fluvoxamine (Rx)

Obsessive-Compulsive Disorder

Conventional tablets

• 50 mg qHS initially; may increase by 50 mg/day q4-7Days up to 100-300 mg/day
• Dose >100 mg/day should be divided q12hr

Social Phobia (Off-label)

Immediate release

• 50 mg PO qDay; may increase by 50 mg at 1 week interval; usual dose range is 100-300 mg/day

Panic Disorder (Off-label)

25-50 mg PO qDay; after several days, gradually increase to 100-200 mg/day; may increase to 300 mg/day for patients who fail to respond after several weeks of treatment

Dosing considerations

• Continue therapy for 1-2 years, and consider discontinuation with close supervision; when discontinuing therapy, a slow taper over 2-6 months is recommended

Posttraumatic Stress Disorder (Off-label)

50 mg/day PO initially; may increase dose to 100-250 mg in adults and 100 mg in older adults; not to exceed 300 mg/day

Dosing considerations

• Patients who respond to therapy may need to continue therapy indefinitely
• May attempt tapering after 6-12 months in patients with acute PTSD; tapering should occur gradually over 2 weeks to 1 month to avoid withdrawal symptoms; tapering should take place over 4-12 weeks in patients at risk of relapse

Dosing Modifications

Hepatic impairment: Decrease dose

Therapy discontinuation

• To discontinue therapy, gradually taper the dose to minimize the incidence of withdrawal symptoms and allow for detection of re-emerging symptoms

Obsessive-Compulsive Disorder

<8 years: Safety and efficacy not established

Ages 8-17 years (conventional tablets): 25 mg PO qHS initially; may titrate by 25 mg/day increments every 4-7 days to 50-200 mg/day

Not to exceed 200 mg (for ages 8-11 years) or 300 mg for adolescents

Give doses >50 mg/day divided q12hr

The elderly are prone to SSRI/SNRI-induced hyponatremia; monitor closely

Obsessive-Compulsive Disorder

Conventional tablets: 25 mg qHS initially; may increase by 50 mg/day q4-7days up to 100-300 mg/day; dose >100 mg/day should be divided q12hr

Social Phobia (Off-label)

Conventional tablets: 50 mg PO qDay initially; may increase by 50 mg at 1 week interval; usual dose range is 100-300 mg/day

Contraindicated (8)

• alosetron

  fluvoxamine will increase the level or effect of alosetron by affecting hepatic enzyme CYP1A2 metabolism. Contraindicated.

• dihydroergotamine

  fluvoxamine will increase the level or effect of dihydroergotamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.

• fezolinetant

  fluvoxamine will increase the level or effect of fezolinetant by affecting hepatic enzyme CYP1A2 metabolism. Contraindicated. Fezolinetant AUC and peak plasma concentration are increased if coadministered with drugs that are weak, moderate, or strong CYP1A2 inhibitors

• isocarboxazid

  fluvoxamine and isocarboxazid both increase serotonin levels. Contraindicated.

• lonafarnib

  fluvoxamine will increase the level or effect of lonafarnib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Lonafarnib is a sensitive CYP3A4 substrate. Coadministration with strong or moderate CYP3A4 inhibitors is contraindicated.

• mavacamten

  fluvoxamine will increase the level or effect of mavacamten by affecting hepatic enzyme CYP2C19 metabolism. Contraindicated. Strong or moderate CYP2C19 inhibitors may increase mavacamten systemic exposure, resulting in heart failure due to systolic dysfunction.

• ramelteon

  fluvoxamine will increase the level or effect of ramelteon by affecting hepatic enzyme CYP1A2 metabolism. Contraindicated.

• selegiline

  fluvoxamine will increase the level or effect of selegiline by affecting hepatic enzyme CYP2B6 metabolism. Contraindicated.

Serious - Use Alternative (132)

• alfentanil

  fluvoxamine and alfentanil both increase serotonin levels. Avoid or Use Alternate Drug.

• almotriptan

  fluvoxamine will increase the level or effect of almotriptan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• amisulpride

  amisulpride and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug. ECG monitoring is recommended if coadministered.

• amitriptyline

  fluvoxamine and amitriptyline both increase serotonin levels. Avoid or Use Alternate Drug.

• amoxapine

  fluvoxamine and amoxapine both increase serotonin levels. Avoid or Use Alternate Drug.

• anagrelide

  anagrelide and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.

• arsenic trioxide

  fluvoxamine and arsenic trioxide both increase QTc interval. Avoid or Use Alternate Drug.

• asenapine

  asenapine and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.

• asenapine transdermal

  asenapine transdermal and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.

• avapritinib

  fluvoxamine will increase the level or effect of avapritinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of avapritinib with moderate CYP3A4 inhibitors. If unable to avoid, reduce avapritinib starting dose. See drug monograph Dosage Modifications

• buprenorphine

  buprenorphine and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.

• buprenorphine buccal

  buprenorphine buccal and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.

• buprenorphine subdermal implant

  buprenorphine subdermal implant and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.

• buprenorphine transdermal

  buprenorphine transdermal and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.

• buprenorphine, long-acting injection

  buprenorphine, long-acting injection and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.

• bupropion

  fluvoxamine increases toxicity of bupropion by Other (see comment). Avoid or Use Alternate Drug. Comment: May lower seizure threshold; keep bupropion dose as low as possible.

• buspirone

  fluvoxamine and buspirone both increase serotonin levels. Avoid or Use Alternate Drug.

• cilostazol

  fluvoxamine increases toxicity of cilostazol by affecting hepatic enzyme CYP2C19 metabolism. Avoid or Use Alternate Drug. Decrease cilostazol dose by 50%; serum levels of 3,4-dehydrocilostazole (active metabolite) increased by strong CYP2C19 inhibitors.

• cimetidine

  fluvoxamine will increase the level or effect of cimetidine by affecting hepatic enzyme CYP2C19 metabolism. Avoid or Use Alternate Drug.

• citalopram

  fluvoxamine and citalopram both increase serotonin levels. Avoid or Use Alternate Drug. Combinatiomay increase risk of serotonin syndrome or neuroleptic malignant syndromn e like reactions.

• clomipramine

  fluvoxamine and clomipramine both increase serotonin levels. Avoid or Use Alternate Drug.

• clopidogrel

  fluvoxamine decreases effects of clopidogrel by affecting hepatic enzyme CYP2C19 metabolism. Avoid or Use Alternate Drug. Clopidogrel efficacy may be reduced by drugs that inhibit CYP2C19. Inhibition of platelet aggregation by clopidogrel is entirely due to an active metabolite. Clopidogrel is metaolized to this active metabolite in part by CYP2C19.

• clozapine

  fluvoxamine will increase the level or effect of clozapine by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug.

• colchicine

  fluvoxamine will increase the level or effect of colchicine by Other (see comment). Avoid or Use Alternate Drug. Colchicine is a P-gp and CYP3A4 substrate. Avoid use with drugs that are both P-gp and strong CYP3A4 inhibitors. If coadministration is necessary, decrease colchicine dose or frequency as recommended in prescribing information. Use of any colchicine product in conjunction with strong CYP3A4 inhibitors is contraindicated in patients with renal or hepatic impairment.

• cyclobenzaprine

  fluvoxamine and cyclobenzaprine both increase serotonin levels. Avoid or Use Alternate Drug.

• dacomitinib

  fluvoxamine will increase the level or effect of dacomitinib by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Avoid use with CYP3D6 substrates where minimal increases in concentration of the CYP2D6 substrate may lead to serious or life-threatening toxicities

• desflurane

  desflurane and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.

• desipramine

  fluvoxamine and desipramine both increase serotonin levels. Avoid or Use Alternate Drug.

• desvenlafaxine

  fluvoxamine and desvenlafaxine both increase serotonin levels. Avoid or Use Alternate Drug.

• dextromethorphan

  fluvoxamine and dextromethorphan both increase serotonin levels. Avoid or Use Alternate Drug.

• dihydroergotamine intranasal

  fluvoxamine will increase the level or effect of dihydroergotamine intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.

• disopyramide

  fluvoxamine and disopyramide both increase QTc interval. Avoid or Use Alternate Drug.

• dolasetron

  fluvoxamine and dolasetron both increase serotonin levels. Avoid or Use Alternate Drug.

• dosulepin

  fluvoxamine and dosulepin both increase serotonin levels. Avoid or Use Alternate Drug.

• doxepin

  fluvoxamine and doxepin both increase serotonin levels. Avoid or Use Alternate Drug.

• dronedarone

  fluvoxamine will increase the level or effect of dronedarone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
  
  dronedarone will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.

• duloxetine

  fluvoxamine will increase the level or effect of duloxetine by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug.
  
  fluvoxamine and duloxetine both increase serotonin levels. Avoid or Use Alternate Drug.

• elacestrant

  fluvoxamine will increase the level or effect of elacestrant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• eliglustat

  eliglustat and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.

• eltrombopag

  fluvoxamine will increase the level or effect of eltrombopag by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug.

• encorafenib

  encorafenib and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.

• entrectinib

  fluvoxamine will increase the level or effect of entrectinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. avoid coadministration of moderate CYP3A4 inhibitors with entrectinib, a CYP3A4 substrate. If coadministration unavoidabole, reduce dose to 200 mg/day for patients aged 12 y or older with BSA >1.5m2. Resume previous entrectinib dose after discontinuing moderate CYP3A4 inhibitor for 3-5 elimination half-lives.
  
  entrectinib and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.

• ergotamine

  fluvoxamine will increase the level or effect of ergotamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.

• eribulin

  eribulin and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.

• escitalopram

  fluvoxamine and escitalopram both increase serotonin levels. Avoid or Use Alternate Drug.

• esomeprazole

  fluvoxamine will increase the level or effect of esomeprazole by affecting hepatic enzyme CYP2C19 metabolism. Avoid or Use Alternate Drug.

• etravirine

  fluvoxamine will increase the level or effect of etravirine by affecting hepatic enzyme CYP2C19 metabolism. Avoid or Use Alternate Drug.

• everolimus

  fluvoxamine will increase the level or effect of everolimus by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.

• fedratinib

  fluvoxamine will increase the level or effect of fedratinib by Other (see comment). Avoid or Use Alternate Drug. Avoid coadministration of fedratinib (a CYP3A4 and CYP2C19 substrate) with dual CYP3A4 and CYP2C19 inhibitor. Effect of coadminitration of a dual CYP3A4 and CYP2C19 inhibitor with fedratinib not studied

• fentanyl

  fluvoxamine and fentanyl both increase serotonin levels. Avoid or Use Alternate Drug.

• fentanyl transdermal

  fluvoxamine and fentanyl transdermal both increase serotonin levels. Avoid or Use Alternate Drug.

• fentanyl transmucosal

  fluvoxamine and fentanyl transmucosal both increase serotonin levels. Avoid or Use Alternate Drug.

• fluoxetine

  fluvoxamine and fluoxetine both increase serotonin levels. Avoid or Use Alternate Drug.

• gilteritinib

  gilteritinib will increase the level or effect of fluvoxamine by Other (see comment). Avoid or Use Alternate Drug. Coadministrationwith drugs that inhibit 5HT2B or sigma nonspecific receptors. Avoid use of these drugs with gilteritinib unless coadministration is necessary
  
  gilteritinib and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.

• givosiran

  givosiran will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP1A2 substrates with givosiran. If unavoidable, decrease the CYP1A2 substrate dosage in accordance with approved product labeling.
  
  givosiran will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP2D6 substrates with givosiran. If unavoidable, decrease the CYP2D6 substrate dosage in accordance with approved product labeling.

• granisetron

  fluvoxamine and granisetron both increase serotonin levels. Avoid or Use Alternate Drug.

• hydromorphone

  fluvoxamine and hydromorphone both increase serotonin levels. Avoid or Use Alternate Drug.

• ibutilide

  fluvoxamine and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.

• imipramine

  fluvoxamine and imipramine both increase serotonin levels. Avoid or Use Alternate Drug.

• indapamide

  fluvoxamine and indapamide both increase QTc interval. Avoid or Use Alternate Drug.

• infigratinib

  fluvoxamine will increase the level or effect of infigratinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• isoflurane

  isoflurane and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.

• leniolisib

  leniolisib will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug. Avoid leniolisib with CYP1A2 substrates that have a narrow therapeutic index

• levomilnacipran

  fluvoxamine and levomilnacipran both increase serotonin levels. Avoid or Use Alternate Drug.

• lidocaine

  fluvoxamine and lidocaine both increase serotonin levels. Avoid or Use Alternate Drug.

• linezolid

  fluvoxamine and linezolid both increase serotonin levels. Avoid or Use Alternate Drug.

• lofepramine

  fluvoxamine and lofepramine both decrease serotonin levels. Avoid or Use Alternate Drug.

• lorcaserin

  fluvoxamine and lorcaserin both increase serotonin levels. Avoid or Use Alternate Drug.

• lovastatin

  fluvoxamine will increase the level or effect of lovastatin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.

• lurbinectedin

  fluvoxamine will increase the level or effect of lurbinectedin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• maprotiline

  fluvoxamine and maprotiline both increase serotonin levels. Avoid or Use Alternate Drug.

• melatonin

  fluvoxamine will increase the level or effect of melatonin by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of melatonin with strong CYP1A2 inhibitors

• meperidine

  fluvoxamine and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.

• methylene blue

  fluvoxamine increases toxicity of methylene blue by serotonin levels. Avoid or Use Alternate Drug.

• metoclopramide

  fluvoxamine and metoclopramide both increase serotonin levels. Avoid or Use Alternate Drug. Additive effects: Increased risk for serotonin syndrome, neuroleptic malignant syndrome, dystonia, or other extrapyramidal reactions

• metoclopramide intranasal

  fluvoxamine, metoclopramide intranasal. Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient.

• mexiletine

  fluvoxamine will increase the level or effect of mexiletine by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug.

• milnacipran

  fluvoxamine and milnacipran both increase serotonin levels. Avoid or Use Alternate Drug.

• mirtazapine

  mirtazapine and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.

• mobocertinib

  fluvoxamine will increase the level or effect of mobocertinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If use of moderate CYP3A4 inhibitor unavoidable, reduce mobocertinib dose by ~50% (eg, 160 to 80 mg); closely monitor QTc interval.

• nefazodone

  fluvoxamine and nefazodone both increase serotonin levels. Avoid or Use Alternate Drug.

• neratinib

  fluvoxamine will increase the level or effect of neratinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• netupitant/palonosetron

  fluvoxamine increases toxicity of netupitant/palonosetron by serotonin levels. Avoid or Use Alternate Drug.

• nortriptyline

  fluvoxamine and nortriptyline both increase serotonin levels. Avoid or Use Alternate Drug.

• olanzapine

  fluvoxamine will increase the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug.
  
  olanzapine and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.

• olopatadine intranasal

  fluvoxamine and olopatadine intranasal both increase sedation. Avoid or Use Alternate Drug. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.

• omaveloxolone

  fluvoxamine will increase the level or effect of omaveloxolone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If unavoidable, reduce omaveloxolone dose to 100 mg/day. Closely monitor for adverse effects. If adverse effects emerge, further reduce to 50 mg/day.

• omeprazole

  fluvoxamine will increase the level or effect of omeprazole by affecting hepatic enzyme CYP2C19 metabolism. Avoid or Use Alternate Drug.

• ondansetron

  fluvoxamine and ondansetron both increase serotonin levels. Avoid or Use Alternate Drug.

• oxaliplatin

  oxaliplatin and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.

• ozanimod

  ozanimod increases toxicity of fluvoxamine by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Because active metabolite of ozanimod inhibits MAO-B in vitro, there is potential for serious adverse reactions, including hypertensive crisis. Therefore, coadministration of ozanimod with drugs that can increase norepinephrine or serotonin is not recommended. Monitor for hypertension with concomitant use. .

• pacritinib

  fluvoxamine will increase the level or effect of pacritinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• palonosetron

  fluvoxamine and palonosetron both increase serotonin levels. Avoid or Use Alternate Drug.

• paroxetine

  fluvoxamine and paroxetine both increase serotonin levels. Avoid or Use Alternate Drug.

• pazopanib

  fluvoxamine will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If it must be coadminister, decrease pazotinib dose to 400 mg/day

• pentamidine

  fluvoxamine and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

• pexidartinib

  fluvoxamine will increase the level or effect of pexidartinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration with strong or moderate CYP3A4 inhibitors is unavoidable, reduce pexidartinib dose (refer to drug monograph dosage modifications). After discontinuing the CYP3A4 inhibitor for 3 elimination half-lives, may resume previous pexidartinib dose.

• phenelzine

  fluvoxamine and phenelzine both increase serotonin levels. Contraindicated.

• phentermine

  fluvoxamine and phentermine both increase serotonin levels. Avoid or Use Alternate Drug.

• pimozide

  fluvoxamine increases toxicity of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
  
  fluvoxamine and pimozide both increase QTc interval. Avoid or Use Alternate Drug.

• pirfenidone

  fluvoxamine will increase the level or effect of pirfenidone by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug. Use of strong CYP1A2 inhibitors should be discontinued before initiating treatment and avoided during treatment; if strong CYP1A2 inhibitor is only option, dosage reduction recommended

• pomalidomide

  fluvoxamine will increase the level or effect of pomalidomide by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug.

• procainamide

  fluvoxamine and procainamide both increase QTc interval. Avoid or Use Alternate Drug.

• procarbazine

  fluvoxamine and procarbazine both increase serotonin levels. Contraindicated.

• protriptyline

  fluvoxamine and protriptyline both increase serotonin levels. Avoid or Use Alternate Drug.

• quinidine

  fluvoxamine and quinidine both increase QTc interval. Avoid or Use Alternate Drug.

• ranolazine

  fluvoxamine will increase the level or effect of ranolazine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.

• rasagiline

  fluvoxamine and rasagiline both increase serotonin levels. Avoid or Use Alternate Drug. Severe CNS toxicity associated with hyperpyrexia reported with combined treatment of antidepressant and rasagiline; avoid combination within 14 days of MAOI use

• remifentanil

  fluvoxamine and remifentanil both increase serotonin levels. Avoid or Use Alternate Drug.

• ropinirole

  fluvoxamine will increase the level or effect of ropinirole by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug.

• selegiline

  fluvoxamine and selegiline both increase serotonin levels. Contraindicated. At least 14 days should elapse between discontinuation of either drug and initiation of the other one

• selegiline transdermal

  fluvoxamine and selegiline transdermal both increase serotonin levels. Avoid or Use Alternate Drug.

• selinexor

  selinexor, fluvoxamine. unspecified interaction mechanism. Avoid or Use Alternate Drug. Patients treated with selinexor may experience neurological toxicities. Avoid taking selinexor with other medications that may cause dizziness or confusion.

• sertraline

  fluvoxamine and sertraline both increase serotonin levels. Avoid or Use Alternate Drug.
  
  sertraline and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.

• sevoflurane

  sevoflurane and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.

• siponimod

  fluvoxamine will increase the level or effect of siponimod by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration with a moderate or strong CYP3A4 inhibitor PLUS a moderate or strong CYP2C9 inhibitor not recommended
  
  siponimod and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.

• sotalol

  fluvoxamine and sotalol both increase QTc interval. Avoid or Use Alternate Drug.

• St John's Wort

  fluvoxamine and St John's Wort both increase serotonin levels. Avoid or Use Alternate Drug.

• tazemetostat

  fluvoxamine will increase the level or effect of tazemetostat by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of avapritinib with moderate CYP3A4 inhibitors. If unable to avoid, reduce avapritinib starting dose. See drug monograph Dosage Modifications

• tedizolid

  fluvoxamine and tedizolid both increase serotonin levels. Avoid or Use Alternate Drug.

• tetrabenazine

  tetrabenazine and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.

• theophylline

  fluvoxamine will increase the level or effect of theophylline by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug.

• thioridazine

  fluvoxamine will increase the level or effect of thioridazine by affecting hepatic enzyme CYP1A2 metabolism. Contraindicated.
  
  fluvoxamine and thioridazine both increase QTc interval. Contraindicated.

• tipranavir

  tipranavir will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.

• tizanidine

  fluvoxamine will increase the level or effect of tizanidine by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug.

• tolvaptan

  fluvoxamine will increase the level or effect of tolvaptan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.

• tranylcypromine

  fluvoxamine and tranylcypromine both increase serotonin levels. Contraindicated.

• trazodone

  fluvoxamine and trazodone both increase serotonin levels. Avoid or Use Alternate Drug.

• trimipramine

  fluvoxamine will increase the level or effect of trimipramine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.

• venlafaxine

  fluvoxamine and venlafaxine both increase serotonin levels. Avoid or Use Alternate Drug.

• vilazodone

  fluvoxamine and vilazodone both increase serotonin levels. Avoid or Use Alternate Drug. Discontinue concomitant therapy immediately if signs and symptoms of serotonin syndrome emerge and supportive sympathomimetic treatment should be initiated

• vortioxetine

  fluvoxamine, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.

Monitor Closely (326)

• 5-HTP

  fluvoxamine and 5-HTP both increase serotonin levels. Modify Therapy/Monitor Closely.

• abiraterone

  abiraterone will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. If therapy cannot be avoided, exercise caution and consider a dose reduction of CYP2D6 substrate

• abrocitinib

  fluvoxamine will increase the level or effect of abrocitinib by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Start abrocitinib 50 mg qDay when coadministered with CYP2C19 inhibitors. If adequate response not achieved after 12 weeks, may increase to 100 mg qDay. Discontinue if inadequate response after dosage increase.

• acalabrutinib

  fluvoxamine will increase the level or effect of acalabrutinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Decrease dose to 100 mg once daily if coadministered with CYP3A4 inhibitor

• aceclofenac

  fluvoxamine, aceclofenac. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• acemetacin

  fluvoxamine, acemetacin. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• alfentanil

  fluvoxamine will increase the level or effect of alfentanil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• alfuzosin

  fluvoxamine and alfuzosin both increase QTc interval. Use Caution/Monitor.

• almotriptan

  fluvoxamine and almotriptan both increase serotonin levels. Modify Therapy/Monitor Closely.

• alosetron

  fluvoxamine will increase the level or effect of alosetron by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.

• alprazolam

  fluvoxamine will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• amifampridine

  fluvoxamine increases toxicity of amifampridine by Other (see comment). Modify Therapy/Monitor Closely. Comment: Amifampridine can cause seizures. Coadministration with drugs that lower seizure threshold may increase this risk.

• amiodarone

  fluvoxamine and amiodarone both increase QTc interval. Use Caution/Monitor.

• amitriptyline

  fluvoxamine and amitriptyline both increase QTc interval. Modify Therapy/Monitor Closely.

• amoxapine

  fluvoxamine and amoxapine both increase QTc interval. Modify Therapy/Monitor Closely.

• antipyrine

  fluvoxamine will increase the level or effect of antipyrine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.

• apixaban

  fluvoxamine increases effects of apixaban by anticoagulation. Use Caution/Monitor. SSRIs may inhibit platelet aggregation, thus increase bleeding risk when coadministered with anticoagulants.

• asenapine

  fluvoxamine will increase the level or effect of asenapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. Dose reduction may be necessary

• asenapine transdermal

  fluvoxamine will increase the level or effect of asenapine transdermal by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. Dose reduction may be necessary

• aspirin

  fluvoxamine, aspirin. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding SSRIs inhib. serotonin uptake by platelets.

• aspirin rectal

  fluvoxamine, aspirin rectal. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding SSRIs inhib. serotonin uptake by platelets.

• atogepant

  fluvoxamine will increase the level or effect of atogepant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• avanafil

  fluvoxamine will increase the level or effect of avanafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Maximum recommended dose of STENDRA is 50mg, not to exceed once every 24hr for patients taking concomitant moderate CYP3A4 inhibitors

• axitinib

  fluvoxamine will increase the level or effect of axitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• belzutifan

  fluvoxamine will increase the level or effect of belzutifan by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Belzutifan is a CYP2C19 substrate. Coadministration with CYP2C19 inhibitors may increase incidence or severity of adverse effects. Monitor for anemia and hypoxia and reduce belzutifan dose as recommended.

• bendamustine

  fluvoxamine will increase the level or effect of bendamustine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. Decreased conversion of bendamustine to active metabolite. May decrease concentration of active metabolites

• benzhydrocodone/acetaminophen

  fluvoxamine, benzhydrocodone/acetaminophen. Either increases toxicity of the other by serotonin levels. Use Caution/Monitor. If concomitant use warranted, carfully observe patient, particularly during treatment initiation and dose adjustment.

• betrixaban

  fluvoxamine, betrixaban. Either increases toxicity of the other by anticoagulation. Use Caution/Monitor.

• bexarotene

  fluvoxamine will increase the level or effect of bexarotene by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• bortezomib

  fluvoxamine will increase the level or effect of bortezomib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• bosentan

  fluvoxamine will increase the level or effect of bosentan by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.

• budesonide

  fluvoxamine will increase the level or effect of budesonide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• buprenorphine subdermal implant

  fluvoxamine and buprenorphine subdermal implant both increase serotonin levels. Use Caution/Monitor. If concomitant use warranted, carefully observe patient, particularly during treatment initiation, and during dose adjustment of serotonergic drug. Discontinue buprenorphine if serotonin syndrome suspected

• buprenorphine, long-acting injection

  fluvoxamine and buprenorphine, long-acting injection both increase serotonin levels. Use Caution/Monitor. If concomitant use warranted, carefully observe patient, particularly during treatment initiation, and during dose adjustment of serotonergic drug. Discontinue buprenorphine if serotonin syndrome suspected

• bupropion

  fluvoxamine will increase the level or effect of bupropion by affecting hepatic enzyme CYP2B6 metabolism. Use Caution/Monitor.

• buspirone

  fluvoxamine will increase the level or effect of buspirone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• caffeine

  fluvoxamine will increase the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.

• cannabidiol

  fluvoxamine will increase the level or effect of cannabidiol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Consider reducing cannabidiol dose when coadministered with a moderate CYP3A4 inhibitor

• carbamazepine

  fluvoxamine will increase the level or effect of carbamazepine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Monitor plasma levels when used concomitantly

• carvedilol

  fluvoxamine will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.

• celecoxib

  fluvoxamine will increase the level or effect of celecoxib by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.

• chlorpromazine

  fluvoxamine and chlorpromazine both increase QTc interval. Modify Therapy/Monitor Closely.

• choline magnesium trisalicylate

  fluvoxamine, choline magnesium trisalicylate. Either decreases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding SSRIs inhib. serotonin uptake by platelets.

• cilostazol

  fluvoxamine will increase the level or effect of cilostazol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• cimetidine

  cimetidine will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

• cinacalcet

  fluvoxamine will increase the level or effect of cinacalcet by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• citalopram

  fluvoxamine will increase the level or effect of citalopram by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. Citalopram 20 mg/day is maximum recommended dose for patients taking CYP2C19 inhibitors because of the risk of QT prolongation

• clarithromycin

  fluvoxamine and clarithromycin both increase QTc interval. Modify Therapy/Monitor Closely.

• clobazam

  fluvoxamine will increase the level or effect of clobazam by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. Dosage adjustment may be necessary ; CYP2C19 inhibitors may result in increased exposure to N-desmethylclobazam (active metabolite)
  
  clobazam will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. May be necessary to admininister lower doses of drugs metabolized by CYP2D6 when used concomitantly

• clomipramine

  fluvoxamine and clomipramine both increase QTc interval. Modify Therapy/Monitor Closely.

• clonidine

  fluvoxamine, clonidine. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. CNS derpressant effects enhanced.

• clopidogrel

  fluvoxamine will increase the level or effect of clopidogrel by pharmacodynamic synergism. Use Caution/Monitor. SSRIs affect platelet activation; coadministration may increase risk of bleeding

• clozapine

  fluvoxamine will increase the level or effect of clozapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.

• cobicistat

  fluvoxamine will increase the level or effect of cobicistat by Other (see comment). Use Caution/Monitor. Carfully titrate dose of antidepressant to desired effect, including using lowest feasible initial or maintenance dose , and monitor its response during coadministration with SSRIs and cobicistat

• cocaine topical

  fluvoxamine and cocaine topical both increase serotonin levels. Modify Therapy/Monitor Closely.

• conivaptan

  fluvoxamine will increase the level or effect of conivaptan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• cortisone

  fluvoxamine will increase the level or effect of cortisone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• cyclophosphamide

  fluvoxamine will increase the level or effect of cyclophosphamide by affecting hepatic enzyme CYP2B6 metabolism. Use Caution/Monitor.

• cyclosporine

  fluvoxamine will increase the level or effect of cyclosporine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.

• cyproheptadine

  cyproheptadine decreases effects of fluvoxamine by pharmacodynamic antagonism. Use Caution/Monitor. May deminish serotonergic effect of SSRIs.

• daridorexant

  fluvoxamine will increase the level or effect of daridorexant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Daridorexant dose should not exceed 25 mg per night when coadministered with moderate CYP3A4 inhibitors.
  
  fluvoxamine and daridorexant both increase sedation. Modify Therapy/Monitor Closely. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.

• darifenacin

  fluvoxamine will increase the level or effect of darifenacin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• darunavir

  fluvoxamine will increase the level or effect of darunavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• dasatinib

  fluvoxamine and dasatinib both increase QTc interval. Modify Therapy/Monitor Closely.

• deferasirox

  deferasirox will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.

• defibrotide

  defibrotide increases effects of fluvoxamine by Other (see comment). Use Caution/Monitor. Comment: Defibrotide may enhance effects of platelet inhibitors.

• deflazacort

  fluvoxamine will increase the level or effect of deflazacort by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Decrease deflazacort dose by one-third of recommended dose if coadministered with moderate or strong CYP3A4 inhibitors

• degarelix

  degarelix and fluvoxamine both increase QTc interval. Use Caution/Monitor.

• desipramine

  fluvoxamine and desipramine both increase QTc interval. Modify Therapy/Monitor Closely.

• desvenlafaxine

  desvenlafaxine will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. With higher desvenlafaxine doses (eg, 400 mg) decrease CYP2D6 substrate dose by up to 50%; dose adjustment not necessary with desvenlafaxine doses <100mg

• deutetrabenazine

  deutetrabenazine and fluvoxamine both increase QTc interval. Use Caution/Monitor. At the maximum recommended dose, deutetrabenazine does not prolong QT interval to a clinically relevant extent. Certain circumstances may increase risk of torsade de pointes and/or sudden death in association with drugs that prolong the QTc interval (eg, bradycardia, hypokalemia or hypomagnesemia, coadministration with other drugs that prolong QTc interval, presence of congenital QT prolongation).

• dexfenfluramine

  fluvoxamine and dexfenfluramine both increase serotonin levels. Modify Therapy/Monitor Closely.

• dextroamphetamine

  fluvoxamine and dextroamphetamine both decrease serotonin levels. Modify Therapy/Monitor Closely.

• dextroamphetamine transdermal

  fluvoxamine, dextroamphetamine transdermal. Either increases effects of the other by serotonin levels. Modify Therapy/Monitor Closely. Initiate with lower doses and monitor for signs and symptoms of serotonin syndrome, particularly during initiation or dosage increase. If serotonin syndrome occurs, discontinue dextroamphetamine transdermal and concomitant serotonergic drug(s).

• diazepam

  fluvoxamine will increase the level or effect of diazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• diazepam intranasal

  fluvoxamine will increase the level or effect of diazepam intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. May decrease rate of diazepam elimination, causing a decrease in diazepam elimnation, thereby increasing adverse reactions to diazepam

• dichlorphenamide

  dichlorphenamide and fluvoxamine both decrease serum potassium. Use Caution/Monitor.

• diclofenac

  fluvoxamine, diclofenac. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• difelikefalin

  difelikefalin and fluvoxamine both increase sedation. Use Caution/Monitor.

• diflunisal

  fluvoxamine, diflunisal. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• dihydroergotamine

  fluvoxamine and dihydroergotamine both increase serotonin levels. Modify Therapy/Monitor Closely.

• dihydroergotamine intranasal

  fluvoxamine and dihydroergotamine intranasal both increase serotonin levels. Modify Therapy/Monitor Closely.

• diltiazem

  fluvoxamine will increase the level or effect of diltiazem by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• dofetilide

  fluvoxamine and dofetilide both increase QTc interval. Modify Therapy/Monitor Closely.

• dolasetron

  fluvoxamine and dolasetron both increase QTc interval. Use Caution/Monitor.

• donepezil

  donepezil and fluvoxamine both increase QTc interval. Use Caution/Monitor.

• edoxaban

  fluvoxamine will increase the level or effect of edoxaban by anticoagulation. Use Caution/Monitor. SSRIs affect platelet activation; coadministration may increase risk of bleeding

• efavirenz

  fluvoxamine will increase the level or effect of efavirenz by affecting hepatic enzyme CYP2B6 metabolism. Use Caution/Monitor.
  
  efavirenz and fluvoxamine both increase QTc interval. Use Caution/Monitor.

• eletriptan

  fluvoxamine and eletriptan both increase serotonin levels. Modify Therapy/Monitor Closely.

• eliglustat

  eliglustat will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Monitor therapeutic drug concentrations; consider reducing dosage of concomitant drug and titrate to clincal effect

• elranatamab

  elranatamab will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. Elranatamab causes cytokine release syndrome (CRS) that may suppress activity of CYP enzymes, resulting in increased exposure of CYP substrates. This is more likely to occur from initiation of elranatamab step-up dosing up to 14 days after the first treatment dose and during and after CRS.

• eltrombopag

  fluvoxamine will increase the level or effect of eltrombopag by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.

• eluxadoline

  fluvoxamine will increase the level or effect of eluxadoline by affecting hepatic enzyme CYP1A2 metabolism. Modify Therapy/Monitor Closely. Use caution when coadministering with strong CYP1A2 inhibitors; Not studied
  
  fluvoxamine will increase the level or effect of eluxadoline by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. Use caution when coadministering with CYP2C19 inhibitors; not studied

• elvitegravir/cobicistat/emtricitabine/tenofovir DF

  elvitegravir/cobicistat/emtricitabine/tenofovir DF will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Caution with CYP2D6 substrates for which elevated plasma concentrations may cause life-threatening events

• epcoritamab

  epcoritamab, fluvoxamine. affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. Epcoritamab causes release of cytokines that may suppress activity of CYP enzymes, resulting in increased exposure of CYP substrates. For certain CYP substrates, minimal changes in their concentration may lead to serious adverse reactions. If needed, modify therapy as recommended in the substrate's prescribing information. .

• epinephrine

  fluvoxamine and epinephrine both increase QTc interval. Modify Therapy/Monitor Closely.

• epinephrine racemic

  fluvoxamine and epinephrine racemic both increase QTc interval. Modify Therapy/Monitor Closely.

• ergotamine

  fluvoxamine and ergotamine both increase serotonin levels. Modify Therapy/Monitor Closely.

• erlotinib

  fluvoxamine will increase the level or effect of erlotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• erythromycin base

  fluvoxamine and erythromycin base both increase QTc interval. Modify Therapy/Monitor Closely.

• erythromycin ethylsuccinate

  fluvoxamine and erythromycin ethylsuccinate both increase QTc interval. Modify Therapy/Monitor Closely.

• erythromycin lactobionate

  fluvoxamine and erythromycin lactobionate both increase QTc interval. Modify Therapy/Monitor Closely.

• erythromycin stearate

  fluvoxamine and erythromycin stearate both increase QTc interval. Modify Therapy/Monitor Closely.

• ethinylestradiol

  ethinylestradiol will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.

• ethotoin

  fluvoxamine will increase the level or effect of ethotoin by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.

• etodolac

  fluvoxamine, etodolac. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding; SSRIs inhib. srotonin uptake by platelets.

• etravirine

  fluvoxamine will increase the level or effect of etravirine by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.

• fedratinib

  fedratinib will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Adjust dose of CYP2D6 substrates as necessary

• felodipine

  fluvoxamine will increase the level or effect of felodipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• fenbufen

  fluvoxamine, fenbufen. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding; SSRIs inhib. srotonin uptake by platelets.

• fenfluramine

  fluvoxamine and fenfluramine both increase serotonin levels. Modify Therapy/Monitor Closely.
  
  fenfluramine, fluvoxamine. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration with drugs that increase serotoninergic effects may increase the risk of serotonin syndrome.

• fenoprofen

  fluvoxamine, fenoprofen. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• fesoterodine

  fluvoxamine will increase the level or effect of fesoterodine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• fexinidazole

  fexinidazole will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.

• finerenone

  fluvoxamine will increase the level or effect of finerenone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Monitor serum potassium during initiation and dosage adjustment of either finererone or moderate CYP3A4 inhibitors. Adjust finererone dosage as needed.

• fingolimod

  fingolimod and fluvoxamine both increase QTc interval. Use Caution/Monitor.

• fish oil triglycerides

  fish oil triglycerides will increase the level or effect of fluvoxamine by anticoagulation. Use Caution/Monitor. Prolonged bleeding reported in patients taking antiplatelet agents or anticoagulants and oral omega-3 fatty acids. Periodically monitor bleeding time in patients receiving fish oil triglycerides and concomitant antiplatelet agents or anticoagulants

• flecainide

  fluvoxamine and flecainide both increase QTc interval. Use Caution/Monitor.

• flibanserin

  fluvoxamine will increase the level or effect of flibanserin by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. May increase risk of hypotension, syncope, and CNS depression

• fluconazole

  fluvoxamine and fluconazole both increase QTc interval. Modify Therapy/Monitor Closely.

• fluphenazine

  fluvoxamine and fluphenazine both increase QTc interval. Use Caution/Monitor.

• flurbiprofen

  fluvoxamine, flurbiprofen. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor.

• fluvastatin

  fluvoxamine will increase the level or effect of fluvastatin by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.

• fondaparinux

  fluvoxamine will increase the level or effect of fondaparinux by anticoagulation. Use Caution/Monitor. SSRIs may inhibit platelet aggregation, which may increase bleeding risk when coadministered with anticoabulants

• formoterol

  fluvoxamine and formoterol both increase QTc interval. Modify Therapy/Monitor Closely.

• fosamprenavir

  fluvoxamine will increase the level or effect of fosamprenavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• foscarnet

  fluvoxamine and foscarnet both increase QTc interval. Use Caution/Monitor.

• fosphenytoin

  fluvoxamine will increase the level or effect of fosphenytoin by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.

• frovatriptan

  fluvoxamine and frovatriptan both increase serotonin levels. Modify Therapy/Monitor Closely.

• gabapentin

  fluvoxamine, gabapentin. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coaadministration with CNS depressant may result in fatal respiratory depression. Use lowest dose possible and monnitor for respiratory depression and sedation.

• gabapentin enacarbil

  fluvoxamine, gabapentin enacarbil. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coaadministration with CNS depressant may result in fatal respiratory depression. Use lowest dose possible and monnitor for respiratory depression and sedation.

• ganaxolone

  fluvoxamine and ganaxolone both increase sedation. Use Caution/Monitor.

• gemifloxacin

  gemifloxacin and fluvoxamine both increase QTc interval. Use Caution/Monitor.

• gepirone

  fluvoxamine will increase the level or effect of gepirone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce gepirone dose by 50% when used concomitantly with a moderate CYP3A4 inhibitor.

• glofitamab

  glofitamab, fluvoxamine. affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. Glofitamab causes release of cytokines that may suppress activity of CYP enzymes, resulting in increased exposure of CYP substrates. For certain CYP substrates, minimal changes in their concentration may lead to serious adverse reactions. If needed, modify therapy as recommended in the substrate's prescribing information. .

• granisetron

  granisetron and fluvoxamine both increase QTc interval. Use Caution/Monitor.

• grapefruit

  grapefruit will increase the level or effect of fluvoxamine by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• green tea

  green tea, fluvoxamine. Either increases toxicity of the other by anticoagulation. Use Caution/Monitor.

• guanfacine

  fluvoxamine will increase the level or effect of guanfacine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. If coadministered with extended release, reduce guanfacine dosage in half of recommended dose; specific recommendation for immediate release form not available

• haloperidol

  fluvoxamine and haloperidol both increase QTc interval. Modify Therapy/Monitor Closely.

• hydrocodone

  fluvoxamine and hydrocodone both increase serotonin levels. Use Caution/Monitor. If concomitant use warranted, carfully observe patient, particularly during treatment initiation and dose adjustment

• hydroxyzine

  hydroxyzine and fluvoxamine both increase QTc interval. Use Caution/Monitor.

• ibrutinib

  ibrutinib will increase the level or effect of fluvoxamine by anticoagulation. Use Caution/Monitor. Ibrutinib may increase risk of hemorrhage in patients receiving antiplatelet or anticoagulant therapies and monitor for signs of bleeding

• ibuprofen

  fluvoxamine, ibuprofen. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding; SSRIs inhib. srotonin uptake by platelets.

• ibuprofen IV

  fluvoxamine, ibuprofen IV. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• ifosfamide

  fluvoxamine will decrease the level or effect of ifosfamide by affecting hepatic enzyme CYP2B6 metabolism. Use Caution/Monitor. CYP2B6 inhibitors may decrease metabolism of ifosfamide to its active metabolite, potentially reducing ifosfamide therapeutic effects

• iloperidone

  fluvoxamine and iloperidone both increase QTc interval. Use Caution/Monitor.

• imatinib

  imatinib will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

• imipramine

  fluvoxamine will increase the level or effect of imipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.

• indinavir

  fluvoxamine will increase the level or effect of indinavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• indomethacin

  fluvoxamine, indomethacin. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• irinotecan

  fluvoxamine will increase the level or effect of irinotecan by affecting hepatic enzyme CYP2B6 metabolism. Use Caution/Monitor.

• irinotecan liposomal

  fluvoxamine will increase the level or effect of irinotecan liposomal by affecting hepatic enzyme CYP2B6 metabolism. Use Caution/Monitor.

• isavuconazonium sulfate

  fluvoxamine will increase the level or effect of isavuconazonium sulfate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• isoniazid

  fluvoxamine and isoniazid both increase serotonin levels. Modify Therapy/Monitor Closely.

• itraconazole

  itraconazole and fluvoxamine both increase QTc interval. Use Caution/Monitor.

• ivacaftor

  fluvoxamine will increase the level or effect of ivacaftor by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce ivacaftor dose if coadministered with CYP3A4 inhibitors; see ivacaftor prescribing information for precise dosage information

• ivosidenib

  fluvoxamine will increase the level or effect of ivosidenib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. May increase ivosidenib plasma concentrations, thus increasing risk of QTc prolongation; monitor for increased risk of QTc interval prolongation

• ixabepilone

  fluvoxamine will increase the level or effect of ixabepilone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• ketamine

  fluvoxamine will increase the level or effect of ketamine by affecting hepatic enzyme CYP2B6 metabolism. Use Caution/Monitor.

• ketoconazole

  fluvoxamine and ketoconazole both increase QTc interval. Modify Therapy/Monitor Closely.

• ketoprofen

  fluvoxamine, ketoprofen. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding SSRIs inhib. serotonin uptake by platelets.

• ketorolac

  fluvoxamine, ketorolac. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding SSRIs inhib. serotonin uptake by platelets.

• ketorolac intranasal

  fluvoxamine, ketorolac intranasal. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding; SSRIs inhib. srotonin uptake by platelets.

• L-tryptophan

  fluvoxamine and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.

• lamotrigine

  lamotrigine increases toxicity of fluvoxamine by serotonin levels. Modify Therapy/Monitor Closely. psychomotor impairment may be enhanced.

• lansoprazole

  fluvoxamine will increase the level or effect of lansoprazole by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.

• lapatinib

  fluvoxamine and lapatinib both increase QTc interval. Use Caution/Monitor.

• lasmiditan

  fluvoxamine and lasmiditan both increase serotonin levels. Use Caution/Monitor.

• lefamulin

  fluvoxamine will increase the level or effect of lefamulin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Monitor for adverse effects if lefamulin is coadministered with moderate CYP3A inhibitors.

• lemborexant

  fluvoxamine will increase the level or effect of lemborexant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Avoid coadministration of lemborexant with moderate or strong CYP3A4 inhibitors
  
  fluvoxamine, lemborexant. Either increases effects of the other by sedation. Modify Therapy/Monitor Closely. May have additive effect with other CNS depressants; dose adjustment may be necessary.

• levamlodipine

  fluvoxamine will increase the level or effect of levamlodipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. May requre amlodipine dose reduction; monitor for symptoms of hypotension and edema when amlodipine is coadminitered with CYP3A4 inhibitors to determine need for those adjustment

• levofloxacin

  fluvoxamine and levofloxacin both increase QTc interval. Use Caution/Monitor.

• levoketoconazole

  fluvoxamine and levoketoconazole both increase QTc interval. Modify Therapy/Monitor Closely.

• lisdexamfetamine

  fluvoxamine, lisdexamfetamine. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Initiate with lower doses and monitor for signs and symptoms of serotonin syndrome, particularly during initiation or dosage increase. If serotonin syndrome occurs, discontinue along with concomitant serotonergic drug(s).

• lithium

  fluvoxamine and lithium both increase serotonin levels. Modify Therapy/Monitor Closely.
  
  lithium and fluvoxamine both increase QTc interval. Use Caution/Monitor.

• lofepramine

  fluvoxamine and lofepramine both increase QTc interval. Modify Therapy/Monitor Closely.

• lomitapide

  fluvoxamine will increase the level or effect of lomitapide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Lomitapide dose should not exceed 30 mg/day

• lonapegsomatropin

  lonapegsomatropin will decrease the level or effect of fluvoxamine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. Limited published data indicate that growth hormone treatment increases cytochrome P450 (CYP450)-mediated antipyrine clearance. Caution with sensitive CYP substrates

• lopinavir

  fluvoxamine will increase the level or effect of lopinavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• loratadine

  fluvoxamine will increase the level or effect of loratadine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• lorcaserin

  lorcaserin will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

• lornoxicam

  fluvoxamine, lornoxicam. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• lsd

  fluvoxamine and lsd both increase serotonin levels. Modify Therapy/Monitor Closely.

• lumateperone

  fluvoxamine will increase the level or effect of lumateperone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce lumateperone dose to 21 mg/day if coadministered with moderate CYP3A4 inhibitors.

• lumefantrine

  fluvoxamine and lumefantrine both increase QTc interval. Modify Therapy/Monitor Closely.

• lurasidone

  fluvoxamine, lurasidone. Either increases toxicity of the other by sedation. Use Caution/Monitor. Monitor for increased adverse effects and toxicity.

• maprotiline

  fluvoxamine and maprotiline both increase QTc interval. Modify Therapy/Monitor Closely.

• maraviroc

  fluvoxamine will increase the level or effect of maraviroc by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• mavacamten

  fluvoxamine will increase the level or effect of mavacamten by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Inititiation of moderate CYP3A4 inhibitors may require decreased mavacamten dose.

• meclofenamate

  fluvoxamine, meclofenamate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding SSRIs inhib. serotonin uptake by platelets.

• mefenamic acid

  fluvoxamine, mefenamic acid. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding SSRIs inhib. serotonin uptake by platelets.

• meloxicam

  fluvoxamine, meloxicam. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding; SSRIs inhib. srotonin uptake by platelets.

• metformin

  fluvoxamine increases effects of metformin by pharmacodynamic synergism. Use Caution/Monitor.

• methadone

  fluvoxamine and methadone both increase QTc interval. Use Caution/Monitor.

• methylphenidate transdermal

  methylphenidate transdermal will increase the level or effect of fluvoxamine by decreasing metabolism. Modify Therapy/Monitor Closely. Consider decreasing the dose of these drugs when given coadministered with methylphenidate. Monitor for drug toxiticities when initiating or discontinuing methylphenidate.

• midazolam

  fluvoxamine will increase the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. May increase risk of hypoventilation, airway obstruction, or apnea and may contribute to profound and/or prolonged drug effect

• midazolam intranasal

  fluvoxamine will increase the level or effect of midazolam intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. May increase risk of hypoventilation, airway obstruction, or apnea and may contribute to profound and/or prolonged drug effect

• mirabegron

  mirabegron will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

• mirtazapine

  fluvoxamine and mirtazapine both increase serotonin levels. Modify Therapy/Monitor Closely.

• morphine

  fluvoxamine and morphine both increase serotonin levels. Modify Therapy/Monitor Closely.

• moxifloxacin

  fluvoxamine and moxifloxacin both increase QTc interval. Modify Therapy/Monitor Closely.

• nabumetone

  fluvoxamine, nabumetone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding SSRIs inhib. serotonin uptake by platelets.

• naldemedine

  fluvoxamine will increase the level or effect of naldemedine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Monitor for potential adverse effects

• naproxen

  fluvoxamine, naproxen. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• naratriptan

  fluvoxamine and naratriptan both increase serotonin levels. Modify Therapy/Monitor Closely.

• nateglinide

  fluvoxamine will increase the level or effect of nateglinide by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.

• nelfinavir

  fluvoxamine will increase the level or effect of nelfinavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• nicardipine

  fluvoxamine will increase the level or effect of nicardipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• nifedipine

  fluvoxamine will increase the level or effect of nifedipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• nilotinib

  fluvoxamine will increase the level or effect of nilotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• nimodipine

  fluvoxamine will increase the level or effect of nimodipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• nisoldipine

  fluvoxamine will increase the level or effect of nisoldipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• nitrendipine

  fluvoxamine will increase the level or effect of nitrendipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• norgestrel

  fluvoxamine will increase the level or effect of norgestrel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Strong or moderate CYP3A4 inhibitors may increase systemic concentration of norgestrel, which may increase risk for adverse effects

• nortriptyline

  fluvoxamine and nortriptyline both increase QTc interval. Modify Therapy/Monitor Closely.

• octreotide

  fluvoxamine and octreotide both increase QTc interval. Modify Therapy/Monitor Closely.

• octreotide (Antidote)

  fluvoxamine and octreotide (Antidote) both increase QTc interval. Modify Therapy/Monitor Closely.

• ofloxacin

  fluvoxamine and ofloxacin both increase QTc interval. Modify Therapy/Monitor Closely.

• oliceridine

  fluvoxamine will increase the level or effect of oliceridine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. If concomitant use is necessary, may require less frequent oliceridine dosing. Closely monitor for respiratory depression and sedation and titrate subsequent doses accordingly. If inhibitor is discontinued, consider increase oliceridine dosage until stable drug effects are achieved. Monitor for signs of opioid withdrawal.
  
  fluvoxamine, oliceridine. Either increases toxicity of the other by serotonin levels. Modify Therapy/Monitor Closely.

• ospemifene

  fluvoxamine will increase the level or effect of ospemifene by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.

• oxaprozin

  fluvoxamine, oxaprozin. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• oxycodone

  fluvoxamine and oxycodone both increase serotonin levels. Use Caution/Monitor.

• paliperidone

  fluvoxamine and paliperidone both increase QTc interval. Use Caution/Monitor.

• palovarotene

  fluvoxamine will increase the level or effect of palovarotene by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Avoid coadministration of palovarotene, a CYP3A substrate, with moderate CYP3A inhibitors. If unavoidable, reduce palovarotene dose by 50%.

• pantoprazole

  fluvoxamine will increase the level or effect of pantoprazole by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.

• parecoxib

  fluvoxamine will increase the level or effect of parecoxib by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Increased risk of upper GI bleeding; SSRIs inhib. srotonin uptake by platelets

• paroxetine

  fluvoxamine and paroxetine both increase QTc interval. Use Caution/Monitor.

• peginterferon alfa 2b

  fluvoxamine, peginterferon alfa 2b. Other (see comment). Use Caution/Monitor. Comment: Therapeutic effect may be altered with coadministration of CYP2D6 substrates; peginterferon alpha-2b may increase or decrease levels of CYP2D6 substrate.

• pentazocine

  fluvoxamine and pentazocine both increase serotonin levels. Modify Therapy/Monitor Closely.

• pentoxifylline

  fluvoxamine and pentoxifylline both increase anticoagulation. Use Caution/Monitor. may increase bleeding

• perphenazine

  fluvoxamine and perphenazine both increase QTc interval. Use Caution/Monitor.

• phenytoin

  fluvoxamine will increase the level or effect of phenytoin by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.

• piroxicam

  fluvoxamine, piroxicam. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• posaconazole

  fluvoxamine and posaconazole both increase QTc interval. Use Caution/Monitor.

• pregabalin

  fluvoxamine, pregabalin. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration may result in life-threatening, and fatal respiratory depression; use lowest dose possible and monitor for respiratory depression and sedation.

• primaquine

  primaquine and fluvoxamine both increase QTc interval. Use Caution/Monitor.

• prochlorperazine

  fluvoxamine and prochlorperazine both increase QTc interval. Use Caution/Monitor.

• promazine

  fluvoxamine and promazine both increase QTc interval. Modify Therapy/Monitor Closely.

• promethazine

  fluvoxamine and promethazine both increase QTc interval. Use Caution/Monitor.

• propafenone

  fluvoxamine will increase the level or effect of propafenone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• propofol

  fluvoxamine will increase the level or effect of propofol by affecting hepatic enzyme CYP2B6 metabolism. Use Caution/Monitor.

• protriptyline

  fluvoxamine and protriptyline both increase QTc interval. Modify Therapy/Monitor Closely.

• quetiapine

  fluvoxamine will increase the level or effect of quetiapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• quinidine

  quinidine will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

• rabeprazole

  fluvoxamine will increase the level or effect of rabeprazole by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.

• ramelteon

  fluvoxamine will increase the level or effect of ramelteon by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.

• ranolazine

  fluvoxamine and ranolazine both increase QTc interval. Use Caution/Monitor.

• remimazolam

  remimazolam, fluvoxamine. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely. Coadministration may result in profound sedation, respiratory depression, coma, and/or death. Continuously monitor vital signs during sedation and recovery period if coadministered. Carefully titrate remimazolam dose if administered with opioid analgesics and/or sedative/hypnotics.

• repaglinide

  fluvoxamine will increase the level or effect of repaglinide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• riluzole

  fluvoxamine will increase the level or effect of riluzole by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.

• rimegepant

  fluvoxamine will increase the level or effect of rimegepant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Avoid repeating dose within 48 hr if coadministered with moderate CYP3A4

• risperidone

  fluvoxamine and risperidone both increase QTc interval. Use Caution/Monitor.

• ritlecitinib

  ritlecitinib will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP1A2 metabolism. Modify Therapy/Monitor Closely. Ritlecitinib inhibits CYP1A2 substrates; coadministration increases AUC and peak plasma concentration sensitive substrates, which may increase risk of adverse reactions. Additional monitoring and dosage adjustment may be needed in accordance with product labeling of CYP1A2 substrates.

• ritonavir

  fluvoxamine will increase the level or effect of ritonavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• rivaroxaban

  fluvoxamine will increase the level or effect of rivaroxaban by pharmacodynamic synergism. Use Caution/Monitor. May increase risk of bleeding

• rizatriptan

  fluvoxamine and rizatriptan both increase serotonin levels. Modify Therapy/Monitor Closely.

• roflumilast

  fluvoxamine increases levels of roflumilast by Other (see comment). Modify Therapy/Monitor Closely. Comment: coadministration with dual inhibitors of CYP3A4 and CYP1A2 may increase systemic exposure and result in increased adverse reactions.

• rolapitant

  rolapitant will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Rolapitant may increase serum concentrations of CYP2D6 substrates for at least 28 days following rolapitant administration

• romidepsin

  fluvoxamine and romidepsin both increase QTc interval. Use Caution/Monitor.

• rucaparib

  rucaparib will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP1A2 metabolism. Modify Therapy/Monitor Closely. Adjust dosage of CYP1A2 substrates, if clinically indicated.

• safinamide

  fluvoxamine, safinamide. Either increases toxicity of the other by serotonin levels. Use Caution/Monitor. Monitor for serotonin syndrome.

• salicylates (non-asa)

  fluvoxamine, salicylates (non-asa). Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• salsalate

  fluvoxamine, salsalate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• SAMe

  fluvoxamine and SAMe both increase serotonin levels. Modify Therapy/Monitor Closely.

• saquinavir

  fluvoxamine will increase the level or effect of saquinavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• silodosin

  fluvoxamine will increase the level or effect of silodosin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• sodium sulfate/?magnesium sulfate/potassium chloride

  sodium sulfate/?magnesium sulfate/potassium chloride increases effects of fluvoxamine by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of seizures when using bowel preps together with drugs that lower the seizure threshold.

• sodium sulfate/potassium chloride/magnesium sulfate/polyethylene glycol

  fluvoxamine, sodium sulfate/potassium chloride/magnesium sulfate/polyethylene glycol. Other (see comment). Use Caution/Monitor. Comment: Increased risk for water retention or electrolyte imbalance.

• sodium sulfate/potassium sulfate/magnesium sulfate

  sodium sulfate/potassium sulfate/magnesium sulfate increases effects of fluvoxamine by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of seizures when using bowel preps together with drugs that lower the seizure threshold.

• sofosbuvir/velpatasvir

  fluvoxamine will increase the level or effect of sofosbuvir/velpatasvir by affecting hepatic enzyme CYP2B6 metabolism. Use Caution/Monitor.

• solifenacin

  fluvoxamine will increase the level or effect of solifenacin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  solifenacin and fluvoxamine both increase QTc interval. Use Caution/Monitor.

• somapacitan

  somapacitan will decrease the level or effect of fluvoxamine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. Limited published data indicate that growth hormone treatment increases cytochrome P450 (CYP450)-mediated antipyrine clearance. Caution with sensitive CYP substrates

• somatrogon

  somatrogon will decrease the level or effect of fluvoxamine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. Limited published data indicate that growth hormone treatment increases cytochrome P450 (CYP450)-mediated antipyrine clearance. Caution with sensitive CYP substrates

• somatropin

  somatropin will decrease the level or effect of fluvoxamine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. Limited published data indicate that growth hormone treatment increases cytochrome P450 (CYP450)-mediated antipyrine clearance. Caution with sensitive CYP substrates

• sparsentan

  fluvoxamine will increase the level or effect of sparsentan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. No dosage adjustment needed. Monitor blood pressure, serum potassium, edema, and kidney function regularly if sparsentan is coadministered with moderate CYP3A4 inhibitors.

• stiripentol

  fluvoxamine, stiripentol. affecting hepatic enzyme CYP1A2 metabolism. Modify Therapy/Monitor Closely. May require dosage adjustment.

• sufentanil

  fluvoxamine and sufentanil both increase serotonin levels. Use Caution/Monitor. Carefully observe patient for serotonin syndrome during treatment initiation and dose adjustment

• sufentanil SL

  fluvoxamine and sufentanil SL both decrease serotonin levels. Use Caution/Monitor. Carefully observe patient for serotonin syndrome during treatment initiation and dose adjustment

• sulfamethoxazole

  fluvoxamine and sulfamethoxazole both increase QTc interval. Use Caution/Monitor.

• sulfasalazine

  fluvoxamine will increase the level or effect of sulfasalazine by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding SSRIs inhib. serotonin uptake by platelets

• sulindac

  fluvoxamine, sulindac. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor.

• sumatriptan

  fluvoxamine and sumatriptan both increase serotonin levels. Modify Therapy/Monitor Closely.

• sumatriptan intranasal

  fluvoxamine and sumatriptan intranasal both increase serotonin levels. Modify Therapy/Monitor Closely.

• sunitinib

  fluvoxamine will increase the level or effect of sunitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  sunitinib and fluvoxamine both increase QTc interval. Use Caution/Monitor.

• tacrolimus

  fluvoxamine will increase the level or effect of tacrolimus by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  tacrolimus and fluvoxamine both increase QTc interval. Use Caution/Monitor.

• tadalafil

  fluvoxamine will increase the level or effect of tadalafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• talquetamab

  talquetamab will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. Talquetamab causes cytokine release syndrome (CRS) that may suppress activity of CYP enzymes, resulting in increased exposure of CYP substrates. This is more likely to occur from initiation of talquetamab step-up dosing up to 14 days after the first treatment dose and during and after CRS.

• tamoxifen

  fluvoxamine, tamoxifen. affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Decreases tamoxifen metabolism to active metabolites.

• tapentadol

  fluvoxamine and tapentadol both increase serotonin levels. Modify Therapy/Monitor Closely.

• tasimelteon

  fluvoxamine will increase the level or effect of tasimelteon by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. May increase adverse effects

• telavancin

  fluvoxamine and telavancin both increase QTc interval. Use Caution/Monitor.

• temsirolimus

  fluvoxamine will increase the level or effect of temsirolimus by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• terbinafine

  terbinafine will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Assess need to reduce dose of CYP2D6-metabolized drug.
  
  fluvoxamine will increase the level or effect of terbinafine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.

• teriflunomide

  teriflunomide will decrease the level or effect of fluvoxamine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.

• tezacaftor

  fluvoxamine will increase the level or effect of tezacaftor by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Adjust dose when coadministered with a moderate CYP3A4 inhibitor

• tinidazole

  fluvoxamine will increase the level or effect of tinidazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• tipranavir

  fluvoxamine will increase the level or effect of tipranavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• tofacitinib

  fluvoxamine increases levels of tofacitinib by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. Decrease tofacitinib dose is coadministered with both moderate CYP3A4 and potent CYP2C19 inhibitors.

• tolbutamide

  fluvoxamine will increase the level or effect of tolbutamide by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.

• tolfenamic acid

  fluvoxamine, tolfenamic acid. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• tolmetin

  fluvoxamine, tolmetin. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• tramadol

  fluvoxamine and tramadol both increase serotonin levels. Modify Therapy/Monitor Closely.

• trazodone

  fluvoxamine and trazodone both increase QTc interval. Modify Therapy/Monitor Closely.

• triazolam

  fluvoxamine will increase the level or effect of triazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• trifluoperazine

  fluvoxamine and trifluoperazine both increase QTc interval. Modify Therapy/Monitor Closely.

• trimethoprim

  fluvoxamine and trimethoprim both increase QTc interval. Use Caution/Monitor.

• trimipramine

  fluvoxamine and trimipramine both increase QTc interval. Modify Therapy/Monitor Closely.

• tropisetron

  fluvoxamine and tropisetron both increase QTc interval. Use Caution/Monitor.

• valbenazine

  valbenazine and fluvoxamine both increase QTc interval. Use Caution/Monitor.

• valerian

  fluvoxamine and valerian both increase sedation. Use Caution/Monitor.

• vardenafil

  fluvoxamine will increase the level or effect of vardenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Vardenafil dose may need to be reduced if coadministered with moderate or strong CYP3A4 inhibitors

• velpatasvir

  fluvoxamine will increase the level or effect of velpatasvir by affecting hepatic enzyme CYP2B6 metabolism. Use Caution/Monitor.

• venlafaxine

  fluvoxamine and venlafaxine both increase QTc interval. Use Caution/Monitor.

• verapamil

  fluvoxamine will increase the level or effect of verapamil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• voclosporin

  fluvoxamine will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce voclosporin daily dosage to 15.8 mg PO in AM and 7.9 mg PO in PM.

• vorapaxar

  fluvoxamine, vorapaxar. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. SSRIs and SNRIs may cause platelet serotonin depletion.

• voriconazole

  fluvoxamine and voriconazole both increase QTc interval. Use Caution/Monitor.

• vorinostat

  vorinostat and fluvoxamine both increase QTc interval. Use Caution/Monitor.

• warfarin

  fluvoxamine, warfarin. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Serotonin release by platelets plays an important role in hemostasis. SSRIs and SNRIs may increase anticoagulation effect of warfarin. .

• zaleplon

  fluvoxamine will increase the level or effect of zaleplon by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• zanubrutinib

  fluvoxamine will increase the level or effect of zanubrutinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce zanubrutinib (a CYP3A4 substrate) to 80 mg PO BID to when coadministered with a moderate CYP3A4 inhibitor. Interrupt dose as recommended for adverse reactions. After discontinuing the CYP3A4 inhibitor, resume previous dose of zanubrutinib.

• ziprasidone

  fluvoxamine and ziprasidone both increase QTc interval. Modify Therapy/Monitor Closely.

• zolmitriptan

  fluvoxamine and zolmitriptan both increase serotonin levels. Modify Therapy/Monitor Closely.

• zolpidem

  fluvoxamine will increase the level or effect of zolpidem by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• zonisamide

  fluvoxamine will increase the level or effect of zonisamide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

Minor (0)

• 5-HTP

  Monitor Closely (1)fluvoxamine and 5-HTP both increase serotonin levels. Modify Therapy/Monitor Closely.

• abiraterone

  Monitor Closely (1)abiraterone will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. If therapy cannot be avoided, exercise caution and consider a dose reduction of CYP2D6 substrate

• abrocitinib

  Monitor Closely (1)fluvoxamine will increase the level or effect of abrocitinib by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Start abrocitinib 50 mg qDay when coadministered with CYP2C19 inhibitors. If adequate response not achieved after 12 weeks, may increase to 100 mg qDay. Discontinue if inadequate response after dosage increase.

• acalabrutinib

  Monitor Closely (1)fluvoxamine will increase the level or effect of acalabrutinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Decrease dose to 100 mg once daily if coadministered with CYP3A4 inhibitor

• aceclofenac

  Monitor Closely (1)fluvoxamine, aceclofenac. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• acemetacin

  Monitor Closely (1)fluvoxamine, acemetacin. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• alfentanil

  Monitor Closely (1)fluvoxamine will increase the level or effect of alfentanil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)fluvoxamine and alfentanil both increase serotonin levels. Avoid or Use Alternate Drug.

• alfuzosin

  Monitor Closely (1)fluvoxamine and alfuzosin both increase QTc interval. Use Caution/Monitor.

• almotriptan

  Monitor Closely (1)fluvoxamine and almotriptan both increase serotonin levels. Modify Therapy/Monitor Closely.Serious - Use Alternative (1)fluvoxamine will increase the level or effect of almotriptan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• alosetron

  Contraindicated (1)fluvoxamine will increase the level or effect of alosetron by affecting hepatic enzyme CYP1A2 metabolism. Contraindicated.Monitor Closely (1)fluvoxamine will increase the level or effect of alosetron by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.

• alprazolam

  Monitor Closely (1)fluvoxamine will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• amifampridine

  Monitor Closely (1)fluvoxamine increases toxicity of amifampridine by Other (see comment). Modify Therapy/Monitor Closely. Comment: Amifampridine can cause seizures. Coadministration with drugs that lower seizure threshold may increase this risk.

• amiodarone

  Monitor Closely (1)fluvoxamine and amiodarone both increase QTc interval. Use Caution/Monitor.

• amisulpride

  Serious - Use Alternative (1)amisulpride and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug. ECG monitoring is recommended if coadministered.

• amitriptyline

  Monitor Closely (1)fluvoxamine and amitriptyline both increase QTc interval. Modify Therapy/Monitor Closely.Serious - Use Alternative (1)fluvoxamine and amitriptyline both increase serotonin levels. Avoid or Use Alternate Drug.

• amoxapine

  Monitor Closely (1)fluvoxamine and amoxapine both increase QTc interval. Modify Therapy/Monitor Closely.Serious - Use Alternative (1)fluvoxamine and amoxapine both increase serotonin levels. Avoid or Use Alternate Drug.

• anagrelide

  Serious - Use Alternative (1)anagrelide and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.

• antipyrine

  Monitor Closely (1)fluvoxamine will increase the level or effect of antipyrine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.

• apixaban

  Monitor Closely (1)fluvoxamine increases effects of apixaban by anticoagulation. Use Caution/Monitor. SSRIs may inhibit platelet aggregation, thus increase bleeding risk when coadministered with anticoagulants.

• arsenic trioxide

  Serious - Use Alternative (1)fluvoxamine and arsenic trioxide both increase QTc interval. Avoid or Use Alternate Drug.

• asenapine

  Monitor Closely (1)fluvoxamine will increase the level or effect of asenapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. Dose reduction may be necessarySerious - Use Alternative (1)asenapine and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.

• asenapine transdermal

  Monitor Closely (1)fluvoxamine will increase the level or effect of asenapine transdermal by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. Dose reduction may be necessarySerious - Use Alternative (1)asenapine transdermal and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.

• aspirin

  Monitor Closely (1)fluvoxamine, aspirin. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding SSRIs inhib. serotonin uptake by platelets.

• aspirin rectal

  Monitor Closely (1)fluvoxamine, aspirin rectal. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding SSRIs inhib. serotonin uptake by platelets.

• atogepant

  Monitor Closely (1)fluvoxamine will increase the level or effect of atogepant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• avanafil

  Monitor Closely (1)fluvoxamine will increase the level or effect of avanafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Maximum recommended dose of STENDRA is 50mg, not to exceed once every 24hr for patients taking concomitant moderate CYP3A4 inhibitors

• avapritinib

  Serious - Use Alternative (1)fluvoxamine will increase the level or effect of avapritinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of avapritinib with moderate CYP3A4 inhibitors. If unable to avoid, reduce avapritinib starting dose. See drug monograph Dosage Modifications

• axitinib

  Monitor Closely (1)fluvoxamine will increase the level or effect of axitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• belzutifan

  Monitor Closely (1)fluvoxamine will increase the level or effect of belzutifan by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Belzutifan is a CYP2C19 substrate. Coadministration with CYP2C19 inhibitors may increase incidence or severity of adverse effects. Monitor for anemia and hypoxia and reduce belzutifan dose as recommended.

• bendamustine

  Monitor Closely (1)fluvoxamine will increase the level or effect of bendamustine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. Decreased conversion of bendamustine to active metabolite. May decrease concentration of active metabolites

• benzhydrocodone/acetaminophen

  Monitor Closely (1)fluvoxamine, benzhydrocodone/acetaminophen. Either increases toxicity of the other by serotonin levels. Use Caution/Monitor. If concomitant use warranted, carfully observe patient, particularly during treatment initiation and dose adjustment.

• betrixaban

  Monitor Closely (1)fluvoxamine, betrixaban. Either increases toxicity of the other by anticoagulation. Use Caution/Monitor.

• bexarotene

  Monitor Closely (1)fluvoxamine will increase the level or effect of bexarotene by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• bortezomib

  Monitor Closely (1)fluvoxamine will increase the level or effect of bortezomib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• bosentan

  Monitor Closely (1)fluvoxamine will increase the level or effect of bosentan by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.

• budesonide

  Monitor Closely (1)fluvoxamine will increase the level or effect of budesonide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• buprenorphine

  Serious - Use Alternative (1)buprenorphine and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.

• buprenorphine buccal

  Serious - Use Alternative (1)buprenorphine buccal and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.

• buprenorphine subdermal implant

  Monitor Closely (1)fluvoxamine and buprenorphine subdermal implant both increase serotonin levels. Use Caution/Monitor. If concomitant use warranted, carefully observe patient, particularly during treatment initiation, and during dose adjustment of serotonergic drug. Discontinue buprenorphine if serotonin syndrome suspectedSerious - Use Alternative (1)buprenorphine subdermal implant and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.

• buprenorphine transdermal

  Serious - Use Alternative (1)buprenorphine transdermal and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.

• buprenorphine, long-acting injection

  Monitor Closely (1)fluvoxamine and buprenorphine, long-acting injection both increase serotonin levels. Use Caution/Monitor. If concomitant use warranted, carefully observe patient, particularly during treatment initiation, and during dose adjustment of serotonergic drug. Discontinue buprenorphine if serotonin syndrome suspectedSerious - Use Alternative (1)buprenorphine, long-acting injection and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.

• bupropion

  Monitor Closely (1)fluvoxamine will increase the level or effect of bupropion by affecting hepatic enzyme CYP2B6 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)fluvoxamine increases toxicity of bupropion by Other (see comment). Avoid or Use Alternate Drug. Comment: May lower seizure threshold; keep bupropion dose as low as possible.

• buspirone

  Monitor Closely (1)fluvoxamine will increase the level or effect of buspirone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)fluvoxamine and buspirone both increase serotonin levels. Avoid or Use Alternate Drug.

• caffeine

  Monitor Closely (1)fluvoxamine will increase the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.

• cannabidiol

  Monitor Closely (1)fluvoxamine will increase the level or effect of cannabidiol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Consider reducing cannabidiol dose when coadministered with a moderate CYP3A4 inhibitor

• carbamazepine

  Monitor Closely (1)fluvoxamine will increase the level or effect of carbamazepine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Monitor plasma levels when used concomitantly

• carvedilol

  Monitor Closely (1)fluvoxamine will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.

• celecoxib

  Monitor Closely (1)fluvoxamine will increase the level or effect of celecoxib by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.

• chlorpromazine

  Monitor Closely (1)fluvoxamine and chlorpromazine both increase QTc interval. Modify Therapy/Monitor Closely.

• choline magnesium trisalicylate

  Monitor Closely (1)fluvoxamine, choline magnesium trisalicylate. Either decreases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding SSRIs inhib. serotonin uptake by platelets.

• cilostazol

  Monitor Closely (1)fluvoxamine will increase the level or effect of cilostazol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)fluvoxamine increases toxicity of cilostazol by affecting hepatic enzyme CYP2C19 metabolism. Avoid or Use Alternate Drug. Decrease cilostazol dose by 50%; serum levels of 3,4-dehydrocilostazole (active metabolite) increased by strong CYP2C19 inhibitors.

• cimetidine

  Monitor Closely (1)cimetidine will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)fluvoxamine will increase the level or effect of cimetidine by affecting hepatic enzyme CYP2C19 metabolism. Avoid or Use Alternate Drug.

• cinacalcet

  Monitor Closely (1)fluvoxamine will increase the level or effect of cinacalcet by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• citalopram

  Monitor Closely (1)fluvoxamine will increase the level or effect of citalopram by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. Citalopram 20 mg/day is maximum recommended dose for patients taking CYP2C19 inhibitors because of the risk of QT prolongationSerious - Use Alternative (1)fluvoxamine and citalopram both increase serotonin levels. Avoid or Use Alternate Drug. Combinatiomay increase risk of serotonin syndrome or neuroleptic malignant syndromn e like reactions.

• clarithromycin

  Monitor Closely (1)fluvoxamine and clarithromycin both increase QTc interval. Modify Therapy/Monitor Closely.

• clobazam

  Monitor Closely (2)fluvoxamine will increase the level or effect of clobazam by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. Dosage adjustment may be necessary ; CYP2C19 inhibitors may result in increased exposure to N-desmethylclobazam (active metabolite)
  
  clobazam will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. May be necessary to admininister lower doses of drugs metabolized by CYP2D6 when used concomitantly

• clomipramine

  Monitor Closely (1)fluvoxamine and clomipramine both increase QTc interval. Modify Therapy/Monitor Closely.Serious - Use Alternative (1)fluvoxamine and clomipramine both increase serotonin levels. Avoid or Use Alternate Drug.

• clonidine

  Monitor Closely (1)fluvoxamine, clonidine. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. CNS derpressant effects enhanced.

• clopidogrel

  Monitor Closely (1)fluvoxamine will increase the level or effect of clopidogrel by pharmacodynamic synergism. Use Caution/Monitor. SSRIs affect platelet activation; coadministration may increase risk of bleedingSerious - Use Alternative (1)fluvoxamine decreases effects of clopidogrel by affecting hepatic enzyme CYP2C19 metabolism. Avoid or Use Alternate Drug. Clopidogrel efficacy may be reduced by drugs that inhibit CYP2C19. Inhibition of platelet aggregation by clopidogrel is entirely due to an active metabolite. Clopidogrel is metaolized to this active metabolite in part by CYP2C19.

• clozapine

  Monitor Closely (1)fluvoxamine will increase the level or effect of clozapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.Serious - Use Alternative (1)fluvoxamine will increase the level or effect of clozapine by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug.

• cobicistat

  Monitor Closely (1)fluvoxamine will increase the level or effect of cobicistat by Other (see comment). Use Caution/Monitor. Carfully titrate dose of antidepressant to desired effect, including using lowest feasible initial or maintenance dose , and monitor its response during coadministration with SSRIs and cobicistat

• cocaine topical

  Monitor Closely (1)fluvoxamine and cocaine topical both increase serotonin levels. Modify Therapy/Monitor Closely.

• colchicine

  Serious - Use Alternative (1)fluvoxamine will increase the level or effect of colchicine by Other (see comment). Avoid or Use Alternate Drug. Colchicine is a P-gp and CYP3A4 substrate. Avoid use with drugs that are both P-gp and strong CYP3A4 inhibitors. If coadministration is necessary, decrease colchicine dose or frequency as recommended in prescribing information. Use of any colchicine product in conjunction with strong CYP3A4 inhibitors is contraindicated in patients with renal or hepatic impairment.

• conivaptan

  Monitor Closely (1)fluvoxamine will increase the level or effect of conivaptan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• cortisone

  Monitor Closely (1)fluvoxamine will increase the level or effect of cortisone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• cyclobenzaprine

  Serious - Use Alternative (1)fluvoxamine and cyclobenzaprine both increase serotonin levels. Avoid or Use Alternate Drug.

• cyclophosphamide

  Monitor Closely (1)fluvoxamine will increase the level or effect of cyclophosphamide by affecting hepatic enzyme CYP2B6 metabolism. Use Caution/Monitor.

• cyclosporine

  Monitor Closely (1)fluvoxamine will increase the level or effect of cyclosporine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.

• cyproheptadine

  Monitor Closely (1)cyproheptadine decreases effects of fluvoxamine by pharmacodynamic antagonism. Use Caution/Monitor. May deminish serotonergic effect of SSRIs.

• dacomitinib

  Serious - Use Alternative (1)fluvoxamine will increase the level or effect of dacomitinib by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Avoid use with CYP3D6 substrates where minimal increases in concentration of the CYP2D6 substrate may lead to serious or life-threatening toxicities

• daridorexant

  Monitor Closely (2)fluvoxamine will increase the level or effect of daridorexant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Daridorexant dose should not exceed 25 mg per night when coadministered with moderate CYP3A4 inhibitors.
  
  fluvoxamine and daridorexant both increase sedation. Modify Therapy/Monitor Closely. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.

• darifenacin

  Monitor Closely (1)fluvoxamine will increase the level or effect of darifenacin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• darunavir

  Monitor Closely (1)fluvoxamine will increase the level or effect of darunavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• dasatinib

  Monitor Closely (1)fluvoxamine and dasatinib both increase QTc interval. Modify Therapy/Monitor Closely.

• deferasirox

  Monitor Closely (1)deferasirox will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.

• defibrotide

  Monitor Closely (1)defibrotide increases effects of fluvoxamine by Other (see comment). Use Caution/Monitor. Comment: Defibrotide may enhance effects of platelet inhibitors.

• deflazacort

  Monitor Closely (1)fluvoxamine will increase the level or effect of deflazacort by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Decrease deflazacort dose by one-third of recommended dose if coadministered with moderate or strong CYP3A4 inhibitors

• degarelix

  Monitor Closely (1)degarelix and fluvoxamine both increase QTc interval. Use Caution/Monitor.

• desflurane

  Serious - Use Alternative (1)desflurane and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.

• desipramine

  Monitor Closely (1)fluvoxamine and desipramine both increase QTc interval. Modify Therapy/Monitor Closely.Serious - Use Alternative (1)fluvoxamine and desipramine both increase serotonin levels. Avoid or Use Alternate Drug.

• desvenlafaxine

  Monitor Closely (1)desvenlafaxine will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. With higher desvenlafaxine doses (eg, 400 mg) decrease CYP2D6 substrate dose by up to 50%; dose adjustment not necessary with desvenlafaxine doses <100mgSerious - Use Alternative (1)fluvoxamine and desvenlafaxine both increase serotonin levels. Avoid or Use Alternate Drug.

• deutetrabenazine

  Monitor Closely (1)deutetrabenazine and fluvoxamine both increase QTc interval. Use Caution/Monitor. At the maximum recommended dose, deutetrabenazine does not prolong QT interval to a clinically relevant extent. Certain circumstances may increase risk of torsade de pointes and/or sudden death in association with drugs that prolong the QTc interval (eg, bradycardia, hypokalemia or hypomagnesemia, coadministration with other drugs that prolong QTc interval, presence of congenital QT prolongation).

• dexfenfluramine

  Monitor Closely (1)fluvoxamine and dexfenfluramine both increase serotonin levels. Modify Therapy/Monitor Closely.

• dextroamphetamine

  Monitor Closely (1)fluvoxamine and dextroamphetamine both decrease serotonin levels. Modify Therapy/Monitor Closely.

• dextroamphetamine transdermal

  Monitor Closely (1)fluvoxamine, dextroamphetamine transdermal. Either increases effects of the other by serotonin levels. Modify Therapy/Monitor Closely. Initiate with lower doses and monitor for signs and symptoms of serotonin syndrome, particularly during initiation or dosage increase. If serotonin syndrome occurs, discontinue dextroamphetamine transdermal and concomitant serotonergic drug(s).

• dextromethorphan

  Serious - Use Alternative (1)fluvoxamine and dextromethorphan both increase serotonin levels. Avoid or Use Alternate Drug.

• diazepam

  Monitor Closely (1)fluvoxamine will increase the level or effect of diazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• diazepam intranasal

  Monitor Closely (1)fluvoxamine will increase the level or effect of diazepam intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. May decrease rate of diazepam elimination, causing a decrease in diazepam elimnation, thereby increasing adverse reactions to diazepam

• dichlorphenamide

  Monitor Closely (1)dichlorphenamide and fluvoxamine both decrease serum potassium. Use Caution/Monitor.

• diclofenac

  Monitor Closely (1)fluvoxamine, diclofenac. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• difelikefalin

  Monitor Closely (1)difelikefalin and fluvoxamine both increase sedation. Use Caution/Monitor.

• diflunisal

  Monitor Closely (1)fluvoxamine, diflunisal. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• dihydroergotamine

  Contraindicated (1)fluvoxamine will increase the level or effect of dihydroergotamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.Monitor Closely (1)fluvoxamine and dihydroergotamine both increase serotonin levels. Modify Therapy/Monitor Closely.

• dihydroergotamine intranasal

  Monitor Closely (1)fluvoxamine and dihydroergotamine intranasal both increase serotonin levels. Modify Therapy/Monitor Closely.Serious - Use Alternative (1)fluvoxamine will increase the level or effect of dihydroergotamine intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.

• diltiazem

  Monitor Closely (1)fluvoxamine will increase the level or effect of diltiazem by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• disopyramide

  Serious - Use Alternative (1)fluvoxamine and disopyramide both increase QTc interval. Avoid or Use Alternate Drug.

• dofetilide

  Monitor Closely (1)fluvoxamine and dofetilide both increase QTc interval. Modify Therapy/Monitor Closely.

• dolasetron

  Monitor Closely (1)fluvoxamine and dolasetron both increase QTc interval. Use Caution/Monitor.Serious - Use Alternative (1)fluvoxamine and dolasetron both increase serotonin levels. Avoid or Use Alternate Drug.

• donepezil

  Monitor Closely (1)donepezil and fluvoxamine both increase QTc interval. Use Caution/Monitor.

• dosulepin

  Serious - Use Alternative (1)fluvoxamine and dosulepin both increase serotonin levels. Avoid or Use Alternate Drug.

• doxepin

  Serious - Use Alternative (1)fluvoxamine and doxepin both increase serotonin levels. Avoid or Use Alternate Drug.

• dronedarone

  Serious - Use Alternative (2)dronedarone will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.
  
  fluvoxamine will increase the level or effect of dronedarone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.

• duloxetine

  Serious - Use Alternative (2)fluvoxamine will increase the level or effect of duloxetine by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug.
  
  fluvoxamine and duloxetine both increase serotonin levels. Avoid or Use Alternate Drug.

• edoxaban

  Monitor Closely (1)fluvoxamine will increase the level or effect of edoxaban by anticoagulation. Use Caution/Monitor. SSRIs affect platelet activation; coadministration may increase risk of bleeding

• efavirenz

  Monitor Closely (2)fluvoxamine will increase the level or effect of efavirenz by affecting hepatic enzyme CYP2B6 metabolism. Use Caution/Monitor.
  
  efavirenz and fluvoxamine both increase QTc interval. Use Caution/Monitor.

• elacestrant

  Serious - Use Alternative (1)fluvoxamine will increase the level or effect of elacestrant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• eletriptan

  Monitor Closely (1)fluvoxamine and eletriptan both increase serotonin levels. Modify Therapy/Monitor Closely.

• eliglustat

  Monitor Closely (1)eliglustat will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Monitor therapeutic drug concentrations; consider reducing dosage of concomitant drug and titrate to clincal effectSerious - Use Alternative (1)eliglustat and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.

• elranatamab

  Monitor Closely (1)elranatamab will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. Elranatamab causes cytokine release syndrome (CRS) that may suppress activity of CYP enzymes, resulting in increased exposure of CYP substrates. This is more likely to occur from initiation of elranatamab step-up dosing up to 14 days after the first treatment dose and during and after CRS.

• eltrombopag

  Monitor Closely (1)fluvoxamine will increase the level or effect of eltrombopag by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)fluvoxamine will increase the level or effect of eltrombopag by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug.

• eluxadoline

  Monitor Closely (2)fluvoxamine will increase the level or effect of eluxadoline by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. Use caution when coadministering with CYP2C19 inhibitors; not studied
  
  fluvoxamine will increase the level or effect of eluxadoline by affecting hepatic enzyme CYP1A2 metabolism. Modify Therapy/Monitor Closely. Use caution when coadministering with strong CYP1A2 inhibitors; Not studied

• elvitegravir/cobicistat/emtricitabine/tenofovir DF

  Monitor Closely (1)elvitegravir/cobicistat/emtricitabine/tenofovir DF will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Caution with CYP2D6 substrates for which elevated plasma concentrations may cause life-threatening events

• encorafenib

  Serious - Use Alternative (1)encorafenib and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.

• entrectinib

  Serious - Use Alternative (2)fluvoxamine will increase the level or effect of entrectinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. avoid coadministration of moderate CYP3A4 inhibitors with entrectinib, a CYP3A4 substrate. If coadministration unavoidabole, reduce dose to 200 mg/day for patients aged 12 y or older with BSA >1.5m2. Resume previous entrectinib dose after discontinuing moderate CYP3A4 inhibitor for 3-5 elimination half-lives.
  
  entrectinib and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.

• epcoritamab

  Monitor Closely (1)epcoritamab, fluvoxamine. affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. Epcoritamab causes release of cytokines that may suppress activity of CYP enzymes, resulting in increased exposure of CYP substrates. For certain CYP substrates, minimal changes in their concentration may lead to serious adverse reactions. If needed, modify therapy as recommended in the substrate's prescribing information. .

• epinephrine

  Monitor Closely (1)fluvoxamine and epinephrine both increase QTc interval. Modify Therapy/Monitor Closely.

• epinephrine racemic

  Monitor Closely (1)fluvoxamine and epinephrine racemic both increase QTc interval. Modify Therapy/Monitor Closely.

• ergotamine

  Monitor Closely (1)fluvoxamine and ergotamine both increase serotonin levels. Modify Therapy/Monitor Closely.Serious - Use Alternative (1)fluvoxamine will increase the level or effect of ergotamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.

• eribulin

  Serious - Use Alternative (1)eribulin and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.

• erlotinib

  Monitor Closely (1)fluvoxamine will increase the level or effect of erlotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• erythromycin base

  Monitor Closely (1)fluvoxamine and erythromycin base both increase QTc interval. Modify Therapy/Monitor Closely.

• erythromycin ethylsuccinate

  Monitor Closely (1)fluvoxamine and erythromycin ethylsuccinate both increase QTc interval. Modify Therapy/Monitor Closely.

• erythromycin lactobionate

  Monitor Closely (1)fluvoxamine and erythromycin lactobionate both increase QTc interval. Modify Therapy/Monitor Closely.

• erythromycin stearate

  Monitor Closely (1)fluvoxamine and erythromycin stearate both increase QTc interval. Modify Therapy/Monitor Closely.

• escitalopram

  Serious - Use Alternative (1)fluvoxamine and escitalopram both increase serotonin levels. Avoid or Use Alternate Drug.

• esomeprazole

  Serious - Use Alternative (1)fluvoxamine will increase the level or effect of esomeprazole by affecting hepatic enzyme CYP2C19 metabolism. Avoid or Use Alternate Drug.

• ethinylestradiol

  Monitor Closely (1)ethinylestradiol will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.

• ethotoin

  Monitor Closely (1)fluvoxamine will increase the level or effect of ethotoin by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.

• etodolac

  Monitor Closely (1)fluvoxamine, etodolac. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding; SSRIs inhib. srotonin uptake by platelets.

• etravirine

  Monitor Closely (1)fluvoxamine will increase the level or effect of etravirine by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)fluvoxamine will increase the level or effect of etravirine by affecting hepatic enzyme CYP2C19 metabolism. Avoid or Use Alternate Drug.

• everolimus

  Serious - Use Alternative (1)fluvoxamine will increase the level or effect of everolimus by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.

• fedratinib

  Monitor Closely (1)fedratinib will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Adjust dose of CYP2D6 substrates as necessarySerious - Use Alternative (1)fluvoxamine will increase the level or effect of fedratinib by Other (see comment). Avoid or Use Alternate Drug. Avoid coadministration of fedratinib (a CYP3A4 and CYP2C19 substrate) with dual CYP3A4 and CYP2C19 inhibitor. Effect of coadminitration of a dual CYP3A4 and CYP2C19 inhibitor with fedratinib not studied

• felodipine

  Monitor Closely (1)fluvoxamine will increase the level or effect of felodipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• fenbufen

  Monitor Closely (1)fluvoxamine, fenbufen. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding; SSRIs inhib. srotonin uptake by platelets.

• fenfluramine

  Monitor Closely (2)fenfluramine, fluvoxamine. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration with drugs that increase serotoninergic effects may increase the risk of serotonin syndrome.
  
  fluvoxamine and fenfluramine both increase serotonin levels. Modify Therapy/Monitor Closely.

• fenoprofen

  Monitor Closely (1)fluvoxamine, fenoprofen. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• fentanyl

  Serious - Use Alternative (1)fluvoxamine and fentanyl both increase serotonin levels. Avoid or Use Alternate Drug.

• fentanyl transdermal

  Serious - Use Alternative (1)fluvoxamine and fentanyl transdermal both increase serotonin levels. Avoid or Use Alternate Drug.

• fentanyl transmucosal

  Serious - Use Alternative (1)fluvoxamine and fentanyl transmucosal both increase serotonin levels. Avoid or Use Alternate Drug.

• fesoterodine

  Monitor Closely (1)fluvoxamine will increase the level or effect of fesoterodine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• fexinidazole

  Monitor Closely (1)fexinidazole will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.

• fezolinetant

  Contraindicated (1)fluvoxamine will increase the level or effect of fezolinetant by affecting hepatic enzyme CYP1A2 metabolism. Contraindicated. Fezolinetant AUC and peak plasma concentration are increased if coadministered with drugs that are weak, moderate, or strong CYP1A2 inhibitors

• finerenone

  Monitor Closely (1)fluvoxamine will increase the level or effect of finerenone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Monitor serum potassium during initiation and dosage adjustment of either finererone or moderate CYP3A4 inhibitors. Adjust finererone dosage as needed.

• fingolimod

  Monitor Closely (1)fingolimod and fluvoxamine both increase QTc interval. Use Caution/Monitor.

• fish oil triglycerides

  Monitor Closely (1)fish oil triglycerides will increase the level or effect of fluvoxamine by anticoagulation. Use Caution/Monitor. Prolonged bleeding reported in patients taking antiplatelet agents or anticoagulants and oral omega-3 fatty acids. Periodically monitor bleeding time in patients receiving fish oil triglycerides and concomitant antiplatelet agents or anticoagulants

• flecainide

  Monitor Closely (1)fluvoxamine and flecainide both increase QTc interval. Use Caution/Monitor.

• flibanserin

  Monitor Closely (1)fluvoxamine will increase the level or effect of flibanserin by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. May increase risk of hypotension, syncope, and CNS depression

• fluconazole

  Monitor Closely (1)fluvoxamine and fluconazole both increase QTc interval. Modify Therapy/Monitor Closely.

• fluoxetine

  Serious - Use Alternative (1)fluvoxamine and fluoxetine both increase serotonin levels. Avoid or Use Alternate Drug.

• fluphenazine

  Monitor Closely (1)fluvoxamine and fluphenazine both increase QTc interval. Use Caution/Monitor.

• flurbiprofen

  Monitor Closely (1)fluvoxamine, flurbiprofen. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor.

• fluvastatin

  Monitor Closely (1)fluvoxamine will increase the level or effect of fluvastatin by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.

• fondaparinux

  Monitor Closely (1)fluvoxamine will increase the level or effect of fondaparinux by anticoagulation. Use Caution/Monitor. SSRIs may inhibit platelet aggregation, which may increase bleeding risk when coadministered with anticoabulants

• formoterol

  Monitor Closely (1)fluvoxamine and formoterol both increase QTc interval. Modify Therapy/Monitor Closely.

• fosamprenavir

  Monitor Closely (1)fluvoxamine will increase the level or effect of fosamprenavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• foscarnet

  Monitor Closely (1)fluvoxamine and foscarnet both increase QTc interval. Use Caution/Monitor.

• fosphenytoin

  Monitor Closely (1)fluvoxamine will increase the level or effect of fosphenytoin by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.

• frovatriptan

  Monitor Closely (1)fluvoxamine and frovatriptan both increase serotonin levels. Modify Therapy/Monitor Closely.

• gabapentin

  Monitor Closely (1)fluvoxamine, gabapentin. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coaadministration with CNS depressant may result in fatal respiratory depression. Use lowest dose possible and monnitor for respiratory depression and sedation.

• gabapentin enacarbil

  Monitor Closely (1)fluvoxamine, gabapentin enacarbil. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coaadministration with CNS depressant may result in fatal respiratory depression. Use lowest dose possible and monnitor for respiratory depression and sedation.

• ganaxolone

  Monitor Closely (1)fluvoxamine and ganaxolone both increase sedation. Use Caution/Monitor.

• gemifloxacin

  Monitor Closely (1)gemifloxacin and fluvoxamine both increase QTc interval. Use Caution/Monitor.

• gepirone

  Monitor Closely (1)fluvoxamine will increase the level or effect of gepirone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce gepirone dose by 50% when used concomitantly with a moderate CYP3A4 inhibitor.

• gilteritinib

  Serious - Use Alternative (2)gilteritinib will increase the level or effect of fluvoxamine by Other (see comment). Avoid or Use Alternate Drug. Coadministrationwith drugs that inhibit 5HT2B or sigma nonspecific receptors. Avoid use of these drugs with gilteritinib unless coadministration is necessary
  
  gilteritinib and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.

• givosiran

  Serious - Use Alternative (2)givosiran will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP1A2 substrates with givosiran. If unavoidable, decrease the CYP1A2 substrate dosage in accordance with approved product labeling.
  
  givosiran will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP2D6 substrates with givosiran. If unavoidable, decrease the CYP2D6 substrate dosage in accordance with approved product labeling.

• glofitamab

  Monitor Closely (1)glofitamab, fluvoxamine. affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. Glofitamab causes release of cytokines that may suppress activity of CYP enzymes, resulting in increased exposure of CYP substrates. For certain CYP substrates, minimal changes in their concentration may lead to serious adverse reactions. If needed, modify therapy as recommended in the substrate's prescribing information. .

• granisetron

  Monitor Closely (1)granisetron and fluvoxamine both increase QTc interval. Use Caution/Monitor.Serious - Use Alternative (1)fluvoxamine and granisetron both increase serotonin levels. Avoid or Use Alternate Drug.

• grapefruit

  Monitor Closely (1)grapefruit will increase the level or effect of fluvoxamine by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• green tea

  Monitor Closely (1)green tea, fluvoxamine. Either increases toxicity of the other by anticoagulation. Use Caution/Monitor.

• guanfacine

  Monitor Closely (1)fluvoxamine will increase the level or effect of guanfacine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. If coadministered with extended release, reduce guanfacine dosage in half of recommended dose; specific recommendation for immediate release form not available

• haloperidol

  Monitor Closely (1)fluvoxamine and haloperidol both increase QTc interval. Modify Therapy/Monitor Closely.

• hydrocodone

  Monitor Closely (1)fluvoxamine and hydrocodone both increase serotonin levels. Use Caution/Monitor. If concomitant use warranted, carfully observe patient, particularly during treatment initiation and dose adjustment

• hydromorphone

  Serious - Use Alternative (1)fluvoxamine and hydromorphone both increase serotonin levels. Avoid or Use Alternate Drug.

• hydroxyzine

  Monitor Closely (1)hydroxyzine and fluvoxamine both increase QTc interval. Use Caution/Monitor.

• ibrutinib

  Monitor Closely (1)ibrutinib will increase the level or effect of fluvoxamine by anticoagulation. Use Caution/Monitor. Ibrutinib may increase risk of hemorrhage in patients receiving antiplatelet or anticoagulant therapies and monitor for signs of bleeding

• ibuprofen

  Monitor Closely (1)fluvoxamine, ibuprofen. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding; SSRIs inhib. srotonin uptake by platelets.

• ibuprofen IV

  Monitor Closely (1)fluvoxamine, ibuprofen IV. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• ibutilide

  Serious - Use Alternative (1)fluvoxamine and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.

• ifosfamide

  Monitor Closely (1)fluvoxamine will decrease the level or effect of ifosfamide by affecting hepatic enzyme CYP2B6 metabolism. Use Caution/Monitor. CYP2B6 inhibitors may decrease metabolism of ifosfamide to its active metabolite, potentially reducing ifosfamide therapeutic effects

• iloperidone

  Monitor Closely (1)fluvoxamine and iloperidone both increase QTc interval. Use Caution/Monitor.

• imatinib

  Monitor Closely (1)imatinib will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

• imipramine

  Monitor Closely (1)fluvoxamine will increase the level or effect of imipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.Serious - Use Alternative (1)fluvoxamine and imipramine both increase serotonin levels. Avoid or Use Alternate Drug.

• indapamide

  Serious - Use Alternative (1)fluvoxamine and indapamide both increase QTc interval. Avoid or Use Alternate Drug.

• indinavir

  Monitor Closely (1)fluvoxamine will increase the level or effect of indinavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• indomethacin

  Monitor Closely (1)fluvoxamine, indomethacin. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• infigratinib

  Serious - Use Alternative (1)fluvoxamine will increase the level or effect of infigratinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• irinotecan

  Monitor Closely (1)fluvoxamine will increase the level or effect of irinotecan by affecting hepatic enzyme CYP2B6 metabolism. Use Caution/Monitor.

• irinotecan liposomal

  Monitor Closely (1)fluvoxamine will increase the level or effect of irinotecan liposomal by affecting hepatic enzyme CYP2B6 metabolism. Use Caution/Monitor.

• isavuconazonium sulfate

  Monitor Closely (1)fluvoxamine will increase the level or effect of isavuconazonium sulfate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• isocarboxazid

  Contraindicated (1)fluvoxamine and isocarboxazid both increase serotonin levels. Contraindicated.

• isoflurane

  Serious - Use Alternative (1)isoflurane and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.

• isoniazid

  Monitor Closely (1)fluvoxamine and isoniazid both increase serotonin levels. Modify Therapy/Monitor Closely.

• itraconazole

  Monitor Closely (1)itraconazole and fluvoxamine both increase QTc interval. Use Caution/Monitor.

• ivacaftor

  Monitor Closely (1)fluvoxamine will increase the level or effect of ivacaftor by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce ivacaftor dose if coadministered with CYP3A4 inhibitors; see ivacaftor prescribing information for precise dosage information

• ivosidenib

  Monitor Closely (1)fluvoxamine will increase the level or effect of ivosidenib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. May increase ivosidenib plasma concentrations, thus increasing risk of QTc prolongation; monitor for increased risk of QTc interval prolongation

• ixabepilone

  Monitor Closely (1)fluvoxamine will increase the level or effect of ixabepilone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• ketamine

  Monitor Closely (1)fluvoxamine will increase the level or effect of ketamine by affecting hepatic enzyme CYP2B6 metabolism. Use Caution/Monitor.

• ketoconazole

  Monitor Closely (1)fluvoxamine and ketoconazole both increase QTc interval. Modify Therapy/Monitor Closely.

• ketoprofen

  Monitor Closely (1)fluvoxamine, ketoprofen. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding SSRIs inhib. serotonin uptake by platelets.

• ketorolac

  Monitor Closely (1)fluvoxamine, ketorolac. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding SSRIs inhib. serotonin uptake by platelets.

• ketorolac intranasal

  Monitor Closely (1)fluvoxamine, ketorolac intranasal. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding; SSRIs inhib. srotonin uptake by platelets.

• L-tryptophan

  Monitor Closely (1)fluvoxamine and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.

• lamotrigine

  Monitor Closely (1)lamotrigine increases toxicity of fluvoxamine by serotonin levels. Modify Therapy/Monitor Closely. psychomotor impairment may be enhanced.

• lansoprazole

  Monitor Closely (1)fluvoxamine will increase the level or effect of lansoprazole by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.

• lapatinib

  Monitor Closely (1)fluvoxamine and lapatinib both increase QTc interval. Use Caution/Monitor.

• lasmiditan

  Monitor Closely (1)fluvoxamine and lasmiditan both increase serotonin levels. Use Caution/Monitor.

• lefamulin

  Monitor Closely (1)fluvoxamine will increase the level or effect of lefamulin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Monitor for adverse effects if lefamulin is coadministered with moderate CYP3A inhibitors.

• lemborexant

  Monitor Closely (2)fluvoxamine, lemborexant. Either increases effects of the other by sedation. Modify Therapy/Monitor Closely. May have additive effect with other CNS depressants; dose adjustment may be necessary.
  
  fluvoxamine will increase the level or effect of lemborexant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Avoid coadministration of lemborexant with moderate or strong CYP3A4 inhibitors

• leniolisib

  Serious - Use Alternative (1)leniolisib will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug. Avoid leniolisib with CYP1A2 substrates that have a narrow therapeutic index

• levamlodipine

  Monitor Closely (1)fluvoxamine will increase the level or effect of levamlodipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. May requre amlodipine dose reduction; monitor for symptoms of hypotension and edema when amlodipine is coadminitered with CYP3A4 inhibitors to determine need for those adjustment

• levofloxacin

  Monitor Closely (1)fluvoxamine and levofloxacin both increase QTc interval. Use Caution/Monitor.

• levoketoconazole

  Monitor Closely (1)fluvoxamine and levoketoconazole both increase QTc interval. Modify Therapy/Monitor Closely.

• levomilnacipran

  Serious - Use Alternative (1)fluvoxamine and levomilnacipran both increase serotonin levels. Avoid or Use Alternate Drug.

• lidocaine

  Serious - Use Alternative (1)fluvoxamine and lidocaine both increase serotonin levels. Avoid or Use Alternate Drug.

• linezolid

  Serious - Use Alternative (1)fluvoxamine and linezolid both increase serotonin levels. Avoid or Use Alternate Drug.

• lisdexamfetamine

  Monitor Closely (1)fluvoxamine, lisdexamfetamine. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Initiate with lower doses and monitor for signs and symptoms of serotonin syndrome, particularly during initiation or dosage increase. If serotonin syndrome occurs, discontinue along with concomitant serotonergic drug(s).

• lithium

  Monitor Closely (2)lithium and fluvoxamine both increase QTc interval. Use Caution/Monitor.
  
  fluvoxamine and lithium both increase serotonin levels. Modify Therapy/Monitor Closely.

• lofepramine

  Monitor Closely (1)fluvoxamine and lofepramine both increase QTc interval. Modify Therapy/Monitor Closely.Serious - Use Alternative (1)fluvoxamine and lofepramine both decrease serotonin levels. Avoid or Use Alternate Drug.

• lomitapide

  Monitor Closely (1)fluvoxamine will increase the level or effect of lomitapide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Lomitapide dose should not exceed 30 mg/day

• lonafarnib

  Contraindicated (1)fluvoxamine will increase the level or effect of lonafarnib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Lonafarnib is a sensitive CYP3A4 substrate. Coadministration with strong or moderate CYP3A4 inhibitors is contraindicated.

• lonapegsomatropin

  Monitor Closely (1)lonapegsomatropin will decrease the level or effect of fluvoxamine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. Limited published data indicate that growth hormone treatment increases cytochrome P450 (CYP450)-mediated antipyrine clearance. Caution with sensitive CYP substrates

• lopinavir

  Monitor Closely (1)fluvoxamine will increase the level or effect of lopinavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• loratadine

  Monitor Closely (1)fluvoxamine will increase the level or effect of loratadine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• lorcaserin

  Monitor Closely (1)lorcaserin will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)fluvoxamine and lorcaserin both increase serotonin levels. Avoid or Use Alternate Drug.

• lornoxicam

  Monitor Closely (1)fluvoxamine, lornoxicam. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• lovastatin

  Serious - Use Alternative (1)fluvoxamine will increase the level or effect of lovastatin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.

• lsd

  Monitor Closely (1)fluvoxamine and lsd both increase serotonin levels. Modify Therapy/Monitor Closely.

• lumateperone

  Monitor Closely (1)fluvoxamine will increase the level or effect of lumateperone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce lumateperone dose to 21 mg/day if coadministered with moderate CYP3A4 inhibitors.

• lumefantrine

  Monitor Closely (1)fluvoxamine and lumefantrine both increase QTc interval. Modify Therapy/Monitor Closely.

• lurasidone

  Monitor Closely (1)fluvoxamine, lurasidone. Either increases toxicity of the other by sedation. Use Caution/Monitor. Monitor for increased adverse effects and toxicity.

• lurbinectedin

  Serious - Use Alternative (1)fluvoxamine will increase the level or effect of lurbinectedin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• maprotiline

  Monitor Closely (1)fluvoxamine and maprotiline both increase QTc interval. Modify Therapy/Monitor Closely.Serious - Use Alternative (1)fluvoxamine and maprotiline both increase serotonin levels. Avoid or Use Alternate Drug.

• maraviroc

  Monitor Closely (1)fluvoxamine will increase the level or effect of maraviroc by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• mavacamten

  Contraindicated (1)fluvoxamine will increase the level or effect of mavacamten by affecting hepatic enzyme CYP2C19 metabolism. Contraindicated. Strong or moderate CYP2C19 inhibitors may increase mavacamten systemic exposure, resulting in heart failure due to systolic dysfunction. Monitor Closely (1)fluvoxamine will increase the level or effect of mavacamten by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Inititiation of moderate CYP3A4 inhibitors may require decreased mavacamten dose.

• meclofenamate

  Monitor Closely (1)fluvoxamine, meclofenamate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding SSRIs inhib. serotonin uptake by platelets.

• mefenamic acid

  Monitor Closely (1)fluvoxamine, mefenamic acid. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding SSRIs inhib. serotonin uptake by platelets.

• melatonin

  Serious - Use Alternative (1)fluvoxamine will increase the level or effect of melatonin by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of melatonin with strong CYP1A2 inhibitors

• meloxicam

  Monitor Closely (1)fluvoxamine, meloxicam. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding; SSRIs inhib. srotonin uptake by platelets.

• meperidine

  Serious - Use Alternative (1)fluvoxamine and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.

• metformin

  Monitor Closely (1)fluvoxamine increases effects of metformin by pharmacodynamic synergism. Use Caution/Monitor.

• methadone

  Monitor Closely (1)fluvoxamine and methadone both increase QTc interval. Use Caution/Monitor.

• methylene blue

  Serious - Use Alternative (1)fluvoxamine increases toxicity of methylene blue by serotonin levels. Avoid or Use Alternate Drug.

• methylphenidate transdermal

  Monitor Closely (1)methylphenidate transdermal will increase the level or effect of fluvoxamine by decreasing metabolism. Modify Therapy/Monitor Closely. Consider decreasing the dose of these drugs when given coadministered with methylphenidate. Monitor for drug toxiticities when initiating or discontinuing methylphenidate.

• metoclopramide

  Serious - Use Alternative (1)fluvoxamine and metoclopramide both increase serotonin levels. Avoid or Use Alternate Drug. Additive effects: Increased risk for serotonin syndrome, neuroleptic malignant syndrome, dystonia, or other extrapyramidal reactions

• metoclopramide intranasal

  Serious - Use Alternative (1)fluvoxamine, metoclopramide intranasal. Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient.

• mexiletine

  Serious - Use Alternative (1)fluvoxamine will increase the level or effect of mexiletine by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug.

• midazolam

  Monitor Closely (1)fluvoxamine will increase the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. May increase risk of hypoventilation, airway obstruction, or apnea and may contribute to profound and/or prolonged drug effect

• midazolam intranasal

  Monitor Closely (1)fluvoxamine will increase the level or effect of midazolam intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. May increase risk of hypoventilation, airway obstruction, or apnea and may contribute to profound and/or prolonged drug effect

• milnacipran

  Serious - Use Alternative (1)fluvoxamine and milnacipran both increase serotonin levels. Avoid or Use Alternate Drug.

• mirabegron

  Monitor Closely (1)mirabegron will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

• mirtazapine

  Monitor Closely (1)fluvoxamine and mirtazapine both increase serotonin levels. Modify Therapy/Monitor Closely.Serious - Use Alternative (1)mirtazapine and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.

• mobocertinib

  Serious - Use Alternative (1)fluvoxamine will increase the level or effect of mobocertinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If use of moderate CYP3A4 inhibitor unavoidable, reduce mobocertinib dose by ~50% (eg, 160 to 80 mg); closely monitor QTc interval.

• morphine

  Monitor Closely (1)fluvoxamine and morphine both increase serotonin levels. Modify Therapy/Monitor Closely.

• moxifloxacin

  Monitor Closely (1)fluvoxamine and moxifloxacin both increase QTc interval. Modify Therapy/Monitor Closely.

• nabumetone

  Monitor Closely (1)fluvoxamine, nabumetone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding SSRIs inhib. serotonin uptake by platelets.

• naldemedine

  Monitor Closely (1)fluvoxamine will increase the level or effect of naldemedine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Monitor for potential adverse effects

• naproxen

  Monitor Closely (1)fluvoxamine, naproxen. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• naratriptan

  Monitor Closely (1)fluvoxamine and naratriptan both increase serotonin levels. Modify Therapy/Monitor Closely.

• nateglinide

  Monitor Closely (1)fluvoxamine will increase the level or effect of nateglinide by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.

• nefazodone

  Serious - Use Alternative (1)fluvoxamine and nefazodone both increase serotonin levels. Avoid or Use Alternate Drug.

• nelfinavir

  Monitor Closely (1)fluvoxamine will increase the level or effect of nelfinavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• neratinib

  Serious - Use Alternative (1)fluvoxamine will increase the level or effect of neratinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• netupitant/palonosetron

  Serious - Use Alternative (1)fluvoxamine increases toxicity of netupitant/palonosetron by serotonin levels. Avoid or Use Alternate Drug.

• nicardipine

  Monitor Closely (1)fluvoxamine will increase the level or effect of nicardipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• nifedipine

  Monitor Closely (1)fluvoxamine will increase the level or effect of nifedipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• nilotinib

  Monitor Closely (1)fluvoxamine will increase the level or effect of nilotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• nimodipine

  Monitor Closely (1)fluvoxamine will increase the level or effect of nimodipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• nisoldipine

  Monitor Closely (1)fluvoxamine will increase the level or effect of nisoldipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• nitrendipine

  Monitor Closely (1)fluvoxamine will increase the level or effect of nitrendipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• norgestrel

  Monitor Closely (1)fluvoxamine will increase the level or effect of norgestrel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Strong or moderate CYP3A4 inhibitors may increase systemic concentration of norgestrel, which may increase risk for adverse effects

• nortriptyline

  Monitor Closely (1)fluvoxamine and nortriptyline both increase QTc interval. Modify Therapy/Monitor Closely.Serious - Use Alternative (1)fluvoxamine and nortriptyline both increase serotonin levels. Avoid or Use Alternate Drug.

• octreotide

  Monitor Closely (1)fluvoxamine and octreotide both increase QTc interval. Modify Therapy/Monitor Closely.

• octreotide (Antidote)

  Monitor Closely (1)fluvoxamine and octreotide (Antidote) both increase QTc interval. Modify Therapy/Monitor Closely.

• ofloxacin

  Monitor Closely (1)fluvoxamine and ofloxacin both increase QTc interval. Modify Therapy/Monitor Closely.

• olanzapine

  Serious - Use Alternative (2)fluvoxamine will increase the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug.
  
  olanzapine and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.

• oliceridine

  Monitor Closely (2)fluvoxamine will increase the level or effect of oliceridine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. If concomitant use is necessary, may require less frequent oliceridine dosing. Closely monitor for respiratory depression and sedation and titrate subsequent doses accordingly. If inhibitor is discontinued, consider increase oliceridine dosage until stable drug effects are achieved. Monitor for signs of opioid withdrawal.
  
  fluvoxamine, oliceridine. Either increases toxicity of the other by serotonin levels. Modify Therapy/Monitor Closely.

• olopatadine intranasal

  Serious - Use Alternative (1)fluvoxamine and olopatadine intranasal both increase sedation. Avoid or Use Alternate Drug. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.

• omaveloxolone

  Serious - Use Alternative (1)fluvoxamine will increase the level or effect of omaveloxolone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If unavoidable, reduce omaveloxolone dose to 100 mg/day. Closely monitor for adverse effects. If adverse effects emerge, further reduce to 50 mg/day.

• omeprazole

  Serious - Use Alternative (1)fluvoxamine will increase the level or effect of omeprazole by affecting hepatic enzyme CYP2C19 metabolism. Avoid or Use Alternate Drug.

• ondansetron

  Serious - Use Alternative (1)fluvoxamine and ondansetron both increase serotonin levels. Avoid or Use Alternate Drug.

• ospemifene

  Monitor Closely (1)fluvoxamine will increase the level or effect of ospemifene by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.

• oxaliplatin

  Serious - Use Alternative (1)oxaliplatin and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.

• oxaprozin

  Monitor Closely (1)fluvoxamine, oxaprozin. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• oxycodone

  Monitor Closely (1)fluvoxamine and oxycodone both increase serotonin levels. Use Caution/Monitor.

• ozanimod

  Serious - Use Alternative (1)ozanimod increases toxicity of fluvoxamine by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Because active metabolite of ozanimod inhibits MAO-B in vitro, there is potential for serious adverse reactions, including hypertensive crisis. Therefore, coadministration of ozanimod with drugs that can increase norepinephrine or serotonin is not recommended. Monitor for hypertension with concomitant use. .

• pacritinib

  Serious - Use Alternative (1)fluvoxamine will increase the level or effect of pacritinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• paliperidone

  Monitor Closely (1)fluvoxamine and paliperidone both increase QTc interval. Use Caution/Monitor.

• palonosetron

  Serious - Use Alternative (1)fluvoxamine and palonosetron both increase serotonin levels. Avoid or Use Alternate Drug.

• palovarotene

  Monitor Closely (1)fluvoxamine will increase the level or effect of palovarotene by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Avoid coadministration of palovarotene, a CYP3A substrate, with moderate CYP3A inhibitors. If unavoidable, reduce palovarotene dose by 50%.

• pantoprazole

  Monitor Closely (1)fluvoxamine will increase the level or effect of pantoprazole by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.

• parecoxib

  Monitor Closely (1)fluvoxamine will increase the level or effect of parecoxib by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Increased risk of upper GI bleeding; SSRIs inhib. srotonin uptake by platelets

• paroxetine

  Monitor Closely (1)fluvoxamine and paroxetine both increase QTc interval. Use Caution/Monitor.Serious - Use Alternative (1)fluvoxamine and paroxetine both increase serotonin levels. Avoid or Use Alternate Drug.

• pazopanib

  Serious - Use Alternative (1)fluvoxamine will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If it must be coadminister, decrease pazotinib dose to 400 mg/day

• peginterferon alfa 2b

  Monitor Closely (1)fluvoxamine, peginterferon alfa 2b. Other (see comment). Use Caution/Monitor. Comment: Therapeutic effect may be altered with coadministration of CYP2D6 substrates; peginterferon alpha-2b may increase or decrease levels of CYP2D6 substrate.

• pentamidine

  Serious - Use Alternative (1)fluvoxamine and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

• pentazocine

  Monitor Closely (1)fluvoxamine and pentazocine both increase serotonin levels. Modify Therapy/Monitor Closely.

• pentoxifylline

  Monitor Closely (1)fluvoxamine and pentoxifylline both increase anticoagulation. Use Caution/Monitor. may increase bleeding

• perphenazine

  Monitor Closely (1)fluvoxamine and perphenazine both increase QTc interval. Use Caution/Monitor.

• pexidartinib

  Serious - Use Alternative (1)fluvoxamine will increase the level or effect of pexidartinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration with strong or moderate CYP3A4 inhibitors is unavoidable, reduce pexidartinib dose (refer to drug monograph dosage modifications). After discontinuing the CYP3A4 inhibitor for 3 elimination half-lives, may resume previous pexidartinib dose.

• phenelzine

  Serious - Use Alternative (1)fluvoxamine and phenelzine both increase serotonin levels. Contraindicated.

• phentermine

  Serious - Use Alternative (1)fluvoxamine and phentermine both increase serotonin levels. Avoid or Use Alternate Drug.

• phenytoin

  Monitor Closely (1)fluvoxamine will increase the level or effect of phenytoin by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.

• pimozide

  Serious - Use Alternative (2)fluvoxamine increases toxicity of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
  
  fluvoxamine and pimozide both increase QTc interval. Avoid or Use Alternate Drug.

• pirfenidone

  Serious - Use Alternative (1)fluvoxamine will increase the level or effect of pirfenidone by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug. Use of strong CYP1A2 inhibitors should be discontinued before initiating treatment and avoided during treatment; if strong CYP1A2 inhibitor is only option, dosage reduction recommended

• piroxicam

  Monitor Closely (1)fluvoxamine, piroxicam. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• pomalidomide

  Serious - Use Alternative (1)fluvoxamine will increase the level or effect of pomalidomide by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug.

• posaconazole

  Monitor Closely (1)fluvoxamine and posaconazole both increase QTc interval. Use Caution/Monitor.

• pregabalin

  Monitor Closely (1)fluvoxamine, pregabalin. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration may result in life-threatening, and fatal respiratory depression; use lowest dose possible and monitor for respiratory depression and sedation.

• primaquine

  Monitor Closely (1)primaquine and fluvoxamine both increase QTc interval. Use Caution/Monitor.

• procainamide

  Serious - Use Alternative (1)fluvoxamine and procainamide both increase QTc interval. Avoid or Use Alternate Drug.

• procarbazine

  Serious - Use Alternative (1)fluvoxamine and procarbazine both increase serotonin levels. Contraindicated.

• prochlorperazine

  Monitor Closely (1)fluvoxamine and prochlorperazine both increase QTc interval. Use Caution/Monitor.

• promazine

  Monitor Closely (1)fluvoxamine and promazine both increase QTc interval. Modify Therapy/Monitor Closely.

• promethazine

  Monitor Closely (1)fluvoxamine and promethazine both increase QTc interval. Use Caution/Monitor.

• propafenone

  Monitor Closely (1)fluvoxamine will increase the level or effect of propafenone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• propofol

  Monitor Closely (1)fluvoxamine will increase the level or effect of propofol by affecting hepatic enzyme CYP2B6 metabolism. Use Caution/Monitor.

• protriptyline

  Monitor Closely (1)fluvoxamine and protriptyline both increase QTc interval. Modify Therapy/Monitor Closely.Serious - Use Alternative (1)fluvoxamine and protriptyline both increase serotonin levels. Avoid or Use Alternate Drug.

• quetiapine

  Monitor Closely (1)fluvoxamine will increase the level or effect of quetiapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• quinidine

  Monitor Closely (1)quinidine will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)fluvoxamine and quinidine both increase QTc interval. Avoid or Use Alternate Drug.

• rabeprazole

  Monitor Closely (1)fluvoxamine will increase the level or effect of rabeprazole by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.

• ramelteon

  Contraindicated (1)fluvoxamine will increase the level or effect of ramelteon by affecting hepatic enzyme CYP1A2 metabolism. Contraindicated.Monitor Closely (1)fluvoxamine will increase the level or effect of ramelteon by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.

• ranolazine

  Monitor Closely (1)fluvoxamine and ranolazine both increase QTc interval. Use Caution/Monitor.Serious - Use Alternative (1)fluvoxamine will increase the level or effect of ranolazine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.

• rasagiline

  Serious - Use Alternative (1)fluvoxamine and rasagiline both increase serotonin levels. Avoid or Use Alternate Drug. Severe CNS toxicity associated with hyperpyrexia reported with combined treatment of antidepressant and rasagiline; avoid combination within 14 days of MAOI use

• remifentanil

  Serious - Use Alternative (1)fluvoxamine and remifentanil both increase serotonin levels. Avoid or Use Alternate Drug.

• remimazolam

  Monitor Closely (1)remimazolam, fluvoxamine. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely. Coadministration may result in profound sedation, respiratory depression, coma, and/or death. Continuously monitor vital signs during sedation and recovery period if coadministered. Carefully titrate remimazolam dose if administered with opioid analgesics and/or sedative/hypnotics.

• repaglinide

  Monitor Closely (1)fluvoxamine will increase the level or effect of repaglinide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• riluzole

  Monitor Closely (1)fluvoxamine will increase the level or effect of riluzole by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.

• rimegepant

  Monitor Closely (1)fluvoxamine will increase the level or effect of rimegepant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Avoid repeating dose within 48 hr if coadministered with moderate CYP3A4

• risperidone

  Monitor Closely (1)fluvoxamine and risperidone both increase QTc interval. Use Caution/Monitor.

• ritlecitinib

  Monitor Closely (1)ritlecitinib will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP1A2 metabolism. Modify Therapy/Monitor Closely. Ritlecitinib inhibits CYP1A2 substrates; coadministration increases AUC and peak plasma concentration sensitive substrates, which may increase risk of adverse reactions. Additional monitoring and dosage adjustment may be needed in accordance with product labeling of CYP1A2 substrates.

• ritonavir

  Monitor Closely (1)fluvoxamine will increase the level or effect of ritonavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• rivaroxaban

  Monitor Closely (1)fluvoxamine will increase the level or effect of rivaroxaban by pharmacodynamic synergism. Use Caution/Monitor. May increase risk of bleeding

• rizatriptan

  Monitor Closely (1)fluvoxamine and rizatriptan both increase serotonin levels. Modify Therapy/Monitor Closely.

• roflumilast

  Monitor Closely (1)fluvoxamine increases levels of roflumilast by Other (see comment). Modify Therapy/Monitor Closely. Comment: coadministration with dual inhibitors of CYP3A4 and CYP1A2 may increase systemic exposure and result in increased adverse reactions.

• rolapitant

  Monitor Closely (1)rolapitant will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Rolapitant may increase serum concentrations of CYP2D6 substrates for at least 28 days following rolapitant administration

• romidepsin

  Monitor Closely (1)fluvoxamine and romidepsin both increase QTc interval. Use Caution/Monitor.

• ropinirole

  Serious - Use Alternative (1)fluvoxamine will increase the level or effect of ropinirole by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug.

• rucaparib

  Monitor Closely (1)rucaparib will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP1A2 metabolism. Modify Therapy/Monitor Closely. Adjust dosage of CYP1A2 substrates, if clinically indicated.

• safinamide

  Monitor Closely (1)fluvoxamine, safinamide. Either increases toxicity of the other by serotonin levels. Use Caution/Monitor. Monitor for serotonin syndrome.

• salicylates (non-asa)

  Monitor Closely (1)fluvoxamine, salicylates (non-asa). Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• salsalate

  Monitor Closely (1)fluvoxamine, salsalate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• SAMe

  Monitor Closely (1)fluvoxamine and SAMe both increase serotonin levels. Modify Therapy/Monitor Closely.

• saquinavir

  Monitor Closely (1)fluvoxamine will increase the level or effect of saquinavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• selegiline

  Contraindicated (1)fluvoxamine will increase the level or effect of selegiline by affecting hepatic enzyme CYP2B6 metabolism. Contraindicated.Serious - Use Alternative (1)fluvoxamine and selegiline both increase serotonin levels. Contraindicated. At least 14 days should elapse between discontinuation of either drug and initiation of the other one

• selegiline transdermal

  Serious - Use Alternative (1)fluvoxamine and selegiline transdermal both increase serotonin levels. Avoid or Use Alternate Drug.

• selinexor

  Serious - Use Alternative (1)selinexor, fluvoxamine. unspecified interaction mechanism. Avoid or Use Alternate Drug. Patients treated with selinexor may experience neurological toxicities. Avoid taking selinexor with other medications that may cause dizziness or confusion.

• sertraline

  Serious - Use Alternative (2)fluvoxamine and sertraline both increase serotonin levels. Avoid or Use Alternate Drug.
  
  sertraline and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.

• sevoflurane

  Serious - Use Alternative (1)sevoflurane and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.

• silodosin

  Monitor Closely (1)fluvoxamine will increase the level or effect of silodosin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• siponimod

  Serious - Use Alternative (2)fluvoxamine will increase the level or effect of siponimod by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration with a moderate or strong CYP3A4 inhibitor PLUS a moderate or strong CYP2C9 inhibitor not recommended
  
  siponimod and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.

• sodium sulfate/?magnesium sulfate/potassium chloride

  Monitor Closely (1)sodium sulfate/?magnesium sulfate/potassium chloride increases effects of fluvoxamine by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of seizures when using bowel preps together with drugs that lower the seizure threshold.

• sodium sulfate/potassium chloride/magnesium sulfate/polyethylene glycol

  Monitor Closely (1)fluvoxamine, sodium sulfate/potassium chloride/magnesium sulfate/polyethylene glycol. Other (see comment). Use Caution/Monitor. Comment: Increased risk for water retention or electrolyte imbalance.

• sodium sulfate/potassium sulfate/magnesium sulfate

  Monitor Closely (1)sodium sulfate/potassium sulfate/magnesium sulfate increases effects of fluvoxamine by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of seizures when using bowel preps together with drugs that lower the seizure threshold.

• sofosbuvir/velpatasvir

  Monitor Closely (1)fluvoxamine will increase the level or effect of sofosbuvir/velpatasvir by affecting hepatic enzyme CYP2B6 metabolism. Use Caution/Monitor.

• solifenacin

  Monitor Closely (2)fluvoxamine will increase the level or effect of solifenacin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  solifenacin and fluvoxamine both increase QTc interval. Use Caution/Monitor.

• somapacitan

  Monitor Closely (1)somapacitan will decrease the level or effect of fluvoxamine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. Limited published data indicate that growth hormone treatment increases cytochrome P450 (CYP450)-mediated antipyrine clearance. Caution with sensitive CYP substrates

• somatrogon

  Monitor Closely (1)somatrogon will decrease the level or effect of fluvoxamine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. Limited published data indicate that growth hormone treatment increases cytochrome P450 (CYP450)-mediated antipyrine clearance. Caution with sensitive CYP substrates

• somatropin

  Monitor Closely (1)somatropin will decrease the level or effect of fluvoxamine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. Limited published data indicate that growth hormone treatment increases cytochrome P450 (CYP450)-mediated antipyrine clearance. Caution with sensitive CYP substrates

• sotalol

  Serious - Use Alternative (1)fluvoxamine and sotalol both increase QTc interval. Avoid or Use Alternate Drug.

• sparsentan

  Monitor Closely (1)fluvoxamine will increase the level or effect of sparsentan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. No dosage adjustment needed. Monitor blood pressure, serum potassium, edema, and kidney function regularly if sparsentan is coadministered with moderate CYP3A4 inhibitors.

• St John's Wort

  Serious - Use Alternative (1)fluvoxamine and St John's Wort both increase serotonin levels. Avoid or Use Alternate Drug.

• stiripentol

  Monitor Closely (1)fluvoxamine, stiripentol. affecting hepatic enzyme CYP1A2 metabolism. Modify Therapy/Monitor Closely. May require dosage adjustment.

• sufentanil

  Monitor Closely (1)fluvoxamine and sufentanil both increase serotonin levels. Use Caution/Monitor. Carefully observe patient for serotonin syndrome during treatment initiation and dose adjustment

• sufentanil SL

  Monitor Closely (1)fluvoxamine and sufentanil SL both decrease serotonin levels. Use Caution/Monitor. Carefully observe patient for serotonin syndrome during treatment initiation and dose adjustment

• sulfamethoxazole

  Monitor Closely (1)fluvoxamine and sulfamethoxazole both increase QTc interval. Use Caution/Monitor.

• sulfasalazine

  Monitor Closely (1)fluvoxamine will increase the level or effect of sulfasalazine by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding SSRIs inhib. serotonin uptake by platelets

• sulindac

  Monitor Closely (1)fluvoxamine, sulindac. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor.

• sumatriptan

  Monitor Closely (1)fluvoxamine and sumatriptan both increase serotonin levels. Modify Therapy/Monitor Closely.

• sumatriptan intranasal

  Monitor Closely (1)fluvoxamine and sumatriptan intranasal both increase serotonin levels. Modify Therapy/Monitor Closely.

• sunitinib

  Monitor Closely (2)sunitinib and fluvoxamine both increase QTc interval. Use Caution/Monitor.
  
  fluvoxamine will increase the level or effect of sunitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• tacrolimus

  Monitor Closely (2)fluvoxamine will increase the level or effect of tacrolimus by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  tacrolimus and fluvoxamine both increase QTc interval. Use Caution/Monitor.

• tadalafil

  Monitor Closely (1)fluvoxamine will increase the level or effect of tadalafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• talquetamab

  Monitor Closely (1)talquetamab will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. Talquetamab causes cytokine release syndrome (CRS) that may suppress activity of CYP enzymes, resulting in increased exposure of CYP substrates. This is more likely to occur from initiation of talquetamab step-up dosing up to 14 days after the first treatment dose and during and after CRS.

• tamoxifen

  Monitor Closely (1)fluvoxamine, tamoxifen. affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Decreases tamoxifen metabolism to active metabolites.

• tapentadol

  Monitor Closely (1)fluvoxamine and tapentadol both increase serotonin levels. Modify Therapy/Monitor Closely.

• tasimelteon

  Monitor Closely (1)fluvoxamine will increase the level or effect of tasimelteon by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. May increase adverse effects

• tazemetostat

  Serious - Use Alternative (1)fluvoxamine will increase the level or effect of tazemetostat by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of avapritinib with moderate CYP3A4 inhibitors. If unable to avoid, reduce avapritinib starting dose. See drug monograph Dosage Modifications

• tedizolid

  Serious - Use Alternative (1)fluvoxamine and tedizolid both increase serotonin levels. Avoid or Use Alternate Drug.

• telavancin

  Monitor Closely (1)fluvoxamine and telavancin both increase QTc interval. Use Caution/Monitor.

• temsirolimus

  Monitor Closely (1)fluvoxamine will increase the level or effect of temsirolimus by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• terbinafine

  Monitor Closely (2)fluvoxamine will increase the level or effect of terbinafine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
  
  terbinafine will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Assess need to reduce dose of CYP2D6-metabolized drug.

• teriflunomide

  Monitor Closely (1)teriflunomide will decrease the level or effect of fluvoxamine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.

• tetrabenazine

  Serious - Use Alternative (1)tetrabenazine and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.

• tezacaftor

  Monitor Closely (1)fluvoxamine will increase the level or effect of tezacaftor by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Adjust dose when coadministered with a moderate CYP3A4 inhibitor

• theophylline

  Serious - Use Alternative (1)fluvoxamine will increase the level or effect of theophylline by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug.

• thioridazine

  Serious - Use Alternative (2)fluvoxamine will increase the level or effect of thioridazine by affecting hepatic enzyme CYP1A2 metabolism. Contraindicated.
  
  fluvoxamine and thioridazine both increase QTc interval. Contraindicated.

• tinidazole

  Monitor Closely (1)fluvoxamine will increase the level or effect of tinidazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• tipranavir

  Monitor Closely (1)fluvoxamine will increase the level or effect of tipranavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)tipranavir will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.

• tizanidine

  Serious - Use Alternative (1)fluvoxamine will increase the level or effect of tizanidine by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug.

• tofacitinib

  Monitor Closely (1)fluvoxamine increases levels of tofacitinib by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. Decrease tofacitinib dose is coadministered with both moderate CYP3A4 and potent CYP2C19 inhibitors.

• tolbutamide

  Monitor Closely (1)fluvoxamine will increase the level or effect of tolbutamide by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.

• tolfenamic acid

  Monitor Closely (1)fluvoxamine, tolfenamic acid. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• tolmetin

  Monitor Closely (1)fluvoxamine, tolmetin. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• tolvaptan

  Serious - Use Alternative (1)fluvoxamine will increase the level or effect of tolvaptan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.

• tramadol

  Monitor Closely (1)fluvoxamine and tramadol both increase serotonin levels. Modify Therapy/Monitor Closely.

• tranylcypromine

  Serious - Use Alternative (1)fluvoxamine and tranylcypromine both increase serotonin levels. Contraindicated.

• trazodone

  Monitor Closely (1)fluvoxamine and trazodone both increase QTc interval. Modify Therapy/Monitor Closely.Serious - Use Alternative (1)fluvoxamine and trazodone both increase serotonin levels. Avoid or Use Alternate Drug.

• triazolam

  Monitor Closely (1)fluvoxamine will increase the level or effect of triazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• trifluoperazine

  Monitor Closely (1)fluvoxamine and trifluoperazine both increase QTc interval. Modify Therapy/Monitor Closely.

• trimethoprim

  Monitor Closely (1)fluvoxamine and trimethoprim both increase QTc interval. Use Caution/Monitor.

• trimipramine

  Monitor Closely (1)fluvoxamine and trimipramine both increase QTc interval. Modify Therapy/Monitor Closely.Serious - Use Alternative (1)fluvoxamine will increase the level or effect of trimipramine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.

• tropisetron

  Monitor Closely (1)fluvoxamine and tropisetron both increase QTc interval. Use Caution/Monitor.

• valbenazine

  Monitor Closely (1)valbenazine and fluvoxamine both increase QTc interval. Use Caution/Monitor.

• valerian

  Monitor Closely (1)fluvoxamine and valerian both increase sedation. Use Caution/Monitor.

• vardenafil

  Monitor Closely (1)fluvoxamine will increase the level or effect of vardenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Vardenafil dose may need to be reduced if coadministered with moderate or strong CYP3A4 inhibitors

• velpatasvir

  Monitor Closely (1)fluvoxamine will increase the level or effect of velpatasvir by affecting hepatic enzyme CYP2B6 metabolism. Use Caution/Monitor.

• venlafaxine

  Monitor Closely (1)fluvoxamine and venlafaxine both increase QTc interval. Use Caution/Monitor.Serious - Use Alternative (1)fluvoxamine and venlafaxine both increase serotonin levels. Avoid or Use Alternate Drug.

• verapamil

  Monitor Closely (1)fluvoxamine will increase the level or effect of verapamil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• vilazodone

  Serious - Use Alternative (1)fluvoxamine and vilazodone both increase serotonin levels. Avoid or Use Alternate Drug. Discontinue concomitant therapy immediately if signs and symptoms of serotonin syndrome emerge and supportive sympathomimetic treatment should be initiated

• voclosporin

  Monitor Closely (1)fluvoxamine will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce voclosporin daily dosage to 15.8 mg PO in AM and 7.9 mg PO in PM.

• vorapaxar

  Monitor Closely (1)fluvoxamine, vorapaxar. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. SSRIs and SNRIs may cause platelet serotonin depletion.

• voriconazole

  Monitor Closely (1)fluvoxamine and voriconazole both increase QTc interval. Use Caution/Monitor.

• vorinostat

  Monitor Closely (1)vorinostat and fluvoxamine both increase QTc interval. Use Caution/Monitor.

• vortioxetine

  Serious - Use Alternative (1)fluvoxamine, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.

• warfarin

  Monitor Closely (1)fluvoxamine, warfarin. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Serotonin release by platelets plays an important role in hemostasis. SSRIs and SNRIs may increase anticoagulation effect of warfarin. .

• zaleplon

  Monitor Closely (1)fluvoxamine will increase the level or effect of zaleplon by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• zanubrutinib

  Monitor Closely (1)fluvoxamine will increase the level or effect of zanubrutinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce zanubrutinib (a CYP3A4 substrate) to 80 mg PO BID to when coadministered with a moderate CYP3A4 inhibitor. Interrupt dose as recommended for adverse reactions. After discontinuing the CYP3A4 inhibitor, resume previous dose of zanubrutinib.

• ziprasidone

  Monitor Closely (1)fluvoxamine and ziprasidone both increase QTc interval. Modify Therapy/Monitor Closely.

• zolmitriptan

  Monitor Closely (1)fluvoxamine and zolmitriptan both increase serotonin levels. Modify Therapy/Monitor Closely.

• zolpidem

  Monitor Closely (1)fluvoxamine will increase the level or effect of zolpidem by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• zonisamide

  Monitor Closely (1)fluvoxamine will increase the level or effect of zonisamide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.