Drug interactions
Fluoxetine + Vortioxetine
Severity: Major
Fluoxetine and Vortioxetine: 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 act on the serotonin system, so combined use increases the risk of serotonin syndrome. Fluoxetine strongly inhibits CYP2D6, the main enzyme clearing vortioxetine, which can substantially raise vortioxetine levels and cause nausea and other adverse effects.
What this interaction means in plain words
Fluoxetine and Vortioxetine 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; Vortioxetine belongs to Central Nervous System.
Why it happens
Additive serotonergic effects with fluoxetine inhibition of CYP2D6 metabolism of vortioxetine.
What to do
Avoid the combination where possible; if vortioxetine is used with a strong CYP2D6 inhibitor, consider reducing its dose by about half. Monitor for serotonin toxicity and tolerability.
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 Vortioxetine
- Isocarboxazid + Vortioxetine Contraindicated
- Linezolid + Vortioxetine Contraindicated
- Methylene blue + Vortioxetine Contraindicated
- Phenelzine + Vortioxetine Contraindicated
- Rasagiline + Vortioxetine Contraindicated
- Selegiline transdermal + Vortioxetine Contraindicated
Frequently asked questions
Can I take Fluoxetine with Vortioxetine?
MediHelp rates the interaction as major. Fluoxetine and Vortioxetine 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 act on the serotonin system, so combined use increases the risk of serotonin syndrome. Fluoxetine strongly inhibits CYP2D6, the main enzyme clearing vortioxetine, which can substantially raise vortioxetine levels and cause nausea and other adverse effects.
How serious is the interaction between Fluoxetine and Vortioxetine?
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 where possible; if vortioxetine is used with a strong CYP2D6 inhibitor, consider reducing its dose by about half. Monitor for serotonin toxicity and tolerability.
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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