interval. Use Caution/Monitor. Conduct periodic monitoring with ECGs and electrolytes in patients taking drugs known to prolong the QTc interval.oxaliplatinSerious - Use Alternative (1)oxaliplatin and fluoxetine both increase QTc interval. Avoid or Use Alternate Drug.oxaprozinMonitor Closely (1)fluoxetine, oxaprozin. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.oxycodoneSerious - Use Alternative (1)oxycodone will increase the level or effect of fluoxetine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Opioids may enhance the serotonergic effects of SSRIs and increase risk for serotonergic syndromeoxymorphoneSerious - Use Alternative (1)fluoxetine will increase the level or effect of oxymorphone by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.ozanimodMonitor Closely (1)ozanimod and fluoxetine both increase QTc interval. Modify Therapy/Monitor Closely. The potential additive effects on heart rate, treatment with ozanimod should generally not be initiated in patients who are concurrently treated with QT prolonging drugs with known arrhythmogenic properties.Serious - Use Alternative (1)ozanimod increases toxicity of fluoxetine by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Because the active metabolite of ozanimod inhibits MAO-B in vitro, there is a potential for serious adverse reactions, including hypertensive crisis. Therefore, coadministration of ozanimod with drugs that can increase norepinephrine or serotonin is not recommended. Monitor for hypertension with concomitant use.paliperidoneMonitor Closely (1)fluoxetine and paliperidone both increase QTc interval. Use Caution/Monitor.palonosetronSerious - Use Alternative (1)palonosetron, fluoxetine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.panax ginsengMinor (1)panax ginseng increases effects of fluoxetine by pharmacodynamic synergism. Minor/Significance Unknown.panobinostatSerious - Use Alternative (1)fluoxetine and panobinostat both increase QTc interval. Avoid or Use Alternate Drug. Panobinostat is known to significantly prolong QT interval. Panobinostat prescribing information states use with drugs known to prolong QTc is not recommended.parecoxibMonitor Closely (2)fluoxetine will increase the level or effect of parecoxib by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. fluoxetine, parecoxib. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.Minor (1)parecoxib will increase the level or effect of fluoxetine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.paroxetineMonitor Closely (1)fluoxetine and paroxetine both increase QTc interval. Use Caution/Monitor.Serious - Use Alternative (2)fluoxetine and paroxetine both increase serotonin levels. Avoid or Use Alternate Drug. fluoxetine will increase the level or effect of paroxetine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.pasireotideMonitor Closely (1)fluoxetine and pasireotide both increase QTc interval. Modify Therapy/Monitor Closely.pazopanibMinor (1)fluoxetine and pazopanib both increase QTc interval. Minor/Significance Unknown.peginterferon alfa 2bMonitor Closely (1)peginterferon alfa 2b, fluoxetine. Other (see comment). Use Caution/Monitor. Comment: When patients are administered peginterferon alpha-2b with CYP2D6 substrates, the therapeutic effect of these drugs may be altered. Peginterferon alpha-2b may increase or decrease levels of CYP2D6 substrate.pentamidineSerious - Use Alternative (1)fluoxetine and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.pentazocineMonitor Closely (1)fluoxetine and pentazocine both increase serotonin levels. Modify Therapy/Monitor Closely.pentoxifyllineMonitor Closely (1)pentoxifylline increases toxicity of fluoxetine by anticoagulation. Use Caution/Monitor. May increase bleeding.perhexilineMonitor Closely (1)fluoxetine will increase the level or effect of perhexiline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.perphenazineSerious - Use Alternative (3)perphenazine and fluoxetine both increase QTc interval. Avoid or Use Alternate Drug. fluoxetine will increase the level or effect of perphenazine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. perphenazine will increase the level or effect of fluoxetine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.phenelzineContraindicated (1)phenelzine and fluoxetine both increase serotonin levels. Contraindicated.phentermineSerious - Use Alternative (1)fluoxetine, phentermine. Either increases toxicity of the other by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of serotonin syndrome.phenytoinMonitor Closely (1)fluoxetine will increase the level or effect of phenytoin by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.pimozideContraindicated (2)fluoxetine and pimozide both increase QTc interval. Contraindicated. fluoxetine increases levels of pimozide by decreasing metabolism. Contraindicated. Risk of QT interval prolongation.pirbuterolMonitor Closely (1)fluoxetine and pirbuterol both increase QTc interval. Modify Therapy/Monitor Closely. Fluoxetine prolongs the QT interval; the prescribing information for fluoxetine recommends avoiding concurrent use of other drugs that may prolong the QT interval; risk may be increased with higher doses and/or when associated with hypokalemia; drugs that prolong the QTc interval may potentiate the effects of beta2 agonists on the cardiovascular systempirfenidoneSerious - Use Alternative (1)fluoxetine will increase the level or effect of pirfenidone by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug. Avoid; coadministration of pirfenidone and moderate CYP1A2 inhibitors result in moderately increased exposure to pirfenidone; if unable to avoid, decrease dose of moderate CYP1A2 inhibitorpiroxicamMonitor Closely (2)fluoxetine will increase the level or effect of piroxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. fluoxetine, piroxicam. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.pitolisantMonitor Closely (1)fluoxetine will increase the level or effect of pitolisant by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. If coadministered with strong CYP2D6 inhibitors, initiate pitolisant at 8.9 mg/day and increase after 7 days to maximum of 17.8 mg/day. For patients currently taking pitolisant, reduce pitolisant dose by half upon initiating strong CYP2D6 inhibitors.Serious - Use Alternative (1)fluoxetine and pitolisant both increase QTc interval. Avoid or Use Alternate Drug.pleurisy rootMinor (1)pleurisy root decreases effects of fluoxetine by unspecified interaction mechanism. Minor/Significance Unknown. Theoretical interaction.posaconazoleMonitor Closely (1)fluoxetine and posaconazole both increase QTc interval. Use Caution/Monitor.pregabalinMonitor Closely (1)pregabalin, fluoxetine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.primaquineMonitor Closely (1)primaquine and fluoxetine both increase QTc interval. Use Caution/Monitor.procainamideSerious - Use Alternative (1)fluoxetine and procainamide both increase QTc interval. Avoid or Use Alternate Drug.procarbazineContraindicated (1)procarbazine and fluoxetine both increase serotonin levels. Contraindicated. Combinations is contraindicated within 5 weeks of MAOI use.prochlorperazineMonitor Closely (2)prochlorperazine and fluoxetine both increase QTc interval. Use Caution/Monitor. fluoxetine will increase the level or effect of prochlorperazine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.promazineMonitor Closely (2)promazine and fluoxetine both increase QTc interval. Modify Therapy/Monitor Closely. fluoxetine will increase the level or effect of promazine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.promethazineMonitor Closely (1)promethazine and fluoxetine both increase QTc interval. Use Caution/Monitor.Serious - Use Alternative (1)fluoxetine will increase the level or effect of promethazine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.propafenoneSerious - Use Alternative (3)propafenone and fluoxetine both increase QTc interval. Avoid or Use Alternate Drug. fluoxetine will increase the level or effect of propafenone by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. propafenone will increase the level or effect of fluoxetine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.propranololSerious - Use Alternative (1)fluoxetine will increase the level or effect of propranolol by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.protriptylineMonitor Closely (1)protriptyline and fluoxetine both increase QTc interval. Modify Therapy/Monitor Closely.Serious - Use Alternative (1)fluoxetine and protriptyline both increase serotonin levels. Avoid or Use Alternate Drug.quetiapineMonitor Closely (1)quetiapine, fluoxetine. Either increases toxicity of the other by QTc interval. Use Caution/Monitor. Avoid use with drugs that prolong QT and in patients with risk factors for prolonged QT interval. Postmarketing cases show QT prolongation with overdose in patients with concomitant illness or with drugs known to cause electrolyte imbalance or prolong QT.quinacrineMinor (1)quinacrine will increase the level or effect of fluoxetine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.quinidineSerious - Use Alternative (2)quinidine and fluoxetine both increase QTc interval. Avoid or Use Alternate Drug. quinidine will increase the level or effect of fluoxetine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.quinineMonitor Closely (1)fluoxetine and quinine both increase QTc interval. Use Caution/Monitor.rabeprazoleMinor (1)fluoxetine will increase the level or effect of rabeprazole by affecting hepatic enzyme CYP2C19 metabolism. Minor/Significance Unknown.ramelteonMonitor Closely (1)fluoxetine will increase the level or effect of ramelteon by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.ranolazineMonitor Closely (1)fluoxetine and ranolazine both increase QTc interval. Use Caution/Monitor.Minor (1)ranolazine will increase the level or effect of fluoxetine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.rasagilineSerious - Use Alternative (1)rasagiline and fluoxetine both increase serotonin levels. Avoid or Use Alternate Drug. evere CNS toxicity associated with hyperpyrexia has been reported with the combined treatment of an antidepressant and rasagiline. Avoid combination within 14 days of MAOI use.remifentanilMonitor Closely (1)remifentanil, fluoxetine. Either increases toxicity of the other by serotonin levels. Modify Therapy/Monitor Closely.remimazolamMonitor Closely (1)remimazolam, fluoxetine. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely. Coadministration may result in profound sedation, respiratory depression, coma, and/or death. Continuously monitor vital signs during sedation and recovery period if coadministered. Carefully titrate remimazolam dose if administered with opioid analgesics and/or sedative/hypnotics.ribociclibSerious - Use Alternative (2)ribociclib will increase the level or effect of fluoxetine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. ribociclib increases toxicity of fluoxetine by QTc interval. Avoid or Use Alternate Drug.rilpivirineMonitor Closely (1)rilpivirine increases toxicity of fluoxetine by QTc interval. Use Caution/Monitor. Rilpivirine should be used with caution when co-administered with a drug with a known risk of Torsades de Pointes.risperidoneMonitor Closely (1)fluoxetine and risperidone both increase QTc interval. Use Caution/Monitor.Serious - Use Alternative (1)fluoxetine will increase the level or effect of risperidone by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.ritonavirMinor (1)ritonavir will increase the level or effect of fluoxetine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.rivaroxabanMonitor Closely (1)fluoxetine increases effects of rivaroxaban by pharmacodynamic synergism. Use Caution/Monitor. Combination may increase risk of bleeding.rizatriptanMonitor Closely (1)rizatriptan and fluoxetine both increase serotonin levels. Modify Therapy/Monitor Closely.Minor (1)fluoxetine, rizatriptan. Mechanism: unknown. Minor/Significance Unknown. Risk of weakness, dyspnea, chest pain.rolapitantMonitor Closely (1)rolapitant will increase the level or effect of fluoxetine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Rolapitant may increase plasma concentrations of CYP2D6 substrates for at least 28 days following rolapitant administration.romidepsinMonitor Closely (1)fluoxetine and romidepsin both increase QTc interval. Use Caution/Monitor.rucaparibMonitor Closely (1)rucaparib will increase the level or effect of fluoxetine by affecting hepatic enzyme CYP2C9/10 metabolism. Modify Therapy/Monitor Closely. Adjust dosage of CYP2C9 substrates, if clinically indicated.ruxolitinibMinor (1)fluoxetine will increase the level or effect of ruxolitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.ruxolitinib topicalMinor (1)fluoxetine will increase the level or effect of ruxolitinib topical by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.safinamideMonitor Closely (1)fluoxetine, safinamide. Either increases toxicity of the other by serotonin levels. Use Caution/Monitor. Monitor patients for symptoms of serotonin syndrome if SSRIs are coadministered with safinamide.salicylates (non-asa)Monitor Closely (1)fluoxetine, salicylates (non-asa). Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.salmeterolMonitor Closely (1)fluoxetine and salmeterol both increase QTc interval. Modify Therapy/Monitor Closely. Fluoxetine prolongs the QT interval; the prescribing information for fluoxetine recommends avoiding concurrent use of other drugs that may prolong the QT interval; risk may be increased with higher doses and/or when associated with hypokalemia; drugs that prolong the QTc interval may potentiate the effects of beta2 agonists on the cardiovascular systemsalsalateMonitor Closely (1)fluoxetine, salsalate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.SAMeMonitor Closely (1)fluoxetine and SAMe both increase serotonin levels. Modify Therapy/Monitor Closely.saquinavirMonitor Closely (1)saquinavir and fluoxetine both increase QTc interval. Modify Therapy/Monitor Closely.selegilineContraindicated (1)selegiline and fluoxetine both increase serotonin levels. Contraindicated. At least 5 weeks should elapse between discontinuation of fluoxetine and initiation of selegiline.selegiline transdermalSerious - Use Alternative (1)selegiline transdermal and fluoxetine both decrease serotonin levels. Avoid or Use Alternate Drug.selinexorSerious - Use Alternative (1)selinexor, fluoxetine. unspecified interaction mechanism. Avoid or Use Alternate Drug. Patients treated with selinexor may experience neurological toxicities. Avoid taking selinexor with other medications that may cause dizziness or confusion.selpercatinibMonitor Closely (1)selpercatinib increases toxicity of fluoxetine by QTc interval. Use Caution/Monitor.serdexmethylphenidate/dexmethylphenidateMinor (1)serdexmethylphenidate/dexmethylphenidate increases effects of fluoxetine by decreasing metabolism. Minor/Significance Unknown.sertralineMonitor Closely (1)sertraline and fluoxetine both increase QTc interval. Modify Therapy/Monitor Closely.Serious - Use Alternative (2)fluoxetine and sertraline both increase serotonin levels. Avoid or Use Alternate Drug. sertraline will increase the level or effect of fluoxetine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.sevofluraneSerious - Use Alternative (1)sevoflurane and fluoxetine both increase QTc interval. Avoid or Use Alternate Drug.siponimodSerious - Use Alternative (1)siponimod and fluoxetine both increase