Drug interactions
Fluoxetine + Nebivolol
Severity: Moderate
Fluoxetine and Nebivolol: 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
Fluoxetine strongly inhibits CYP2D6, the main enzyme clearing nebivolol, and can substantially increase nebivolol exposure. This can cause excessive bradycardia and hypotension.
What this interaction means in plain words
Fluoxetine and Nebivolol 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.
Fluoxetine belongs to Central Nervous System; Nebivolol belongs to Cardiovascular.
Why it happens
Fluoxetine inhibits CYP2D6, reducing nebivolol metabolism and increasing plasma concentrations of the active drug.
What to do
Monitor heart rate and blood pressure when fluoxetine is started or stopped, and lower the nebivolol dose if bradycardia or hypotension occurs. Consider an alternative antidepressant with weaker CYP2D6 inhibition.
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 Nebivolol
- Acebutolol + Nebivolol Major
- Aldesleukin + Nebivolol Major
- Amiodarone + Nebivolol Major
- Atenolol-chlorthalidone + Nebivolol Major
- Atenolol + Nebivolol Major
- Betaxolol + Nebivolol Major
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 Nebivolol?
MediHelp rates the interaction as moderate. Fluoxetine and Nebivolol 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. Fluoxetine strongly inhibits CYP2D6, the main enzyme clearing nebivolol, and can substantially increase nebivolol exposure. This can cause excessive bradycardia and hypotension.
How serious is the interaction between Fluoxetine and Nebivolol?
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 heart rate and blood pressure when fluoxetine is started or stopped, and lower the nebivolol dose if bradycardia or hypotension occurs. Consider an alternative antidepressant with weaker CYP2D6 inhibition.
What other medicines interact with Nebivolol?
MediHelp also lists interactions of Nebivolol with, for example, Acebutolol, Aldesleukin, Amiodarone. The full list is on the Nebivolol page.
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