Drug interactions
Fluvoxamine + Paroxetine
Severity: Major
Fluvoxamine and Paroxetine: 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
Combining two SSRIs duplicates serotonergic action and increases the risk of serotonin syndrome. Fluvoxamine also inhibits several CYP enzymes, which may alter exposure to other drugs.
What this interaction means in plain words
Fluvoxamine and Paroxetine 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; Paroxetine belongs to Central Nervous System.
Why it happens
Additive serotonin reuptake inhibition.
What to do
Avoid using both; choose one SSRI and cross-taper when switching. Monitor for serotonin toxicity if overlap occurs.
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 Paroxetine
- Isocarboxazid + Paroxetine Contraindicated
- Methylene blue + Paroxetine Contraindicated
- Paroxetine + Phenelzine Contraindicated
- Paroxetine + Pimozide Contraindicated
- Paroxetine + Procarbazine Contraindicated
- Paroxetine + Selegiline 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 Paroxetine?
MediHelp rates the interaction as major. Fluvoxamine and Paroxetine 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. Combining two SSRIs duplicates serotonergic action and increases the risk of serotonin syndrome. Fluvoxamine also inhibits several CYP enzymes, which may alter exposure to other drugs.
How serious is the interaction between Fluvoxamine and Paroxetine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid using both; choose one SSRI and cross-taper when switching. Monitor for serotonin toxicity if overlap occurs.
What other medicines interact with Paroxetine?
MediHelp also lists interactions of Paroxetine with, for example, Isocarboxazid, Methylene blue, Phenelzine. The full list is on the Paroxetine page.
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