Drug interactions
Fluoxetine + Sufentanil sl
Severity: Major
Fluoxetine and Sufentanil sl: 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
Both drugs increase serotonergic activity, so co-administration may cause serotonin syndrome with agitation, hyperthermia, clonus and autonomic instability. Fluoxetine's CYP3A4 and CYP2D6 effects may also modestly alter opioid exposure and add to sedation.
What this interaction means in plain words
Fluoxetine and Sufentanil sl 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.
Why it happens
Additive serotonergic effects from SSRI reuptake inhibition and opioid serotonergic activity.
What to do
If co-use is needed, start with the lowest sufentanil dose and observe closely for serotonin toxicity, especially at initiation and dose changes. Stop the opioid or reassess therapy if symptoms occur.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Fluoxetine and Sufentanil sl, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
References
Other interactions of Fluoxetine
- Fluoxetine + Isocarboxazid Contraindicated
- Fluoxetine + Mavacamten Contraindicated
- Fluoxetine + Methylene blue Contraindicated
- Fluoxetine + Phenelzine Contraindicated
- Fluoxetine + Pimozide Contraindicated
- Fluoxetine + Rasagiline Contraindicated
Frequently asked questions
Can I take Fluoxetine with Sufentanil sl?
MediHelp rates the interaction as major. Fluoxetine and Sufentanil sl 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. Both drugs increase serotonergic activity, so co-administration may cause serotonin syndrome with agitation, hyperthermia, clonus and autonomic instability. Fluoxetine's CYP3A4 and CYP2D6 effects may also modestly alter opioid exposure and add to sedation.
How serious is the interaction between Fluoxetine and Sufentanil sl?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: If co-use is needed, start with the lowest sufentanil dose and observe closely for serotonin toxicity, especially at initiation and dose changes. Stop the opioid or reassess therapy if symptoms occur.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
