Drug interactions
Fluvoxamine + Riluzole
Severity: Major
Fluvoxamine and Riluzole: 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
Riluzole is metabolized mainly by CYP1A2, which fluvoxamine strongly inhibits, so riluzole exposure may increase substantially. This raises the risk of dose-related adverse effects, including hepatotoxicity and nausea.
What this interaction means in plain words
Fluvoxamine and Riluzole 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; Riluzole belongs to Miscellaneous.
Why it happens
Potent CYP1A2 inhibition by fluvoxamine reduces riluzole clearance.
What to do
Avoid the combination if possible, or monitor liver enzymes closely and consider an alternative antidepressant such as sertraline.
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 Riluzole
- Cannabidiol + Riluzole Moderate
- Ciprofloxacin + Riluzole Moderate
- Elranatamab + Riluzole Moderate
- Epcoritamab + Riluzole Moderate
- Fexinidazole + Riluzole Moderate
- Givosiran + Riluzole Moderate
Frequently asked questions
Can I take Fluvoxamine with Riluzole?
MediHelp rates the interaction as major. Fluvoxamine and Riluzole 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. Riluzole is metabolized mainly by CYP1A2, which fluvoxamine strongly inhibits, so riluzole exposure may increase substantially. This raises the risk of dose-related adverse effects, including hepatotoxicity and nausea.
How serious is the interaction between Fluvoxamine and Riluzole?
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 if possible, or monitor liver enzymes closely and consider an alternative antidepressant such as sertraline.
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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