Drug interactions
Fluvoxamine + Oxycodone
Severity: Major
Fluvoxamine and Oxycodone: 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 strongly inhibits CYP1A2 and CYP2C19 and moderately inhibits CYP3A4, which may raise oxycodone levels and increase opioid effects. Both drugs have serotonergic activity, so serotonin syndrome is also a concern.
What this interaction means in plain words
Fluvoxamine and Oxycodone 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; Oxycodone belongs to Musculoskeletal.
Why it happens
CYP3A4 inhibition by fluvoxamine reduces oxycodone clearance, plus additive serotonergic effects.
What to do
Monitor for sedation, respiratory depression and serotonin toxicity, and lower the oxycodone dose if needed. Consider an alternative antidepressant if effects are problematic.
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 Oxycodone
- Alvimopan + Oxycodone Contraindicated
- Calcium / magnesium / potassium / sodium oxybates + Oxycodone Contraindicated
- Isocarboxazid + Oxycodone Contraindicated
- Olanzapine / samidorphan + Oxycodone Contraindicated
- Oxycodone + Phenelzine Contraindicated
- Oxycodone + Sodium oxybate 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 Oxycodone?
MediHelp rates the interaction as major. Fluvoxamine and Oxycodone 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 strongly inhibits CYP1A2 and CYP2C19 and moderately inhibits CYP3A4, which may raise oxycodone levels and increase opioid effects. Both drugs have serotonergic activity, so serotonin syndrome is also a concern.
How serious is the interaction between Fluvoxamine and Oxycodone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for sedation, respiratory depression and serotonin toxicity, and lower the oxycodone dose if needed. Consider an alternative antidepressant if effects are problematic.
What other medicines interact with Oxycodone?
MediHelp also lists interactions of Oxycodone with, for example, Alvimopan, Calcium / magnesium / potassium / sodium oxybates, Isocarboxazid. The full list is on the Oxycodone page.
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