Drug interactions
Bupropion + Fluvoxamine
Severity: Major
Bupropion 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
Both drugs lower the seizure threshold, so combined use may increase seizure risk. Fluvoxamine inhibits several CYP enzymes and may alter bupropion handling, while bupropion may add to serotonergic and CNS effects. Evidence is mostly extrapolated and from case experience.
What this interaction means in plain words
Bupropion 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.
Bupropion belongs to Central Nervous System; Fluvoxamine belongs to Central Nervous System.
Why it happens
Additive seizure-threshold lowering with possible metabolic inhibition by fluvoxamine.
What to do
Avoid if an alternative exists; otherwise keep bupropion at the lowest effective dose. Monitor for seizures and adverse CNS effects.
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 Bupropion
- Bupropion + Isocarboxazid Contraindicated
- Bupropion + Linezolid Contraindicated
- Bupropion + Phenelzine Contraindicated
- Bupropion + Rasagiline Contraindicated
- Bupropion + Selegiline Contraindicated
- Bupropion + Selegiline transdermal Contraindicated
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 Bupropion with Fluvoxamine?
MediHelp rates the interaction as major. Bupropion 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. Both drugs lower the seizure threshold, so combined use may increase seizure risk. Fluvoxamine inhibits several CYP enzymes and may alter bupropion handling, while bupropion may add to serotonergic and CNS effects. Evidence is mostly extrapolated and from case experience.
How serious is the interaction between Bupropion 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 if an alternative exists; otherwise keep bupropion at the lowest effective dose. Monitor for seizures and adverse CNS effects.
What other medicines interact with Bupropion?
MediHelp also lists interactions of Bupropion with, for example, Isocarboxazid, Linezolid, Phenelzine. The full list is on the Bupropion page.
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