Drug interactions
Dextromethorphan + Fluvoxamine
Severity: Major
Dextromethorphan 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
Both drugs increase serotonergic activity, and fluvoxamine may also modestly raise dextromethorphan levels. Serotonin syndrome is possible.
What this interaction means in plain words
Dextromethorphan 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.
Dextromethorphan belongs to Respiratory; Fluvoxamine belongs to Central Nervous System.
Why it happens
Additive serotonergic effects and some inhibition of dextromethorphan metabolism by fluvoxamine.
What to do
Avoid dextromethorphan-containing products and choose an alternative antitussive. If used, monitor for serotonin toxicity symptoms.
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 Dextromethorphan
- Dextromethorphan + Isocarboxazid Contraindicated
- Dextromethorphan + Linezolid Contraindicated
- Dextromethorphan + Phenelzine Contraindicated
- Dextromethorphan + Rasagiline Contraindicated
- Dextromethorphan + Safinamide Contraindicated
- Dextromethorphan + Selegiline Contraindicated
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 Dextromethorphan with Fluvoxamine?
MediHelp rates the interaction as major. Dextromethorphan 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. Both drugs increase serotonergic activity, and fluvoxamine may also modestly raise dextromethorphan levels. Serotonin syndrome is possible.
How serious is the interaction between Dextromethorphan 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 dextromethorphan-containing products and choose an alternative antitussive. If used, monitor for serotonin toxicity symptoms.
What other medicines interact with Dextromethorphan?
MediHelp also lists interactions of Dextromethorphan with, for example, Isocarboxazid, Linezolid, Phenelzine. The full list is on the Dextromethorphan page.
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