Drug interactions
Fluvoxamine + Netupitant / palonosetron
Severity: Moderate
Fluvoxamine and Netupitant / palonosetron: 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
Palonosetron, a 5-HT3 antagonist, has been linked to rare serotonin syndrome reports when used with serotonergic drugs. Netupitant is also a moderate CYP3A4 inhibitor, and fluvoxamine may modestly increase netupitant exposure.
What this interaction means in plain words
Fluvoxamine and Netupitant / palonosetron 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.
Why it happens
Possible additive serotonergic effects, plus minor CYP3A4 inhibition by fluvoxamine.
What to do
Monitor for agitation, tremor, diarrhea, hyperthermia and clonus after a dose; treat as serotonin syndrome if these occur.
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 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 Netupitant / palonosetron?
MediHelp rates the interaction as moderate. Fluvoxamine and Netupitant / palonosetron 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. Palonosetron, a 5-HT3 antagonist, has been linked to rare serotonin syndrome reports when used with serotonergic drugs. Netupitant is also a moderate CYP3A4 inhibitor, and fluvoxamine may modestly increase netupitant exposure.
How serious is the interaction between Fluvoxamine and Netupitant / palonosetron?
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, diarrhea, hyperthermia and clonus after a dose; treat as serotonin syndrome if these occur.
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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