Drug interactions
Fluvoxamine + Meperidine
Severity: Major
Fluvoxamine and Meperidine: 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 is a potent serotonin reuptake inhibitor, and combining it with meperidine raises the risk of serotonin syndrome. Fluvoxamine also inhibits CYP1A2, CYP2C19 and CYP3A4, which may alter meperidine metabolism and increase its neurotoxic metabolite or parent levels.
What this interaction means in plain words
Fluvoxamine and Meperidine 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; Meperidine belongs to Musculoskeletal.
Why it happens
Additive serotonergic effects with possible CYP inhibition changing meperidine disposition.
What to do
Use a non-serotonergic opioid instead of meperidine. If combined, monitor for serotonin toxicity, sedation and neuroexcitation.
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 Meperidine
- Alvimopan + Meperidine Contraindicated
- Isocarboxazid + Meperidine Contraindicated
- Meperidine + Methylene blue Contraindicated
- Meperidine + Olanzapine / samidorphan Contraindicated
- Meperidine + Phenelzine Contraindicated
- Meperidine + Procarbazine 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 Meperidine?
MediHelp rates the interaction as major. Fluvoxamine and Meperidine 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 is a potent serotonin reuptake inhibitor, and combining it with meperidine raises the risk of serotonin syndrome. Fluvoxamine also inhibits CYP1A2, CYP2C19 and CYP3A4, which may alter meperidine metabolism and increase its neurotoxic metabolite or parent levels.
How serious is the interaction between Fluvoxamine and Meperidine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use a non-serotonergic opioid instead of meperidine. If combined, monitor for serotonin toxicity, sedation and neuroexcitation.
What other medicines interact with Meperidine?
MediHelp also lists interactions of Meperidine with, for example, Alvimopan, Isocarboxazid, Methylene blue. The full list is on the Meperidine page.
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