Drug interactions
Fluoxetine + Meperidine
Severity: Major
Fluoxetine and Meperidine: 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 is a strong serotonin reuptake inhibitor, and with meperidine it can cause serotonin syndrome, including severe cases. Fluoxetine's long half-life means the risk persists for weeks after stopping it.
What this interaction means in plain words
Fluoxetine and Meperidine 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 belongs to Central Nervous System; Meperidine belongs to Musculoskeletal.
Why it happens
Additive serotonergic effects, with fluoxetine also inhibiting CYP2D6 and CYP3A4 pathways.
What to do
Avoid meperidine in patients taking fluoxetine or who stopped it recently, and use a non-serotonergic opioid. If exposure occurs, monitor for serotonin toxicity.
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 Fluoxetine and Meperidine, 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 7 days on the web. No card needed.
References
Other interactions of Meperidine
- Alvimopan + Meperidine Contraindicated
- Isocarboxazid + Meperidine Contraindicated
- Meperidine + Methylene blue Contraindicated
- Meperidine + Olanzapine / samidorphan Contraindicated
- Meperidine + Phenelzine Contraindicated
- Meperidine + Procarbazine Contraindicated
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 Meperidine?
MediHelp rates the interaction as major. Fluoxetine and Meperidine 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 is a strong serotonin reuptake inhibitor, and with meperidine it can cause serotonin syndrome, including severe cases. Fluoxetine's long half-life means the risk persists for weeks after stopping it.
How serious is the interaction between Fluoxetine and Meperidine?
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 meperidine in patients taking fluoxetine or who stopped it recently, and use a non-serotonergic opioid. If exposure occurs, monitor for serotonin toxicity.
What other medicines interact with Meperidine?
MediHelp also lists interactions of Meperidine with, for example, Alvimopan, Isocarboxazid, Methylene blue. The full list is on the Meperidine 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.
