Drug interactions
Cilostazol + Fluvoxamine
Severity: Major
Cilostazol 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
Fluvoxamine inhibits CYP2C19 and, to a lesser degree, CYP3A4, raising exposure to the active metabolites of cilostazol. This increases the risk of headache, tachycardia, palpitations, diarrhea and hypotension. Cilostazol is contraindicated in heart failure, so excess exposure matters.
What this interaction means in plain words
Cilostazol 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.
Cilostazol belongs to Cardiovascular; Fluvoxamine belongs to Central Nervous System.
Why it happens
Inhibition of CYP2C19 reduces cilostazol metabolism and increases levels of its active metabolite.
What to do
Reduce the cilostazol dose to 50 mg twice daily when used with strong CYP2C19 inhibitors, as per labeling. Monitor heart rate, blood pressure and adverse 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 Cilostazol
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 Cilostazol with Fluvoxamine?
MediHelp rates the interaction as major. Cilostazol 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 CYP2C19 and, to a lesser degree, CYP3A4, raising exposure to the active metabolites of cilostazol. This increases the risk of headache, tachycardia, palpitations, diarrhea and hypotension. Cilostazol is contraindicated in heart failure, so excess exposure matters.
How serious is the interaction between Cilostazol 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: Reduce the cilostazol dose to 50 mg twice daily when used with strong CYP2C19 inhibitors, as per labeling. Monitor heart rate, blood pressure and adverse effects.
What other medicines interact with Cilostazol?
MediHelp also lists interactions of Cilostazol with, for example, Abrocitinib, Anagrelide, Betrixaban. The full list is on the Cilostazol page.
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