Drug interactions
Fluvoxamine + Vorasidenib
Severity: Major
Fluvoxamine and Vorasidenib: major 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 strongly inhibits CYP1A2, the main enzyme that clears vorasidenib. Co-administration can raise vorasidenib exposure and increase the risk of dose-related toxicity, notably liver enzyme elevations.
What this interaction means in plain words
Fluvoxamine and Vorasidenib 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; Vorasidenib belongs to Oncology.
Why it happens
Strong CYP1A2 inhibition by fluvoxamine reduces the metabolic clearance of vorasidenib.
What to do
Avoid the combination and choose an antidepressant that does not strongly inhibit CYP1A2. If it cannot be avoided, monitor liver function tests closely.
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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Other interactions of Vorasidenib
- Ciprofloxacin + Vorasidenib Major
- Tacrolimus + Vorasidenib Major
- Vorasidenib + Warfarin Major
- Midazolam + Vorasidenib Moderate
- Phenytoin + Vorasidenib Moderate
- Rifampicin + Vorasidenib Moderate
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 Vorasidenib?
MediHelp rates the interaction as major. Fluvoxamine and Vorasidenib 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 strongly inhibits CYP1A2, the main enzyme that clears vorasidenib. Co-administration can raise vorasidenib exposure and increase the risk of dose-related toxicity, notably liver enzyme elevations.
How serious is the interaction between Fluvoxamine and Vorasidenib?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination and choose an antidepressant that does not strongly inhibit CYP1A2. If it cannot be avoided, monitor liver function tests closely.
What other medicines interact with Vorasidenib?
MediHelp also lists interactions of Vorasidenib with, for example, Ciprofloxacin, Tacrolimus, Warfarin. The full list is on the Vorasidenib page.
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