Drug interactions
Fluoxetine + Zotepine
Severity: Moderate
Fluoxetine and Zotepine: 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
Fluoxetine inhibits CYP2D6 and CYP3A4 and may increase zotepine concentrations. This raises the risk of sedation, seizures, extrapyramidal effects and QT prolongation.
What this interaction means in plain words
Fluoxetine and Zotepine 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.
Why it happens
Fluoxetine inhibits hepatic CYP-mediated metabolism of zotepine.
What to do
Start with a low zotepine dose and titrate slowly, watching for seizures, sedation and extrapyramidal symptoms. Obtain an ECG if other QT-prolonging risks exist.
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
Frequently asked questions
Can I take Fluoxetine with Zotepine?
MediHelp rates the interaction as moderate. Fluoxetine and Zotepine 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 inhibits CYP2D6 and CYP3A4 and may increase zotepine concentrations. This raises the risk of sedation, seizures, extrapyramidal effects and QT prolongation.
How serious is the interaction between Fluoxetine and Zotepine?
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 low zotepine dose and titrate slowly, watching for seizures, sedation and extrapyramidal symptoms. Obtain an ECG if other QT-prolonging risks exist.
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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