Drug interactions
Fluvoxamine + Lofepramine
Severity: Major
Fluvoxamine and Lofepramine: 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
Fluvoxamine can inhibit the metabolism of tricyclic antidepressants, raising lofepramine and desipramine levels and increasing anticholinergic, cardiac and seizure risk. Combined serotonergic effects also raise the risk of serotonin syndrome.
What this interaction means in plain words
Fluvoxamine and Lofepramine 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.
Why it happens
Fluvoxamine inhibits CYP enzymes (notably CYP1A2, CYP2C19 and CYP2D6 to a lesser degree) that metabolize tricyclics, plus additive serotonergic effects.
What to do
Avoid if possible; if combined, use reduced lofepramine doses, monitor ECG and for serotonin toxicity, and consider tricyclic levels where available.
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
Frequently asked questions
Can I take Fluvoxamine with Lofepramine?
MediHelp rates the interaction as major. Fluvoxamine and Lofepramine 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 can inhibit the metabolism of tricyclic antidepressants, raising lofepramine and desipramine levels and increasing anticholinergic, cardiac and seizure risk. Combined serotonergic effects also raise the risk of serotonin syndrome.
How serious is the interaction between Fluvoxamine and Lofepramine?
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 if possible; if combined, use reduced lofepramine doses, monitor ECG and for serotonin toxicity, and consider tricyclic levels where available.
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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