Drug interactions
Fluvoxamine + Ropinirole
Severity: Major
Fluvoxamine and Ropinirole: 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
Fluvoxamine is a potent CYP1A2 inhibitor and ropinirole is cleared mainly through CYP1A2. Co-administration can substantially raise ropinirole exposure, increasing dopaminergic adverse effects such as nausea, somnolence, sudden sleep onset, hypotension, hallucinations and dyskinesia.
What this interaction means in plain words
Fluvoxamine and Ropinirole 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; Ropinirole belongs to Central Nervous System.
Why it happens
Fluvoxamine inhibits CYP1A2-mediated hepatic metabolism of ropinirole, reducing its clearance.
What to do
Prefer an antidepressant that does not inhibit CYP1A2 where possible. If the combination is needed, start ropinirole at a low dose, titrate slowly according to response and tolerability, and reduce the dose if adverse effects appear.
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 Ropinirole
- Amisulpride + Ropinirole Contraindicated
- Chlorpromazine + Ropinirole Major
- Droperidol + Ropinirole Major
- Fluphenazine + Ropinirole Major
- Haloperidol + Ropinirole Major
- Loxapine + Ropinirole Major
Frequently asked questions
Can I take Fluvoxamine with Ropinirole?
MediHelp rates the interaction as major. Fluvoxamine and Ropinirole 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 is a potent CYP1A2 inhibitor and ropinirole is cleared mainly through CYP1A2. Co-administration can substantially raise ropinirole exposure, increasing dopaminergic adverse effects such as nausea, somnolence, sudden sleep onset, hypotension, hallucinations and dyskinesia.
How serious is the interaction between Fluvoxamine and Ropinirole?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Prefer an antidepressant that does not inhibit CYP1A2 where possible. If the combination is needed, start ropinirole at a low dose, titrate slowly according to response and tolerability, and reduce the dose if adverse effects appear.
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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