Drug interactions
Fentanyl transmucosal + Fluvoxamine
Severity: Major
Fentanyl transmucosal 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 combined with fentanyl can cause serotonin syndrome. Fluvoxamine also inhibits CYP3A4 to some degree, which can raise fentanyl levels and increase respiratory depression and sedation.
What this interaction means in plain words
Fentanyl transmucosal 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.
Why it happens
Additive serotonergic activity plus CYP3A4 inhibition by fluvoxamine that reduces fentanyl clearance.
What to do
Avoid if possible or use the lowest fentanyl dose with close monitoring for serotonin toxicity and respiratory depression. Consider an alternative analgesic or 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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Fentanyl transmucosal and Fluvoxamine, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 14 days on the web. No card needed.
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 transmucosal with Fluvoxamine?
MediHelp rates the interaction as major. Fentanyl transmucosal 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 combined with fentanyl can cause serotonin syndrome. Fluvoxamine also inhibits CYP3A4 to some degree, which can raise fentanyl levels and increase respiratory depression and sedation.
How serious is the interaction between Fentanyl transmucosal 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 or use the lowest fentanyl dose with close monitoring for serotonin toxicity and respiratory depression. Consider an alternative analgesic or antidepressant.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
