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Drug interactions

Fluoxetine + Mavacamten

Severity: Contraindicated

Fluoxetine and Mavacamten: contraindicated 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

Mavacamten is cleared largely by CYP2C19 with a contribution from CYP3A4, and fluoxetine inhibits both CYP2C19 and CYP2D6. Higher mavacamten exposure can reduce ejection fraction and precipitate heart failure from systolic dysfunction.

What this interaction means in plain words

Fluoxetine and Mavacamten are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.

Fluoxetine belongs to Central Nervous System; Mavacamten belongs to Cardiovascular.

Evidence level: High

Why it happens

Fluoxetine inhibition of CYP2C19 (and CYP3A4 to a lesser degree) decreases mavacamten clearance.

What to do

Avoid the combination; if an antidepressant is needed, choose one without significant CYP2C19 inhibition. If fluoxetine is started or stopped, monitor LVEF and mavacamten dosing closely per labeling.

What to ask your pharmacist

  • Is there an alternative to one of these two medicines for me?
  • If both are essential, who is monitoring me and how often?
  • Which symptoms mean I should stop and seek help straight away?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Fluoxetine with Mavacamten?

MediHelp rates the interaction as contraindicated. Fluoxetine and Mavacamten are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Mavacamten is cleared largely by CYP2C19 with a contribution from CYP3A4, and fluoxetine inhibits both CYP2C19 and CYP2D6. Higher mavacamten exposure can reduce ejection fraction and precipitate heart failure from systolic dysfunction.

How serious is the interaction between Fluoxetine and Mavacamten?

MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination; if an antidepressant is needed, choose one without significant CYP2C19 inhibition. If fluoxetine is started or stopped, monitor LVEF and mavacamten dosing closely per labeling.

What other medicines interact with Fluoxetine?

MediHelp also lists interactions of Fluoxetine with, for example, Isocarboxazid, Methylene blue, Phenelzine. The full list is on the Fluoxetine page.

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