Drug interactions
Fluvoxamine + Hydromorphone
Severity: Moderate
Fluvoxamine and Hydromorphone: 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
Serotonin syndrome is a theoretical concern with serotonergic antidepressants and opioids, though hydromorphone has minimal serotonergic activity. Additive sedation may also occur.
What this interaction means in plain words
Fluvoxamine and Hydromorphone 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.
Fluvoxamine belongs to Central Nervous System; Hydromorphone belongs to Musculoskeletal.
Why it happens
Possible additive serotonergic effect; hydromorphone has little direct serotonergic action so this is largely theoretical.
What to do
Monitor for agitation, tremor, hyperthermia and clonus after starting or adjusting doses. Discontinue the agents and give supportive care if serotonin syndrome develops.
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 Hydromorphone
- Alvimopan + Hydromorphone Contraindicated
- Bupropion-naltrexone + Hydromorphone Contraindicated
- Hydromorphone + Isocarboxazid Contraindicated
- Hydromorphone + Olanzapine / samidorphan Contraindicated
- Hydromorphone + Phenelzine Contraindicated
- Hydromorphone + Tranylcypromine Contraindicated
Other interactions of Fluvoxamine
- Agomelatine + Fluvoxamine Contraindicated
- Alosetron + Fluvoxamine Contraindicated
- Fezolinetant + Fluvoxamine Contraindicated
- Fluvoxamine + Isocarboxazid Contraindicated
- Fluvoxamine + Mavacamten Contraindicated
- Fluvoxamine + Methylene blue Contraindicated
Frequently asked questions
Can I take Fluvoxamine with Hydromorphone?
MediHelp rates the interaction as moderate. Fluvoxamine and Hydromorphone 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. Serotonin syndrome is a theoretical concern with serotonergic antidepressants and opioids, though hydromorphone has minimal serotonergic activity. Additive sedation may also occur.
How serious is the interaction between Fluvoxamine and Hydromorphone?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for agitation, tremor, hyperthermia and clonus after starting or adjusting doses. Discontinue the agents and give supportive care if serotonin syndrome develops.
What other medicines interact with Hydromorphone?
MediHelp also lists interactions of Hydromorphone with, for example, Alvimopan, Bupropion-naltrexone, Isocarboxazid. The full list is on the Hydromorphone page.
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