Drug interactions
Cocaine + Fluoxetine
Severity: Moderate
Cocaine and Fluoxetine: 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
Both agents increase synaptic monoamine availability, and combined use may increase the chance of serotonergic or sympathomimetic toxicity. With topical medical cocaine the systemic exposure is generally low, so clinical significance is limited, but illicit systemic cocaine carries greater risk.
What this interaction means in plain words
Cocaine and Fluoxetine 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.
Cocaine belongs to Central Nervous System; Fluoxetine belongs to Central Nervous System.
Why it happens
Additive inhibition of serotonin reuptake, with cocaine also blocking norepinephrine and dopamine reuptake.
What to do
Watch for agitation, tachycardia, hypertension, hyperthermia and other signs of serotonin syndrome. Use the lowest effective amount of topical cocaine and avoid systemic use.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Cocaine and Fluoxetine, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
Other interactions of Fluoxetine
- Fluoxetine + Isocarboxazid Contraindicated
- Fluoxetine + Mavacamten Contraindicated
- Fluoxetine + Methylene blue Contraindicated
- Fluoxetine + Phenelzine Contraindicated
- Fluoxetine + Pimozide Contraindicated
- Fluoxetine + Rasagiline Contraindicated
Other interactions of Cocaine
- Cocaine + Isocarboxazid Contraindicated
- Cocaine + Phenelzine Contraindicated
- Cocaine + Procarbazine Contraindicated
- Amitriptyline + Cocaine Major
- Bisoprolol + Cocaine Major
- Citalopram + Cocaine Major
Frequently asked questions
Can I take Cocaine with Fluoxetine?
MediHelp rates the interaction as moderate. Cocaine and Fluoxetine 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. Both agents increase synaptic monoamine availability, and combined use may increase the chance of serotonergic or sympathomimetic toxicity. With topical medical cocaine the systemic exposure is generally low, so clinical significance is limited, but illicit systemic cocaine carries greater risk.
How serious is the interaction between Cocaine and Fluoxetine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Watch for agitation, tachycardia, hypertension, hyperthermia and other signs of serotonin syndrome. Use the lowest effective amount of topical cocaine and avoid systemic use.
What other medicines interact with Fluoxetine?
MediHelp also lists interactions of Fluoxetine with, for example, Isocarboxazid, Mavacamten, Methylene blue. The full list is on the Fluoxetine page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
