Drug interactions
Fluoxetine + Vilazodone
Severity: Major
Fluoxetine and Vilazodone: 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
Vilazodone is an SSRI and 5-HT1A partial agonist, so adding fluoxetine increases the risk of serotonin syndrome. Fluoxetine also inhibits CYP3A4 and CYP2C19 to a degree, which may modestly increase vilazodone exposure.
What this interaction means in plain words
Fluoxetine and Vilazodone 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; Vilazodone belongs to Central Nervous System.
Why it happens
Additive serotonergic activity with possible fluoxetine inhibition of vilazodone metabolism.
What to do
Avoid concomitant use; when switching, taper one agent and allow for fluoxetine's long half-life. Stop both and give supportive care if serotonin syndrome occurs.
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 Vilazodone
- Isocarboxazid + Vilazodone Contraindicated
- Methylene blue + Vilazodone Contraindicated
- Phenelzine + Vilazodone Contraindicated
- Rasagiline + Vilazodone Contraindicated
- Selegiline transdermal + Vilazodone Contraindicated
- Selegiline + Vilazodone Contraindicated
Frequently asked questions
Can I take Fluoxetine with Vilazodone?
MediHelp rates the interaction as major. Fluoxetine and Vilazodone 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. Vilazodone is an SSRI and 5-HT1A partial agonist, so adding fluoxetine increases the risk of serotonin syndrome. Fluoxetine also inhibits CYP3A4 and CYP2C19 to a degree, which may modestly increase vilazodone exposure.
How serious is the interaction between Fluoxetine and Vilazodone?
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 concomitant use; when switching, taper one agent and allow for fluoxetine's long half-life. Stop both and give supportive care if serotonin syndrome occurs.
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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