Drug interactions
Fluvoxamine + Lomitapide
Severity: Major
Fluvoxamine and Lomitapide: 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
Lomitapide is highly dependent on CYP3A4 for clearance, and moderate inhibitors increase exposure significantly. This raises the risk of hepatotoxicity and gastrointestinal adverse effects.
What this interaction means in plain words
Fluvoxamine and Lomitapide 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; Lomitapide belongs to Cardiovascular.
Why it happens
Inhibition of CYP3A4 metabolism of lomitapide by fluvoxamine.
What to do
Limit the lomitapide dose as specified in labeling when used with weak or moderate CYP3A4 inhibitors, and monitor liver enzymes. Consider an alternative antidepressant.
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 Lomitapide
- Aprepitant + Lomitapide Contraindicated
- Clarithromycin + Lomitapide Contraindicated
- Crizotinib + Lomitapide Contraindicated
- Diltiazem + Lomitapide Contraindicated
- Efavirenz + Lomitapide Contraindicated
- Ensitrelvir + Lomitapide Contraindicated
Frequently asked questions
Can I take Fluvoxamine with Lomitapide?
MediHelp rates the interaction as major. Fluvoxamine and Lomitapide 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. Lomitapide is highly dependent on CYP3A4 for clearance, and moderate inhibitors increase exposure significantly. This raises the risk of hepatotoxicity and gastrointestinal adverse effects.
How serious is the interaction between Fluvoxamine and Lomitapide?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Limit the lomitapide dose as specified in labeling when used with weak or moderate CYP3A4 inhibitors, and monitor liver enzymes. Consider an alternative antidepressant.
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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