Duloxetine and Fluvoxamine interaction

Duloxetine and Fluvoxamine: both prescribing labels flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.

Major

Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.

What the FDA labels say

From the Duloxetine (Cymbalta) label · effective 2025-07-21

Major

Serotonin Syndrome : Increased risk when co-administered with other serotonergic agents, but also when taken alone.

Warnings and precautionsby drug classView label on DailyMed
Major

Inhibitors of CYP1A2 or Thioridazine : Avoid co-administration with CYMBALTA ( 5.12 )

Warnings and precautionsby drug classView label on DailyMed
Major

If concomitant use of CYMBALTA with other serotonergic drugs is clinically warranted, inform patients of the increased risk for serotonin syndrome and monitor for symptoms.

Warnings and precautionsby drug classView label on DailyMed
Major

Other bleeding events related to SSRI and SNRI use have ranged from ecchymoses, hematomas, epistaxis, and petechiae to life-threatening hemorrhages.

Warnings and precautionsby drug classView label on DailyMed
Major

Potential for Other Drugs to Affect CYMBALTA CYP1A2 Inhibitors — Co-administration of CYMBALTA with potent CYP1A2 inhibitors should be avoided [see Drug Interactions ( 7.1 )] .

Warnings and precautionsby drug classView label on DailyMed

From the Fluvoxamine (fluvoxamine maleate) label · effective 2026-04-23

Major

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.

Boxed warningby drug classView label on DailyMed
Major

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.

Warnings and precautionsby drug classView label on DailyMed
Major

If concomitant use of Fluvoxamine Maleate Tablets with other serotonergic drugs is clinically warranted, inform patients of the increased risk for serotonin syndrome and monitor for symptoms.

Warnings and precautionsby drug classView label on DailyMed
Major

Bleeding events related to SSRIs and SNRIs have ranged from ecchymoses, hematomas, epistaxis, and petechiae to life-threatening hemorrhages.

Warnings and precautionsby drug classView label on DailyMed
Major

If serotonin syndrome occurs, consider discontinuation of Fluvoxamine Maleate Tablets and/or concomitant serotonergic drugs [see Warnings and Precautions ( 5.2 )] .

Drug interactionsby drug classView label on DailyMed

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Not medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.