Drug interactions
Asenapine + Fluvoxamine
Severity: Moderate
Asenapine and Fluvoxamine: 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
Asenapine is associated with QT prolongation, and fluvoxamine may contribute additively. Fluvoxamine inhibits CYP1A2, the main metabolic pathway of asenapine, and may increase its concentrations.
What this interaction means in plain words
Asenapine and Fluvoxamine 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.
Asenapine belongs to Central Nervous System; Fluvoxamine belongs to Central Nervous System.
Why it happens
CYP1A2 inhibition by fluvoxamine raises asenapine exposure, with possible additive QT prolongation.
What to do
Monitor for sedation, hypotension and QTc prolongation, and consider an ECG at baseline. Reduce the asenapine dose if adverse effects emerge.
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 Fluvoxamine
- Agomelatine + Fluvoxamine Contraindicated
- Alosetron + Fluvoxamine Contraindicated
- Fezolinetant + Fluvoxamine Contraindicated
- Fluvoxamine + Isocarboxazid Contraindicated
- Fluvoxamine + Mavacamten Contraindicated
- Fluvoxamine + Methylene blue Contraindicated
Other interactions of Asenapine
- Asenapine + Pimozide Contraindicated
- Asenapine + Thioridazine Contraindicated
- Asenapine + Vandetanib Contraindicated
- Adagrasib + Asenapine Major
- Alfentanil + Asenapine Major
- Alfuzosin + Asenapine Major
Frequently asked questions
Can I take Asenapine with Fluvoxamine?
MediHelp rates the interaction as moderate. Asenapine and Fluvoxamine 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. Asenapine is associated with QT prolongation, and fluvoxamine may contribute additively. Fluvoxamine inhibits CYP1A2, the main metabolic pathway of asenapine, and may increase its concentrations.
How serious is the interaction between Asenapine and Fluvoxamine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for sedation, hypotension and QTc prolongation, and consider an ECG at baseline. Reduce the asenapine dose if adverse effects emerge.
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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