Drug interactions
Fluvoxamine + Pirfenidone
Severity: Major
Fluvoxamine and Pirfenidone: major 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
Pirfenidone is metabolized mainly by CYP1A2, and fluvoxamine, a strong CYP1A2 inhibitor, substantially increases pirfenidone exposure. This raises the risk of nausea, rash, photosensitivity and hepatic toxicity.
What this interaction means in plain words
Fluvoxamine and Pirfenidone 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; Pirfenidone belongs to Miscellaneous.
Why it happens
Strong CYP1A2 inhibition by fluvoxamine decreases pirfenidone clearance.
What to do
Stop fluvoxamine before starting pirfenidone, or avoid the combination. If it cannot be avoided, reduce the pirfenidone dose and monitor liver function and tolerability.
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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Other interactions of Fluvoxamine
- Agomelatine + Fluvoxamine Contraindicated
- Alosetron + Fluvoxamine Contraindicated
- Fezolinetant + Fluvoxamine Contraindicated
- Fluvoxamine + Isocarboxazid Contraindicated
- Fluvoxamine + Mavacamten Contraindicated
- Fluvoxamine + Methylene blue Contraindicated
Other interactions of Pirfenidone
Frequently asked questions
Can I take Fluvoxamine with Pirfenidone?
MediHelp rates the interaction as major. Fluvoxamine and Pirfenidone 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. Pirfenidone is metabolized mainly by CYP1A2, and fluvoxamine, a strong CYP1A2 inhibitor, substantially increases pirfenidone exposure. This raises the risk of nausea, rash, photosensitivity and hepatic toxicity.
How serious is the interaction between Fluvoxamine and Pirfenidone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Stop fluvoxamine before starting pirfenidone, or avoid the combination. If it cannot be avoided, reduce the pirfenidone dose and monitor liver function and tolerability.
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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