Drug interactions
Fluvoxamine + Tofacitinib
Severity: Moderate
Fluvoxamine and Tofacitinib: moderate 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 CYP2C19 inhibitor and also inhibits CYP1A2 and weakly CYP3A4, so it may increase tofacitinib exposure. The effect is greater if a CYP3A4 inhibitor is also present.
What this interaction means in plain words
Fluvoxamine and Tofacitinib can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Fluvoxamine belongs to Central Nervous System; Tofacitinib belongs to Musculoskeletal.
Why it happens
Inhibition of CYP2C19 (a minor tofacitinib pathway) by fluvoxamine reduces tofacitinib clearance.
What to do
Monitor for infection and cytopenias; reduce the tofacitinib dose if combined with a moderate or potent CYP3A4 inhibitor.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Tofacitinib
- Baricitinib + Tofacitinib Contraindicated
- Cladribine + Tofacitinib Contraindicated
- Tofacitinib + Upadacitinib Contraindicated
- Abatacept + Tofacitinib Major
- Anti-thymocyte + Tofacitinib Major
- Antithymocyte globulin equine + Tofacitinib Major
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 Tofacitinib?
MediHelp rates the interaction as moderate. Fluvoxamine and Tofacitinib can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Fluvoxamine is a potent CYP2C19 inhibitor and also inhibits CYP1A2 and weakly CYP3A4, so it may increase tofacitinib exposure. The effect is greater if a CYP3A4 inhibitor is also present.
How serious is the interaction between Fluvoxamine and Tofacitinib?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for infection and cytopenias; reduce the tofacitinib dose if combined with a moderate or potent CYP3A4 inhibitor.
What other medicines interact with Tofacitinib?
MediHelp also lists interactions of Tofacitinib with, for example, Baricitinib, Cladribine, Upadacitinib. The full list is on the Tofacitinib page.
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