Drug interactions
Fluoxetine + Risperidone
Severity: Moderate
Fluoxetine and Risperidone: 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
Risperidone is converted by CYP2D6 to the active metabolite paliperidone, and fluoxetine inhibits this enzyme, raising the concentration of the parent drug. This can increase extrapyramidal symptoms, prolactin elevation and sedation.
What this interaction means in plain words
Fluoxetine and Risperidone 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; Risperidone belongs to Central Nervous System.
Why it happens
Fluoxetine inhibition of CYP2D6 reduces risperidone clearance, though the total active moiety rises less than the parent drug.
What to do
Start with a lower risperidone dose and titrate while watching for extrapyramidal symptoms and sedation. Reassess the dose if fluoxetine is started, stopped or changed.
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 Fluoxetine
- Fluoxetine + Isocarboxazid Contraindicated
- Fluoxetine + Mavacamten Contraindicated
- Fluoxetine + Methylene blue Contraindicated
- Fluoxetine + Phenelzine Contraindicated
- Fluoxetine + Pimozide Contraindicated
- Fluoxetine + Rasagiline Contraindicated
Other interactions of Risperidone
- Ibutilide + Risperidone Contraindicated
- Risperidone + Vandetanib Contraindicated
- Adagrasib + Risperidone Major
- Amiodarone + Risperidone Major
- Amisulpride + Risperidone Major
- Amoxapine + Risperidone Major
Frequently asked questions
Can I take Fluoxetine with Risperidone?
MediHelp rates the interaction as moderate. Fluoxetine and Risperidone 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. Risperidone is converted by CYP2D6 to the active metabolite paliperidone, and fluoxetine inhibits this enzyme, raising the concentration of the parent drug. This can increase extrapyramidal symptoms, prolactin elevation and sedation.
How serious is the interaction between Fluoxetine and Risperidone?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Start with a lower risperidone dose and titrate while watching for extrapyramidal symptoms and sedation. Reassess the dose if fluoxetine is started, stopped or changed.
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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