Drug interactions
Amoxapine + Fluvoxamine
Severity: Major
Amoxapine and Fluvoxamine: major interaction.
Last updated Sources: US FDA label
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Fluvoxamine inhibits CYP2D6 and other enzymes, raising amoxapine levels and toxicity such as anticholinergic effects, seizures and arrhythmia. Combined serotonergic and noradrenergic activity also raises the risk of serotonin syndrome.
What this interaction means in plain words
Amoxapine and Fluvoxamine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Fluvoxamine inhibits CYP2D6 and other pathways increasing amoxapine exposure, with additive serotonergic effects.
What to do
Avoid combining where possible. If necessary, start amoxapine at a low dose, monitor ECG and serotonergic signs, and consider tricyclic levels.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Fluvoxamine
- Agomelatine + Fluvoxamine Contraindicated
- Alosetron + Fluvoxamine Contraindicated
- Fezolinetant + Fluvoxamine Contraindicated
- Fluvoxamine + Isocarboxazid Contraindicated
- Fluvoxamine + Mavacamten Contraindicated
- Fluvoxamine + Methylene blue Contraindicated
Frequently asked questions
Can I take Amoxapine with Fluvoxamine?
MediHelp rates the interaction as major. Amoxapine and Fluvoxamine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Fluvoxamine inhibits CYP2D6 and other enzymes, raising amoxapine levels and toxicity such as anticholinergic effects, seizures and arrhythmia. Combined serotonergic and noradrenergic activity also raises the risk of serotonin syndrome.
How serious is the interaction between Amoxapine and Fluvoxamine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid combining where possible. If necessary, start amoxapine at a low dose, monitor ECG and serotonergic signs, and consider tricyclic levels.
What other medicines interact with Fluvoxamine?
MediHelp also lists interactions of Fluvoxamine with, for example, Agomelatine, Alosetron, Fezolinetant. The full list is on the Fluvoxamine page.
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