Drug interactions
Clopidogrel + Fluvoxamine
Severity: Major
Clopidogrel and Fluvoxamine: major interaction.
Last updated Sources: UK SmPC
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 is a potent CYP2C19 inhibitor and may reduce activation of clopidogrel, lowering its antiplatelet effect. SSRIs also add to bleeding risk through impaired platelet serotonin uptake.
What this interaction means in plain words
Clopidogrel 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.
Clopidogrel belongs to Cardiovascular; Fluvoxamine belongs to Central Nervous System.
Why it happens
Strong CYP2C19 inhibition decreases formation of clopidogrel's active metabolite.
What to do
Avoid the combination and choose an antidepressant with minimal CYP2C19 inhibition, such as sertraline. If unavoidable, consider an alternative P2Y12 inhibitor and monitor for bleeding.
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 Clopidogrel
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 Clopidogrel with Fluvoxamine?
MediHelp rates the interaction as major. Clopidogrel 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 is a potent CYP2C19 inhibitor and may reduce activation of clopidogrel, lowering its antiplatelet effect. SSRIs also add to bleeding risk through impaired platelet serotonin uptake.
How serious is the interaction between Clopidogrel 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 and choose an antidepressant with minimal CYP2C19 inhibition, such as sertraline. If unavoidable, consider an alternative P2Y12 inhibitor and monitor for bleeding.
What other medicines interact with Clopidogrel?
MediHelp also lists interactions of Clopidogrel with, for example, Ombitasvir / paritaprevir / ritonavir and dasabuvir, Abrocitinib, Acetylsalicylic acid. The full list is on the Clopidogrel page.
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