Fluvoxamine and Ramelteon interaction
Fluvoxamine and Ramelteon: both prescribing labels flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.
Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.
What the FDA labels say
From the Fluvoxamine (fluvoxamine maleate) label · effective 2026-04-23
Ramelteon: Should not be used in combination with fluvoxamine ( 5.8 ).
Ramelteon should not be used in combination with fluvoxamine.
Ramelteon: When fluvoxamine 100 mg twice daily was administered for 3 days prior to single-dose coadministration of ramelteon 16 mg and fluvoxamine, the AUC for ramelteon increased approximately 190-fold and the C max increased approximately 70-fold compared to ramelteon administered alone.
Ramelteon: See Warnings and Precautions ( 5.8 ) .
From the Ramelteon (Rozerem) label · effective 2026-04-15
Patients should not take ROZEREM in conjunction with fluvoxamine [see Drug Interactions (7) ] .
ROZEREM should not be used in combination with fluvoxamine [see Contraindications (4) , Clinical Pharmacology (12.5) ] .
Fluvoxamine (strong CYP1A2 inhibitor): Increases AUC for ramelteon and should not be used in combination.
Effects of Other Drugs on ROZEREM Fluvoxamine (strong CYP1A2 inhibitor) AUC 0-inf for ramelteon increased approximately 190-fold, and the C max increased approximately 70-fold upon coadministration of fluvoxamine and ROZEREM, compared to ROZEREM administered alone.
ROZEREM should be administered with caution to patients taking less strong CYP1A2 inhibitors.
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Open in the checkerNot 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.