Drug interactions
Flecainide + Fluvoxamine
Severity: Moderate
Flecainide and Fluvoxamine: moderate 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 can raise flecainide exposure and both agents have been associated with conduction or QT effects. Higher flecainide concentrations raise the risk of QRS widening, proarrhythmia and conduction block.
What this interaction means in plain words
Flecainide and Fluvoxamine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Flecainide belongs to Cardiovascular; Fluvoxamine belongs to Central Nervous System.
Why it happens
Fluvoxamine inhibits CYP2D6 (and to a lesser extent other enzymes), reducing flecainide metabolism, with possible additive effects on cardiac conduction.
What to do
Monitor ECG (PR, QRS, QTc) after starting or stopping fluvoxamine and consider checking flecainide plasma levels. Reduce the flecainide dose if conduction intervals lengthen.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Flecainide
- Flecainide + Nirmatrelvir Contraindicated
- Flecainide + Nirmatrelvir / ritonavir Contraindicated
- Flecainide + Pimozide Contraindicated
- Flecainide + Ritonavir Contraindicated
- Flecainide + Thioridazine Contraindicated
- Flecainide + Tipranavir 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 Flecainide with Fluvoxamine?
MediHelp rates the interaction as moderate. Flecainide and Fluvoxamine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Fluvoxamine can raise flecainide exposure and both agents have been associated with conduction or QT effects. Higher flecainide concentrations raise the risk of QRS widening, proarrhythmia and conduction block.
How serious is the interaction between Flecainide and Fluvoxamine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor ECG (PR, QRS, QTc) after starting or stopping fluvoxamine and consider checking flecainide plasma levels. Reduce the flecainide dose if conduction intervals lengthen.
What other medicines interact with Flecainide?
MediHelp also lists interactions of Flecainide with, for example, Nirmatrelvir, Nirmatrelvir / ritonavir, Pimozide. The full list is on the Flecainide page.
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