a potent inhibitor of CYP3A4, blocks the metabolism of this drug, resulting in increased plasma concentrations of parent drug. (Fluvoxamine label, Warnings and precautions)
- Timololbeta blockerModerate
Propranolol and Other Beta-Blockers: Coadministration of fluvoxamine maleate 100 mg per day and propranolol 160 mg per day in normal volunteers resulted in a mean five-fold increase (range 2 to 17) in minimum propranolol plasma concentrations. (Fluvoxamine label, Drug interactions)
- Tobacco and smokingTobacco and cannabisModerate
Theophylline: The effect of steady-state fluvoxamine (50 mg bid) on the pharmacokinetics of a single dose of theophylline (375 mg as 442 mg aminophylline) was evaluated in 12 healthy non-smoking, male volunteers. (Fluvoxamine label, Warnings and precautions)
- TofacitinibimmunosuppressantModerate
…modification of XELJANZ/XELJANZ XR is recommended [see Dosage and Administration (2) , Clinical Pharmacology, Figure 3 (12.3) ] Moderate CYP3A4 Inhibitors Concomitantly Used with Strong CYP2C19 Inhibitors (e.g., fluconazole) Clinical Impact Increased exposure to tofacitinib Intervention Dosage modification of XELJANZ/XELJANZ XR is recommended [see Dosage and Administration… (Tofacitinib label, Drug interactions)
- Torsemideloop diureticModerate
Also, patients taking diuretics or who are otherwise volume depleted may be at greater risk. (Fluvoxamine label, Warnings and precautions)
- Triamterenepotassium-sparing diureticModerate
Also, patients taking diuretics or who are otherwise volume depleted may be at greater risk. (Fluvoxamine label, Warnings and precautions)
- Triamterene and hydrochlorothiazidepotassium-sparing diureticModerate
Also, patients taking diuretics or who are otherwise volume depleted may be at greater risk. (Fluvoxamine label, Warnings and precautions)
- TriazolambenzodiazepineModerate
Benzodiazepines: Use with caution. (Fluvoxamine label, Warnings and precautions)
- UbrogepantModerate
Dose adjustment is recommended with concomitant use of UBRELVY and moderate CYP3A4 inhibitors (e.g., cyclosporine, ciprofloxacin, fluconazole, fluvoxamine, grapefruit juice) [see Dosage and Administration ( 2.2 )] . (Ubrogepant label, Drug interactions)
- Umeclidinium and vilanterolanticholinergicModerate
• Monoamine oxidase inhibitors and tricyclic antidepressants: Use with extreme caution. (Umeclidinium and vilanterol label, Drug interactions)
- Valsartan and hydrochlorothiazideangiotensin II receptor blocker (ARB)Moderate
Also, patients taking diuretics or who are otherwise volume depleted may be at greater risk. (Fluvoxamine label, Warnings and precautions)
- Verapamilcalcium channel blockerModerate
Potential Pimozide Interaction Pimozide is metabolized by the cytochrome P4503A4 isoenzyme, and it has been demonstrated that ketoconazole, a potent inhibitor of CYP3A4, blocks the metabolism of this drug, resulting in increased plasma concentrations of parent drug. (Fluvoxamine label, Warnings and precautions)
- Voriconazoleazole antifungalModerate
Potential Pimozide Interaction Pimozide is metabolized by the cytochrome P4503A4 isoenzyme, and it has been demonstrated that ketoconazole, a potent inhibitor of CYP3A4, blocks the metabolism of this drug, resulting in increased plasma concentrations of parent drug. (Fluvoxamine label, Warnings and precautions)
- WarfarinanticoagulantModerate
Warfarin: Plasma concentrations increased and prothrombin times prolonged; monitor prothrombin time and adjust warfarin dose accordingly ( 5.8 ). (Fluvoxamine label, Warnings and precautions)
- Zaleplonsedative-hypnoticModerate
Coadministration with other CNS depressants (e.g., benzodiazepines, opioids, tricyclic antidepressants, alcohol) increases the risk of CNS depression. (Zaleplon label, Warnings)
- Zolpidemsedative-hypnoticModerate
Additive effects occur with concomitant use of other CNS depressants (e.g., benzodiazepines, opioids, tricyclic antidepressants, alcohol), including daytime use [see Drug Interactions (7.1) ] . (Zolpidem label, Warnings and precautions)
Minor mentions (18)
- Atomoxetinenorepinephrine reuptake inhibitorMinor
Discontinuation of Treatment with Fluvoxamine Maleate Tablets During marketing of Fluvoxamine Maleate Tablets and other SSRIs and SNRIs (serotonin and norepinephrine reuptake inhibitors), there have been spontaneous reports of adverse events occurring upon discontinuation of these drugs, particularly when abrupt, including the following: dysphoric mood, irritability,… (Fluvoxamine label, Warnings and precautions)
- BenztropineanticholinergicMinor
Paralytic ileus, hyperthermia and heat stroke, all of which have sometimes been fatal, have occurred in patients taking anticholinergic-type antiparkinsonism drugs, including benztropine mesylate, in combination with phenothiazines and/or tricyclic antidepressants. (Benztropine label, Warnings)
- Bethanecholcholinergic agonistMinor
Five subjects experienced nausea, vomiting, sweating, and diarrhea following coadministration, consistent with the cholinergic effects of tacrine. (Fluvoxamine label, Drug interactions)
- Cevimelinecholinergic agonistMinor
Five subjects experienced nausea, vomiting, sweating, and diarrhea following coadministration, consistent with the cholinergic effects of tacrine. (Fluvoxamine label, Drug interactions)
- DiphenhydramineantihistamineMinor
In vitro data suggest that fluvoxamine is a relatively weak inhibitor of CYP2D6. (Fluvoxamine label, Drug interactions)
- Divalproex (valproate)anticonvulsantMinor
In contrast, drugs that are inhibitors of cytochrome P450 isozymes, e.g., antidepressants, may be expected to have little effect on valproate clearance because cytochrome P450 microsomal mediated oxidation is a relatively minor secondary metabolic pathway compared to glucuronidation and beta-oxidation. (Divalproex (valproate) label, Drug interactions)
- Drospirenone and ethinyl estradioloral contraceptiveMinor
In vitro , EE is a reversible inhibitor of CYP2C19, CYP1A1 and CYP1A2 as well as a mechanism-based inhibitor of CYP3A4/5, CYP2C8, and CYP2J2. (Drospirenone and ethinyl estradiol label, Drug interactions)
- GemfibrozilfibrateMinor
(E) In vitro studies of CYP enzymes, UGTA enzymes and OATP1B1 transporter In vitro studies have shown that gemfibrozil is an inhibitor of CYP1A2, CYP2C8, CYP2C9, CYP2C19, OATP1B1, and UDP-glucuronosyltransferase (UGT) 1A1 and 1A3 (see WARNINGS ). (Gemfibrozil label, Drug interactions)
- HydroxyzineantihistamineMinor
…quinidine, procainamide) or Class III (e.g., amiodarone, sotalol) antiarrhythmics, certain antipsychotics (e.g., ziprasidone, iloperidone, clozapine, quetiapine, chlorpromazine), certain antidepressants (e.g., citalopram, fluoxetine), certain antibiotics (e.g., azithromycin, erythromycin, clarithromycin, gatifloxacin, moxifloxacin); and others (e.g., pentamidine, methadone,… (Hydroxyzine label, Precautions)
- LovastatinstatinMinor
These include itraconazole, ketoconazole, posaconazole, voriconazole, the macrolide antibiotics erythromycin and clarithromycin, the ketolide antibiotic telithromycin, HIV protease inhibitors, boceprevir, telaprevir, the antidepressant nefazodone, or cobicistat-containing products. (Lovastatin label, Warnings)
- Pilocarpinecholinergic agonistMinor
Five subjects experienced nausea, vomiting, sweating, and diarrhea following coadministration, consistent with the cholinergic effects of tacrine. (Fluvoxamine label, Drug interactions)
- PropafenoneantiarrhythmicMinor
In vitro data suggest that fluvoxamine is a relatively weak inhibitor of CYP2D6. (Fluvoxamine label, Drug interactions)
- Pyridostigminecholinesterase inhibitorMinor
Five subjects experienced nausea, vomiting, sweating, and diarrhea following coadministration, consistent with the cholinergic effects of tacrine. (Fluvoxamine label, Drug interactions)
- TerbinafineantifungalMinor
In vitro data suggest that fluvoxamine is a relatively weak inhibitor of CYP2D6. (Fluvoxamine label, Drug interactions)
- TiagabineanticonvulsantMinor
In most cases, patients were using concomitant medications (antidepressants, antipsychotics, stimulants, narcotics) that are thought to lower the seizure threshold. (Tiagabine label, Warnings)
- TrihexyphenidylanticholinergicMinor
Monoamine oxidase inhibitors and tricyclic antidepressants possessing significant anticholinergic activity may intensify the anticholinergic effects of antidyskinetic agents because of the secondary anticholinergic activities of these medications. (Trihexyphenidyl label, Drug interactions)
- Valproic acidanticonvulsantMinor
In contrast, drugs that are inhibitors of cytochrome P450 isozymes, e.g., antidepressants, may be expected to have little effect on valproate clearance because cytochrome P450 microsomal mediated oxidation is a relatively minor secondary metabolic pathway compared to glucuronidation and beta-oxidation. (Valproic acid label, Drug interactions)
- Viloxazinenorepinephrine reuptake inhibitorMinor
Discontinuation of Treatment with Fluvoxamine Maleate Tablets During marketing of Fluvoxamine Maleate Tablets and other SSRIs and SNRIs (serotonin and norepinephrine reuptake inhibitors), there have been spontaneous reports of adverse events occurring upon discontinuation of these drugs, particularly when abrupt, including the following: dysphoric mood, irritability,… (Fluvoxamine label, Warnings and precautions)
No significant interaction reported (1)
- Digoxindigitalis glycosideNo interaction
Digoxin: Administration of fluvoxamine maleate 100 mg daily for 18 days (N=8) did not significantly affect the pharmacokinetics of a 1.25 mg single intravenous dose of digoxin. (Fluvoxamine label, Drug interactions)
Check Fluvoxamine against everything you take. Add your full list; every pair is checked at once.
Open in the checkerNot medical advice. Severity reflects the label's wording, not your circumstances. A "major" flag can be routine under supervision and a "minor" one can matter at high doses. Ask a pharmacist.