Drug interactions
Aripiprazole + Fluoxetine
Severity: Moderate
Aripiprazole and Fluoxetine: moderate interaction.
Last updated
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
Fluoxetine is a strong CYP2D6 inhibitor and raises aripiprazole exposure, which may increase adverse effects such as akathisia, sedation and parkinsonism. QT prolongation by aripiprazole is minimal, so the principal concern is the pharmacokinetic effect.
What this interaction means in plain words
Aripiprazole and Fluoxetine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Aripiprazole belongs to Central Nervous System; Fluoxetine belongs to Central Nervous System.
Why it happens
Inhibition of CYP2D6-mediated aripiprazole metabolism by fluoxetine, which also has some CYP3A4 effect via norfluoxetine.
What to do
Reduce the aripiprazole dose to about half the usual dose when starting fluoxetine, as per labeling, and return to the usual dose if fluoxetine is stopped. Monitor for akathisia and extrapyramidal symptoms.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Fluoxetine
- Fluoxetine + Isocarboxazid Contraindicated
- Fluoxetine + Mavacamten Contraindicated
- Fluoxetine + Methylene blue Contraindicated
- Fluoxetine + Phenelzine Contraindicated
- Fluoxetine + Pimozide Contraindicated
- Fluoxetine + Rasagiline Contraindicated
Other interactions of Aripiprazole
- Aripiprazole + Pimozide Contraindicated
- Aripiprazole + Thioridazine Contraindicated
- Amisulpride + Aripiprazole Major
- Aripiprazole + Arsenic trioxide Major
- Aripiprazole + Calcium / magnesium / potassium / sodium oxybates Major
- Aripiprazole + Carbamazepine Major
Frequently asked questions
Can I take Aripiprazole with Fluoxetine?
MediHelp rates the interaction as moderate. Aripiprazole and Fluoxetine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Fluoxetine is a strong CYP2D6 inhibitor and raises aripiprazole exposure, which may increase adverse effects such as akathisia, sedation and parkinsonism. QT prolongation by aripiprazole is minimal, so the principal concern is the pharmacokinetic effect.
How serious is the interaction between Aripiprazole and Fluoxetine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reduce the aripiprazole dose to about half the usual dose when starting fluoxetine, as per labeling, and return to the usual dose if fluoxetine is stopped. Monitor for akathisia and extrapyramidal symptoms.
What other medicines interact with Fluoxetine?
MediHelp also lists interactions of Fluoxetine with, for example, Isocarboxazid, Mavacamten, Methylene blue. The full list is on the Fluoxetine page.
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