Drug interactions
Desvenlafaxine + Fluvoxamine
Severity: Major
Desvenlafaxine 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
Combining an SSRI with an SNRI increases the risk of serotonin syndrome and may cause additive blood pressure elevation. Fluvoxamine may also modestly raise desvenlafaxine exposure.
What this interaction means in plain words
Desvenlafaxine 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.
Desvenlafaxine belongs to Central Nervous System; Fluvoxamine belongs to Central Nervous System.
Why it happens
Additive serotonin and norepinephrine reuptake inhibition, with possible CYP3A4 effects on desvenlafaxine clearance.
What to do
Avoid combined use where possible; if needed, use the lowest effective doses and monitor for serotonin syndrome and blood pressure.
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 Fluvoxamine
- Agomelatine + Fluvoxamine Contraindicated
- Alosetron + Fluvoxamine Contraindicated
- Fezolinetant + Fluvoxamine Contraindicated
- Fluvoxamine + Isocarboxazid Contraindicated
- Fluvoxamine + Mavacamten Contraindicated
- Fluvoxamine + Methylene blue Contraindicated
Other interactions of Desvenlafaxine
- Desvenlafaxine + Isocarboxazid Contraindicated
- Desvenlafaxine + Methylene blue Contraindicated
- Desvenlafaxine + Phenelzine Contraindicated
- Desvenlafaxine + Rasagiline Contraindicated
- Desvenlafaxine + Safinamide Contraindicated
- Desvenlafaxine + Selegiline Contraindicated
Frequently asked questions
Can I take Desvenlafaxine with Fluvoxamine?
MediHelp rates the interaction as major. Desvenlafaxine 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. Combining an SSRI with an SNRI increases the risk of serotonin syndrome and may cause additive blood pressure elevation. Fluvoxamine may also modestly raise desvenlafaxine exposure.
How serious is the interaction between Desvenlafaxine 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 combined use where possible; if needed, use the lowest effective doses and monitor for serotonin syndrome and blood pressure.
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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