Drug interactions
fluvoxamine + sertraline
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.
Overview
Concomitant SSRIs increase risk of serotonin syndrome; fluvoxamine may also raise sertraline exposure via CYP2C19/3A4 inhibition.
Mechanism of action
Pharmacodynamic additive serotonergic effects; pharmacokinetic inhibition of CYP2C19/3A4 by fluvoxamine → ↑ sertraline levels.
Clinical management
Avoid dual SSRI therapy. If switching, use a cautious taper/cross-taper with close monitoring. Educate on serotonin syndrome (agitation, tremor, hyperreflexia, fever).
Drug reference
Frequently asked questions
Can I take fluvoxamine with sertraline?
The interaction is rated: Major. Concomitant SSRIs increase risk of serotonin syndrome; fluvoxamine may also raise sertraline exposure via CYP2C19/3A4 inhibition.
How serious is the interaction between fluvoxamine and sertraline?
The interaction is rated: Major. Evidence level: High.
How is the interaction between fluvoxamine and sertraline managed?
Avoid dual SSRI therapy. If switching, use a cautious taper/cross-taper with close monitoring. Educate on serotonin syndrome (agitation, tremor, hyperreflexia, fever).
Why do fluvoxamine and sertraline interact?
Pharmacodynamic additive serotonergic effects; pharmacokinetic inhibition of CYP2C19/3A4 by fluvoxamine → ↑ sertraline levels.
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