Drug interactions
Deutetrabenazine + Fluoxetine
Severity: Major
Deutetrabenazine and Fluoxetine: 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
Fluoxetine is a strong CYP2D6 inhibitor and markedly increases exposure to the active metabolites of deutetrabenazine, raising the risk of sedation, akathisia, depression and parkinsonism. Both drugs may also modestly affect the QT interval.
What this interaction means in plain words
Deutetrabenazine and Fluoxetine 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.
Deutetrabenazine belongs to Central Nervous System; Fluoxetine belongs to Central Nervous System.
Why it happens
Strong CYP2D6 inhibition by fluoxetine reducing clearance of active deutetrabenazine metabolites, with possible additive QT effects.
What to do
Limit deutetrabenazine to no more than 36 mg per day (18 mg per dose) with fluoxetine. Monitor for depression, sedation and QT-related symptoms, with an ECG when risk factors exist.
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 Fluoxetine
- Fluoxetine + Isocarboxazid Contraindicated
- Fluoxetine + Mavacamten Contraindicated
- Fluoxetine + Methylene blue Contraindicated
- Fluoxetine + Phenelzine Contraindicated
- Fluoxetine + Pimozide Contraindicated
- Fluoxetine + Rasagiline Contraindicated
Other interactions of Deutetrabenazine
- Deutetrabenazine + Isocarboxazid Contraindicated
- Deutetrabenazine + Linezolid Contraindicated
- Deutetrabenazine + Phenelzine Contraindicated
- Deutetrabenazine + Rasagiline Contraindicated
- Deutetrabenazine + Safinamide Contraindicated
- Deutetrabenazine + Selegiline Contraindicated
Frequently asked questions
Can I take Deutetrabenazine with Fluoxetine?
MediHelp rates the interaction as major. Deutetrabenazine and Fluoxetine 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. Fluoxetine is a strong CYP2D6 inhibitor and markedly increases exposure to the active metabolites of deutetrabenazine, raising the risk of sedation, akathisia, depression and parkinsonism. Both drugs may also modestly affect the QT interval.
How serious is the interaction between Deutetrabenazine and Fluoxetine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Limit deutetrabenazine to no more than 36 mg per day (18 mg per dose) with fluoxetine. Monitor for depression, sedation and QT-related symptoms, with an ECG when risk factors exist.
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.
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