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Drug interactions

Fluoxetine + Rasagiline

Severity: Contraindicated

Fluoxetine and Rasagiline: 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

Combining an SSRI with a monoamine oxidase B inhibitor can cause serotonin syndrome, with severe hyperthermia, rigidity and autonomic instability reported with antidepressants and rasagiline. Fluoxetine's very long-acting metabolite prolongs the risk after it is stopped.

What this interaction means in plain words

Fluoxetine and Rasagiline 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; Rasagiline belongs to Central Nervous System.

Evidence level: High

Why it happens

Reduced serotonin breakdown from MAO inhibition combined with serotonin reuptake inhibition produces excess serotonergic activity.

What to do

Do not co-administer; rasagiline labeling advises waiting about five weeks after stopping fluoxetine before starting rasagiline, and at least 14 days after stopping rasagiline before starting fluoxetine. Treat suspected serotonin syndrome by stopping both drugs and giving supportive care.

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 Rasagiline?

MediHelp rates the interaction as contraindicated. Fluoxetine and Rasagiline 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. Combining an SSRI with a monoamine oxidase B inhibitor can cause serotonin syndrome, with severe hyperthermia, rigidity and autonomic instability reported with antidepressants and rasagiline. Fluoxetine's very long-acting metabolite prolongs the risk after it is stopped.

How serious is the interaction between Fluoxetine and Rasagiline?

MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not co-administer; rasagiline labeling advises waiting about five weeks after stopping fluoxetine before starting rasagiline, and at least 14 days after stopping rasagiline before starting fluoxetine. Treat suspected serotonin syndrome by stopping both drugs and giving supportive care.

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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