Drug interactions
Fluvoxamine + Procainamide
Severity: Major
Fluvoxamine and Procainamide: 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
Procainamide prolongs QRS and QT and can cause torsades de pointes. Fluvoxamine adds minor QT risk and may inhibit CYP2D6-mediated metabolism of procainamide to a small extent.
What this interaction means in plain words
Fluvoxamine and Procainamide 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.
Why it happens
Additive effects on cardiac repolarization, with possible modest metabolic inhibition.
What to do
Monitor ECG and procainamide/NAPA levels and correct electrolytes; consider alternatives if QTc lengthens.
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
Frequently asked questions
Can I take Fluvoxamine with Procainamide?
MediHelp rates the interaction as major. Fluvoxamine and Procainamide 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. Procainamide prolongs QRS and QT and can cause torsades de pointes. Fluvoxamine adds minor QT risk and may inhibit CYP2D6-mediated metabolism of procainamide to a small extent.
How serious is the interaction between Fluvoxamine and Procainamide?
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 ECG and procainamide/NAPA levels and correct electrolytes; consider alternatives if QTc lengthens.
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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