Drug interactions
Fluvoxamine + Zolmitriptan
Severity: Major
Fluvoxamine and Zolmitriptan: 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
The combination may add serotonergic stimulation and rarely result in serotonin syndrome. Fluvoxamine inhibits CYP1A2, the main enzyme for zolmitriptan, which can raise triptan levels substantially.
What this interaction means in plain words
Fluvoxamine and Zolmitriptan 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; Zolmitriptan belongs to Central Nervous System.
Why it happens
Fluvoxamine inhibits CYP1A2-mediated zolmitriptan metabolism, and both drugs add serotonergic effects.
What to do
Limit the zolmitriptan dose in line with labeling for CYP1A2 inhibitors, such as a lower maximum single and daily dose. Monitor for serotonin toxicity and raised blood pressure.
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 Zolmitriptan
- Almotriptan + Zolmitriptan Contraindicated
- Dihydroergotamine intranasal + Zolmitriptan Contraindicated
- Dihydroergotamine + Zolmitriptan Contraindicated
- Eletriptan + Zolmitriptan Contraindicated
- Ergoloid mesylates + Zolmitriptan Contraindicated
- Ergotamine + Zolmitriptan Contraindicated
Frequently asked questions
Can I take Fluvoxamine with Zolmitriptan?
MediHelp rates the interaction as major. Fluvoxamine and Zolmitriptan 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. The combination may add serotonergic stimulation and rarely result in serotonin syndrome. Fluvoxamine inhibits CYP1A2, the main enzyme for zolmitriptan, which can raise triptan levels substantially.
How serious is the interaction between Fluvoxamine and Zolmitriptan?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Limit the zolmitriptan dose in line with labeling for CYP1A2 inhibitors, such as a lower maximum single and daily dose. Monitor for serotonin toxicity and raised blood pressure.
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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