Drug interactions
Fluvoxamine + Sufentanil
Severity: Major
Fluvoxamine and Sufentanil: 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
Sufentanil has weak serotonergic activity and combining it with an SSRI may increase the risk of serotonin syndrome. Fluvoxamine may also raise sufentanil levels through CYP3A4 inhibition, increasing opioid effects including respiratory depression.
What this interaction means in plain words
Fluvoxamine and Sufentanil 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; Sufentanil belongs to Musculoskeletal.
Why it happens
Additive serotonergic effects plus CYP3A4 inhibition reducing sufentanil clearance.
What to do
Monitor for serotonin syndrome and excess sedation or respiratory depression, especially at initiation and dose changes; reduce the sufentanil dose if needed.
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
Other interactions of Sufentanil
- Alprazolam + Sufentanil Major
- Amitriptyline + Sufentanil Major
- Amobarbital + Sufentanil Major
- Aripiprazole + Sufentanil Major
- Asenapine + Sufentanil Major
- Baclofen + Sufentanil Major
Frequently asked questions
Can I take Fluvoxamine with Sufentanil?
MediHelp rates the interaction as major. Fluvoxamine and Sufentanil 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. Sufentanil has weak serotonergic activity and combining it with an SSRI may increase the risk of serotonin syndrome. Fluvoxamine may also raise sufentanil levels through CYP3A4 inhibition, increasing opioid effects including respiratory depression.
How serious is the interaction between Fluvoxamine and Sufentanil?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for serotonin syndrome and excess sedation or respiratory depression, especially at initiation and dose changes; reduce the sufentanil dose if needed.
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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