Drug interactions
Fluoxetine + Pitolisant
Severity: Major
Fluoxetine and Pitolisant: major interaction.
Last updated Sources: UK SmPC
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
Pitolisant can prolong the QT interval, and fluoxetine may add to this. Fluoxetine inhibits CYP2D6, a main route of pitolisant clearance, which increases pitolisant exposure and the QT risk.
What this interaction means in plain words
Fluoxetine and Pitolisant 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; Pitolisant belongs to Central Nervous System.
Why it happens
CYP2D6 inhibition by fluoxetine raising pitolisant levels, plus additive QT prolongation.
What to do
Halve the pitolisant dose when giving it with a strong CYP2D6 inhibitor and monitor the ECG. Avoid in patients with other QT risk factors.
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 Pitolisant
- Alfuzosin + Pitolisant Major
- Amiodarone + Pitolisant Major
- Amisulpride + Pitolisant Major
- Anagrelide + Pitolisant Major
- Asenapine + Pitolisant Major
- Bupropion + Pitolisant Major
Frequently asked questions
Can I take Fluoxetine with Pitolisant?
MediHelp rates the interaction as major. Fluoxetine and Pitolisant 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. Pitolisant can prolong the QT interval, and fluoxetine may add to this. Fluoxetine inhibits CYP2D6, a main route of pitolisant clearance, which increases pitolisant exposure and the QT risk.
How serious is the interaction between Fluoxetine and Pitolisant?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Halve the pitolisant dose when giving it with a strong CYP2D6 inhibitor and monitor the ECG. Avoid in patients with other QT risk factors.
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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