Drug interactions
Fluoxetine + Ozanimod
Severity: Major
Fluoxetine and Ozanimod: major interaction.
Last updated Sources: Health Canada product monograph
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
Ozanimod's active metabolites inhibit MAO-B in vitro, so combining it with a serotonergic antidepressant raises concern for serotonin syndrome or hypertensive reactions. Clinical data are limited and the MAO-B inhibition appears weak.
What this interaction means in plain words
Fluoxetine and Ozanimod 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; Ozanimod belongs to Central Nervous System.
Why it happens
Possible MAO-B inhibition by ozanimod metabolites adding to serotonin reuptake inhibition.
What to do
Avoid the combination where an alternative is feasible. If it is used, monitor blood pressure, heart rate, and for serotonin toxicity, especially after starting or increasing doses.
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
Other interactions of Ozanimod
- Isocarboxazid + Ozanimod Contraindicated
- Linezolid + Ozanimod Contraindicated
- Ozanimod + Phenelzine Contraindicated
- Ozanimod + Procarbazine Contraindicated
- Ozanimod + Rasagiline Contraindicated
- Ozanimod + Safinamide Contraindicated
Frequently asked questions
Can I take Fluoxetine with Ozanimod?
MediHelp rates the interaction as major. Fluoxetine and Ozanimod 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. Ozanimod's active metabolites inhibit MAO-B in vitro, so combining it with a serotonergic antidepressant raises concern for serotonin syndrome or hypertensive reactions. Clinical data are limited and the MAO-B inhibition appears weak.
How serious is the interaction between Fluoxetine and Ozanimod?
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 an alternative is feasible. If it is used, monitor blood pressure, heart rate, and for serotonin toxicity, especially after starting or increasing doses.
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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