Drug interactions
Fluoxetine + Safinamide
Severity: Major
Fluoxetine and Safinamide: major interaction.
Last updated Sources: US FDA label
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
Safinamide is a reversible MAO-B inhibitor, and combining it with an SSRI may lead to serotonin syndrome. Its labeling advises caution, and the risk is considered lower than with non-selective MAO inhibitors.
What this interaction means in plain words
Fluoxetine and Safinamide 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; Safinamide belongs to Central Nervous System.
Why it happens
Additive serotonergic effects from SSRI reuptake inhibition and MAO inhibition.
What to do
Avoid the combination if possible. If used, start safinamide at the lowest dose and monitor for agitation, tremor, hyperthermia and autonomic instability.
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 Safinamide
- Amitriptyline + Safinamide Contraindicated
- Amoxapine + Safinamide Contraindicated
- Amphetamine polistirex + Safinamide Contraindicated
- Clomipramine + Safinamide Contraindicated
- Cyclobenzaprine + Safinamide Contraindicated
- Desipramine + Safinamide Contraindicated
Frequently asked questions
Can I take Fluoxetine with Safinamide?
MediHelp rates the interaction as major. Fluoxetine and Safinamide 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. Safinamide is a reversible MAO-B inhibitor, and combining it with an SSRI may lead to serotonin syndrome. Its labeling advises caution, and the risk is considered lower than with non-selective MAO inhibitors.
How serious is the interaction between Fluoxetine and Safinamide?
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 if possible. If used, start safinamide at the lowest dose and monitor for agitation, tremor, hyperthermia and autonomic instability.
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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