Drug interactions
Fluvoxamine + Iloperidone
Severity: Major
Fluvoxamine and Iloperidone: 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
Iloperidone prolongs the QT interval and is metabolized by CYP2D6 and CYP3A4, both of which fluvoxamine can inhibit. Higher iloperidone exposure and additive QT effects raise the risk of arrhythmia.
What this interaction means in plain words
Fluvoxamine and Iloperidone 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.
Fluvoxamine belongs to Central Nervous System; Iloperidone belongs to Central Nervous System.
Why it happens
Additive QTc prolongation plus fluvoxamine inhibition of CYP2D6/CYP3A4 metabolism of iloperidone.
What to do
Reduce the iloperidone dose as per labeling when a CYP2D6 inhibitor is given, and obtain an ECG with electrolyte monitoring. Consider an alternative antidepressant if the QTc lengthens.
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 Fluvoxamine
- Agomelatine + Fluvoxamine Contraindicated
- Alosetron + Fluvoxamine Contraindicated
- Fezolinetant + Fluvoxamine Contraindicated
- Fluvoxamine + Isocarboxazid Contraindicated
- Fluvoxamine + Mavacamten Contraindicated
- Fluvoxamine + Methylene blue Contraindicated
Other interactions of Iloperidone
- Iloperidone + Thioridazine Contraindicated
- Alfuzosin + Iloperidone Major
- Amiodarone + Iloperidone Major
- Amisulpride + Iloperidone Major
- Amitriptyline + Iloperidone Major
- Anagrelide + Iloperidone Major
Frequently asked questions
Can I take Fluvoxamine with Iloperidone?
MediHelp rates the interaction as major. Fluvoxamine and Iloperidone 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. Iloperidone prolongs the QT interval and is metabolized by CYP2D6 and CYP3A4, both of which fluvoxamine can inhibit. Higher iloperidone exposure and additive QT effects raise the risk of arrhythmia.
How serious is the interaction between Fluvoxamine and Iloperidone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reduce the iloperidone dose as per labeling when a CYP2D6 inhibitor is given, and obtain an ECG with electrolyte monitoring. Consider an alternative antidepressant if the QTc lengthens.
What other medicines interact with Fluvoxamine?
MediHelp also lists interactions of Fluvoxamine with, for example, Agomelatine, Alosetron, Fezolinetant. The full list is on the Fluvoxamine page.
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