Drug interactions
Dosulepin + Fluvoxamine
Severity: Major
Dosulepin 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
Fluvoxamine inhibits several CYP enzymes and can raise tricyclic antidepressant concentrations, increasing anticholinergic effects, sedation and cardiac toxicity. The combination also carries serotonin syndrome risk and potential seizure threshold lowering.
What this interaction means in plain words
Dosulepin 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.
Dosulepin belongs to Central Nervous System; Fluvoxamine belongs to Central Nervous System.
Why it happens
Additive serotonergic effects and fluvoxamine inhibition of CYP-mediated tricyclic metabolism.
What to do
Avoid if possible; if used, start dosulepin at a low dose, monitor ECG and tricyclic levels, and watch for serotonin toxicity.
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 Dosulepin
- Dosulepin + Isocarboxazid Contraindicated
- Dosulepin + Phenelzine Contraindicated
- Dosulepin + Thioridazine Contraindicated
- Dosulepin + Tranylcypromine Contraindicated
- Amitriptyline + Dosulepin Major
- Buprenorphine + Dosulepin Major
Frequently asked questions
Can I take Dosulepin with Fluvoxamine?
MediHelp rates the interaction as major. Dosulepin 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 inhibits several CYP enzymes and can raise tricyclic antidepressant concentrations, increasing anticholinergic effects, sedation and cardiac toxicity. The combination also carries serotonin syndrome risk and potential seizure threshold lowering.
How serious is the interaction between Dosulepin 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 if possible; if used, start dosulepin at a low dose, monitor ECG and tricyclic levels, and watch for serotonin toxicity.
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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