Drug interactions
Fluvoxamine + Tolfenamic acid
Severity: Moderate
Fluvoxamine and Tolfenamic acid: 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
Combining an SSRI with an NSAID increases the risk of gastrointestinal bleeding beyond that of either drug alone. The risk is higher in older adults and in those with prior ulcers or taking anticoagulants or corticosteroids.
What this interaction means in plain words
Fluvoxamine and Tolfenamic acid 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; Tolfenamic acid belongs to Musculoskeletal.
Why it happens
SSRIs deplete platelet serotonin and impair aggregation, while NSAIDs inhibit platelet function and damage gastric mucosa, producing additive bleeding risk.
What to do
Avoid the combination where possible or limit NSAID duration, and consider gastroprotection with a proton pump inhibitor in at-risk patients. Advise patients to report black stools or other bleeding.
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 Fluvoxamine
- Agomelatine + Fluvoxamine Contraindicated
- Alosetron + Fluvoxamine Contraindicated
- Fezolinetant + Fluvoxamine Contraindicated
- Fluvoxamine + Isocarboxazid Contraindicated
- Fluvoxamine + Mavacamten Contraindicated
- Fluvoxamine + Methylene blue Contraindicated
Other interactions of Tolfenamic acid
Frequently asked questions
Can I take Fluvoxamine with Tolfenamic acid?
MediHelp rates the interaction as moderate. Fluvoxamine and Tolfenamic acid 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. Combining an SSRI with an NSAID increases the risk of gastrointestinal bleeding beyond that of either drug alone. The risk is higher in older adults and in those with prior ulcers or taking anticoagulants or corticosteroids.
How serious is the interaction between Fluvoxamine and Tolfenamic acid?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination where possible or limit NSAID duration, and consider gastroprotection with a proton pump inhibitor in at-risk patients. Advise patients to report black stools or other bleeding.
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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