Drug interactions
Fluoxetine + Lofepramine
Severity: Major
Fluoxetine and Lofepramine: 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
Fluoxetine inhibits CYP2D6 and can raise tricyclic concentrations, and lofepramine is metabolized to desipramine. The combination also increases serotonergic effects and may cause anticholinergic effects, cardiac conduction changes and seizures.
What this interaction means in plain words
Fluoxetine and Lofepramine 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
CYP2D6 inhibition by fluoxetine raising tricyclic levels, plus additive serotonergic effects.
What to do
Avoid the combination where possible. If it is used, give a reduced lofepramine dose, monitor ECG and for serotonin toxicity, and consider tricyclic levels.
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 Fluoxetine
- Fluoxetine + Isocarboxazid Contraindicated
- Fluoxetine + Mavacamten Contraindicated
- Fluoxetine + Methylene blue Contraindicated
- Fluoxetine + Phenelzine Contraindicated
- Fluoxetine + Pimozide Contraindicated
- Fluoxetine + Rasagiline Contraindicated
Frequently asked questions
Can I take Fluoxetine with Lofepramine?
MediHelp rates the interaction as major. Fluoxetine and Lofepramine 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. Fluoxetine inhibits CYP2D6 and can raise tricyclic concentrations, and lofepramine is metabolized to desipramine. The combination also increases serotonergic effects and may cause anticholinergic effects, cardiac conduction changes and seizures.
How serious is the interaction between Fluoxetine and Lofepramine?
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 the combination where possible. If it is used, give a reduced lofepramine dose, monitor ECG and for serotonin toxicity, and consider tricyclic levels.
What other medicines interact with Fluoxetine?
MediHelp also lists interactions of Fluoxetine with, for example, Isocarboxazid, Mavacamten, Methylene blue. The full list is on the Fluoxetine page.
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