Drug interactions
Fluvoxamine + Parecoxib
Severity: Moderate
Fluvoxamine and Parecoxib: 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
SSRIs impair platelet serotonin uptake and, combined with NSAIDs, raise the risk of gastrointestinal and other bleeding. Parecoxib is a COX-2 selective agent with less platelet effect, but the mucosal and bleeding risk with an SSRI is still increased. Fluvoxamine's CYP2C9 inhibition may also raise valdecoxib (active metabolite) exposure.
What this interaction means in plain words
Fluvoxamine and Parecoxib 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
Additive impairment of hemostasis via SSRI platelet serotonin depletion and NSAID effects on gastric mucosa, plus possible CYP2C9 inhibition.
What to do
Use the lowest effective parecoxib dose for the shortest time and monitor for GI bleeding; consider gastroprotection in high-risk patients.
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 Parecoxib?
MediHelp rates the interaction as moderate. Fluvoxamine and Parecoxib 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. SSRIs impair platelet serotonin uptake and, combined with NSAIDs, raise the risk of gastrointestinal and other bleeding. Parecoxib is a COX-2 selective agent with less platelet effect, but the mucosal and bleeding risk with an SSRI is still increased. Fluvoxamine's CYP2C9 inhibition may also raise valdecoxib (active metabolite) exposure.
How serious is the interaction between Fluvoxamine and Parecoxib?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use the lowest effective parecoxib dose for the shortest time and monitor for GI bleeding; consider gastroprotection in high-risk patients.
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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