Drug interactions
Fluvoxamine + Sufentanil sl
Severity: Major
Fluvoxamine and Sufentanil sl: 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
Sublingual sufentanil combined with an SSRI may increase the risk of serotonin syndrome. Fluvoxamine may also raise sufentanil exposure via CYP3A4 inhibition, increasing opioid-related respiratory depression.
What this interaction means in plain words
Fluvoxamine and Sufentanil sl 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.
Why it happens
Additive serotonergic effects plus CYP3A4 inhibition reducing sufentanil clearance.
What to do
Observe for agitation, tremor, hyperthermia and clonus, and for excessive sedation or respiratory depression; stop one agent if serotonin syndrome is suspected.
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 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 Sufentanil sl?
MediHelp rates the interaction as major. Fluvoxamine and Sufentanil sl 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. Sublingual sufentanil combined with an SSRI may increase the risk of serotonin syndrome. Fluvoxamine may also raise sufentanil exposure via CYP3A4 inhibition, increasing opioid-related respiratory depression.
How serious is the interaction between Fluvoxamine and Sufentanil sl?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Observe for agitation, tremor, hyperthermia and clonus, and for excessive sedation or respiratory depression; stop one agent if serotonin syndrome is suspected.
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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