Drug interactions
Fluvoxamine + Remifentanil
Severity: Moderate
Fluvoxamine and Remifentanil: 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
Fluvoxamine combined with an opioid can contribute to serotonin syndrome. Remifentanil has little serotonergic activity and is not CYP-dependent, so the risk is modest but not negligible.
What this interaction means in plain words
Fluvoxamine and Remifentanil 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.
Fluvoxamine belongs to Central Nervous System; Remifentanil belongs to Musculoskeletal.
Why it happens
Additive serotonergic effects from SSRI reuptake inhibition and opioid activity.
What to do
Monitor for mental status change, clonus, tremor and hyperthermia. Treat suspected serotonin syndrome by withdrawing the serotonergic drugs and giving supportive care.
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 Remifentanil
- Alvimopan + Remifentanil Contraindicated
- Isocarboxazid + Remifentanil Contraindicated
- Olanzapine / samidorphan + Remifentanil Contraindicated
- Phenelzine + Remifentanil Contraindicated
- Benzhydrocodone / acetaminophen + Remifentanil Major
- Brexanolone + Remifentanil Major
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 Remifentanil?
MediHelp rates the interaction as moderate. Fluvoxamine and Remifentanil 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. Fluvoxamine combined with an opioid can contribute to serotonin syndrome. Remifentanil has little serotonergic activity and is not CYP-dependent, so the risk is modest but not negligible.
How serious is the interaction between Fluvoxamine and Remifentanil?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for mental status change, clonus, tremor and hyperthermia. Treat suspected serotonin syndrome by withdrawing the serotonergic drugs and giving supportive care.
What other medicines interact with Remifentanil?
MediHelp also lists interactions of Remifentanil with, for example, Alvimopan, Isocarboxazid, Olanzapine / samidorphan. The full list is on the Remifentanil page.
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