Drug interactions
Fentanyl + Fluvoxamine
Severity: Major
Fentanyl and Fluvoxamine: major 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
Fluvoxamine increases serotonergic load alongside fentanyl, creating a risk of serotonin syndrome. Fluvoxamine also inhibits CYP3A4 to a degree and may raise fentanyl levels, adding to opioid toxicity.
What this interaction means in plain words
Fentanyl 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.
Fentanyl belongs to Musculoskeletal; Fluvoxamine belongs to Central Nervous System.
Why it happens
Additive serotonergic effects together with fluvoxamine inhibition of CYP3A4-mediated fentanyl metabolism.
What to do
Monitor for serotonin syndrome and for excessive sedation or respiratory depression. Reduce the fentanyl dose if needed or choose a different antidepressant.
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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Other interactions of Fentanyl
- Alvimopan + Fentanyl Contraindicated
- Fentanyl + Isocarboxazid Contraindicated
- Fentanyl + Olanzapine / samidorphan Contraindicated
- Fentanyl + Phenelzine Contraindicated
- Fentanyl + Tranylcypromine Contraindicated
- Alfentanil + Fentanyl Major
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 Fentanyl with Fluvoxamine?
MediHelp rates the interaction as major. Fentanyl 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 increases serotonergic load alongside fentanyl, creating a risk of serotonin syndrome. Fluvoxamine also inhibits CYP3A4 to a degree and may raise fentanyl levels, adding to opioid toxicity.
How serious is the interaction between Fentanyl 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: Monitor for serotonin syndrome and for excessive sedation or respiratory depression. Reduce the fentanyl dose if needed or choose a different antidepressant.
What other medicines interact with Fentanyl?
MediHelp also lists interactions of Fentanyl with, for example, Alvimopan, Isocarboxazid, Olanzapine / samidorphan. The full list is on the Fentanyl page.
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