Drug interactions
Fluvoxamine + Quinidine
Severity: Major
Fluvoxamine and Quinidine: 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 can inhibit CYP3A4, CYP1A2 and CYP2C19, and may raise quinidine concentrations, and both agents can affect QT. The combination increases the risk of torsades de pointes.
What this interaction means in plain words
Fluvoxamine and Quinidine 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; Quinidine belongs to Anti Parasitic.
Why it happens
Additive QT prolongation, with fluvoxamine inhibiting quinidine metabolism.
What to do
Avoid the combination where possible and choose an antidepressant with less QT effect. If it is unavoidable, monitor the ECG, electrolytes and quinidine levels.
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 Quinidine
- Adagrasib + Quinidine Contraindicated
- Arsenic trioxide + Quinidine Contraindicated
- Artemether / lumefantrine + Quinidine Contraindicated
- Chloroquine + Quinidine Contraindicated
- Dofetilide + Quinidine Contraindicated
- Dronedarone + Quinidine 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 Quinidine?
MediHelp rates the interaction as major. Fluvoxamine and Quinidine 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 can inhibit CYP3A4, CYP1A2 and CYP2C19, and may raise quinidine concentrations, and both agents can affect QT. The combination increases the risk of torsades de pointes.
How serious is the interaction between Fluvoxamine and Quinidine?
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 the combination where possible and choose an antidepressant with less QT effect. If it is unavoidable, monitor the ECG, electrolytes and quinidine levels.
What other medicines interact with Quinidine?
MediHelp also lists interactions of Quinidine with, for example, Adagrasib, Arsenic trioxide, Artemether / lumefantrine. The full list is on the Quinidine page.
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