Drug interactions
Bupropion-naltrexone + Fluvoxamine
Severity: Major
Bupropion-naltrexone and Fluvoxamine: major interaction.
Last updated Sources: Health Canada product monograph
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 several CYP enzymes and may alter bupropion metabolism, increasing exposure to it or its active metabolites. Together they can increase seizure risk and cause serotonergic or neuropsychiatric adverse effects.
What this interaction means in plain words
Bupropion-naltrexone 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-naltrexone belongs to Miscellaneous; Fluvoxamine belongs to Central Nervous System.
Why it happens
Fluvoxamine inhibition of CYP enzymes may raise bupropion exposure, with additive seizure-threshold lowering; the exact pathway is not well established.
What to do
Avoid the combination where possible; if it is necessary use the lowest bupropion dose. Monitor for seizures and serotonergic symptoms.
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-naltrexone
- Bupropion-naltrexone + Hydrocodone Contraindicated
- Bupropion-naltrexone + Hydromorphone Contraindicated
- Bupropion-naltrexone + Isocarboxazid Contraindicated
- Bupropion-naltrexone + Linezolid Contraindicated
- Bupropion-naltrexone + Phenelzine Contraindicated
- Bupropion-naltrexone + Rasagiline 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-naltrexone with Fluvoxamine?
MediHelp rates the interaction as major. Bupropion-naltrexone 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 several CYP enzymes and may alter bupropion metabolism, increasing exposure to it or its active metabolites. Together they can increase seizure risk and cause serotonergic or neuropsychiatric adverse effects.
How serious is the interaction between Bupropion-naltrexone 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 the combination where possible; if it is necessary use the lowest bupropion dose. Monitor for seizures and serotonergic symptoms.
What other medicines interact with Bupropion-naltrexone?
MediHelp also lists interactions of Bupropion-naltrexone with, for example, Hydrocodone, Hydromorphone, Isocarboxazid. The full list is on the Bupropion-naltrexone page.
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