Drug interactions
Carbamazepine + Fluvoxamine
Severity: Moderate
Carbamazepine 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
Fluvoxamine inhibits CYP3A4 and CYP1A2 and can raise carbamazepine concentrations, leading to dizziness, ataxia, nausea and diplopia. Carbamazepine may also lower fluvoxamine levels through enzyme induction.
What this interaction means in plain words
Carbamazepine 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.
Carbamazepine belongs to Central Nervous System; Fluvoxamine belongs to Central Nervous System.
Why it happens
Inhibition of CYP3A4-mediated carbamazepine metabolism by fluvoxamine, with carbamazepine enzyme induction in the reverse direction.
What to do
Monitor carbamazepine plasma levels and signs of toxicity when fluvoxamine is started or stopped, and adjust the dose accordingly. Assess antidepressant response as well.
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 Carbamazepine
- Artemether / lumefantrine + Carbamazepine Contraindicated
- Cabotegravir + Carbamazepine Contraindicated
- Carbamazepine + Delamanid Contraindicated
- Carbamazepine + Dienogest / estradiol valerate Contraindicated
- Carbamazepine + Doravirine Contraindicated
- Carbamazepine + Elbasvir / grazoprevir Contraindicated
Frequently asked questions
Can I take Carbamazepine with Fluvoxamine?
MediHelp rates the interaction as moderate. Carbamazepine 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. Fluvoxamine inhibits CYP3A4 and CYP1A2 and can raise carbamazepine concentrations, leading to dizziness, ataxia, nausea and diplopia. Carbamazepine may also lower fluvoxamine levels through enzyme induction.
How serious is the interaction between Carbamazepine 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 carbamazepine plasma levels and signs of toxicity when fluvoxamine is started or stopped, and adjust the dose accordingly. Assess antidepressant response as well.
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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