the level or effect of fluvoxamine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Rolapitant may increase serum concentrations of CYP2D6 substrates for at least 28 days following rolapitant administrationromidepsinfluvoxamine and romidepsin both increase QTc interval. Use Caution/Monitor.rucaparibrucaparib will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP1A2 metabolism. Modify Therapy/Monitor Closely. Adjust dosage of CYP1A2 substrates, if clinically indicated.safinamidefluvoxamine, safinamide. Either increases toxicity of the other by serotonin levels. Use Caution/Monitor. Monitor for serotonin syndrome.salicylates (non-asa)fluvoxamine, 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.salsalatefluvoxamine, 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.SAMefluvoxamine and SAMe both increase serotonin levels. Modify Therapy/Monitor Closely.saquinavirfluvoxamine will increase the level or effect of saquinavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.silodosinfluvoxamine will increase the level or effect of silodosin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.sodium sulfate/?magnesium sulfate/potassium chloridesodium sulfate/?magnesium sulfate/potassium chloride increases effects of fluvoxamine by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of seizures when using bowel preps together with drugs that lower the seizure threshold.sodium sulfate/potassium chloride/magnesium sulfate/polyethylene glycolfluvoxamine, sodium sulfate/potassium chloride/magnesium sulfate/polyethylene glycol. Other (see comment). Use Caution/Monitor. Comment: Increased risk for water retention or electrolyte imbalance.sodium sulfate/potassium sulfate/magnesium sulfatesodium sulfate/potassium sulfate/magnesium sulfate increases effects of fluvoxamine by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of seizures when using bowel preps together with drugs that lower the seizure threshold.sofosbuvir/velpatasvirfluvoxamine will increase the level or effect of sofosbuvir/velpatasvir by affecting hepatic enzyme CYP2B6 metabolism. Use Caution/Monitor.solifenacinfluvoxamine will increase the level or effect of solifenacin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.solifenacin and fluvoxamine both increase QTc interval. Use Caution/Monitor.somapacitansomapacitan will decrease the level or effect of fluvoxamine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. Limited published data indicate that growth hormone treatment increases cytochrome P450 (CYP450)-mediated antipyrine clearance. Caution with sensitive CYP substratessomatrogonsomatrogon will decrease the level or effect of fluvoxamine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. Limited published data indicate that growth hormone treatment increases cytochrome P450 (CYP450)-mediated antipyrine clearance. Caution with sensitive CYP substratessomatropinsomatropin will decrease the level or effect of fluvoxamine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. Limited published data indicate that growth hormone treatment increases cytochrome P450 (CYP450)-mediated antipyrine clearance. Caution with sensitive CYP substratessparsentanfluvoxamine will increase the level or effect of sparsentan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. No dosage adjustment needed. Monitor blood pressure, serum potassium, edema, and kidney function regularly if sparsentan is coadministered with moderate CYP3A4 inhibitors. stiripentolfluvoxamine, stiripentol. affecting hepatic enzyme CYP1A2 metabolism. Modify Therapy/Monitor Closely. May require dosage adjustment.sufentanilfluvoxamine and sufentanil both increase serotonin levels. Use Caution/Monitor. Carefully observe patient for serotonin syndrome during treatment initiation and dose adjustmentsufentanil SLfluvoxamine and sufentanil SL both decrease serotonin levels. Use Caution/Monitor. Carefully observe patient for serotonin syndrome during treatment initiation and dose adjustmentsulfamethoxazolefluvoxamine and sulfamethoxazole both increase QTc interval. Use Caution/Monitor.sulfasalazinefluvoxamine will increase the level or effect of sulfasalazine by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding SSRIs inhib. serotonin uptake by plateletssulindacfluvoxamine, sulindac. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor.sumatriptanfluvoxamine and sumatriptan both increase serotonin levels. Modify Therapy/Monitor Closely.sumatriptan intranasalfluvoxamine and sumatriptan intranasal both increase serotonin levels. Modify Therapy/Monitor Closely.sunitinibfluvoxamine will increase the level or effect of sunitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.sunitinib and fluvoxamine both increase QTc interval. Use Caution/Monitor.tacrolimusfluvoxamine will increase the level or effect of tacrolimus by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.tacrolimus and fluvoxamine both increase QTc interval. Use Caution/Monitor.tadalafilfluvoxamine will increase the level or effect of tadalafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.tamoxifenfluvoxamine, tamoxifen. affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Decreases tamoxifen metabolism to active metabolites.tapentadolfluvoxamine and tapentadol both increase serotonin levels. Modify Therapy/Monitor Closely.tasimelteonfluvoxamine will increase the level or effect of tasimelteon by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. May increase adverse effectstelavancinfluvoxamine and telavancin both increase QTc interval. Use Caution/Monitor.temsirolimusfluvoxamine will increase the level or effect of temsirolimus by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.terbinafineterbinafine will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Assess need to reduce dose of CYP2D6-metabolized drug.fluvoxamine will increase the level or effect of terbinafine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.teriflunomideteriflunomide will decrease the level or effect of fluvoxamine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.tezacaftorfluvoxamine will increase the level or effect of tezacaftor by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Adjust dose when coadministered with a moderate CYP3A4 inhibitortinidazolefluvoxamine will increase the level or effect of tinidazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.tipranavirfluvoxamine will increase the level or effect of tipranavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.tofacitinibfluvoxamine increases levels of tofacitinib by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. Decrease tofacitinib dose is coadministered with both moderate CYP3A4 and potent CYP2C19 inhibitors.tolbutamidefluvoxamine will increase the level or effect of tolbutamide by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.tolfenamic acidfluvoxamine, tolfenamic acid. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.tolmetinfluvoxamine, tolmetin. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.tramadolfluvoxamine and tramadol both increase serotonin levels. Modify Therapy/Monitor Closely.trazodonefluvoxamine and trazodone both increase QTc interval. Modify Therapy/Monitor Closely.triazolamfluvoxamine will increase the level or effect of triazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.trifluoperazinefluvoxamine and trifluoperazine both increase QTc interval. Modify Therapy/Monitor Closely.trimethoprimfluvoxamine and trimethoprim both increase QTc interval. Use Caution/Monitor.trimipraminefluvoxamine and trimipramine both increase QTc interval. Modify Therapy/Monitor Closely.tropisetronfluvoxamine and tropisetron both increase QTc interval. Use Caution/Monitor.valbenazinevalbenazine and fluvoxamine both increase QTc interval. Use Caution/Monitor.valerianfluvoxamine and valerian both increase sedation. Use Caution/Monitor.vardenafilfluvoxamine will increase the level or effect of vardenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Vardenafil dose may need to be reduced if coadministered with moderate or strong CYP3A4 inhibitors velpatasvirfluvoxamine will increase the level or effect of velpatasvir by affecting hepatic enzyme CYP2B6 metabolism. Use Caution/Monitor.venlafaxinefluvoxamine and venlafaxine both increase QTc interval. Use Caution/Monitor.verapamilfluvoxamine will increase the level or effect of verapamil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.voclosporinfluvoxamine will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce voclosporin daily dosage to 15.8 mg PO in AM and 7.9 mg PO in PM.vorapaxarfluvoxamine, vorapaxar. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. SSRIs and SNRIs may cause platelet serotonin depletion.voriconazolefluvoxamine and voriconazole both increase QTc interval. Use Caution/Monitor.vorinostatvorinostat and fluvoxamine both increase QTc interval. Use Caution/Monitor.warfarinfluvoxamine, warfarin. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Serotonin release by platelets plays an important role in hemostasis. SSRIs and SNRIs may increase anticoagulation effect of warfarin. .zaleplonfluvoxamine will increase the level or effect of zaleplon by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.zanubrutinibfluvoxamine will increase the level or effect of zanubrutinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce zanubrutinib (a CYP3A4 substrate) to 80 mg PO BID to when coadministered with a moderate CYP3A4 inhibitor. Interrupt dose as recommended for adverse reactions. After discontinuing the CYP3A4 inhibitor, resume previous dose of zanubrutinib. ziprasidonefluvoxamine and ziprasidone both increase QTc interval. Modify Therapy/Monitor Closely.zolmitriptanfluvoxamine and zolmitriptan both increase serotonin levels. Modify Therapy/Monitor Closely.zolpidemfluvoxamine will increase the level or effect of zolpidem by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.zonisamidefluvoxamine will increase the level or effect of zonisamide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Minor (0)5-HTPMonitor Closely (1)fluvoxamine and 5-HTP both increase serotonin levels. Modify Therapy/Monitor Closely.abametapirSerious - Use Alternative (1)abametapir will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug. For 2 weeks after abametapir application, avoid taking drugs that are CYP1A2 substrates. If not feasible, avoid use of abametapir.abirateroneMonitor Closely (1)abiraterone will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. If therapy cannot be avoided, exercise caution and consider a dose reduction of CYP2D6 substrateabrocitinibMonitor Closely (1)fluvoxamine will increase the level or effect of abrocitinib by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Start abrocitinib 50 mg qDay when coadministered with CYP2C19 inhibitors. If adequate response not achieved after 12 weeks, may increase to 100 mg qDay. Discontinue if inadequate response after dosage increase.acalabrutinibMonitor Closely (1)fluvoxamine will increase the level or effect of acalabrutinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Decrease dose to 100 mg once daily if coadministered with CYP3A4 inhibitoraceclofenacMonitor Closely (1)fluvoxamine, aceclofenac. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.acemetacinMonitor Closely (1)fluvoxamine, acemetacin. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.alfentanilMonitor Closely (1)fluvoxamine will increase the level or effect of alfentanil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)fluvoxamine and alfentanil both increase serotonin levels. Avoid or Use Alternate Drug.alfuzosinMonitor Closely (1)fluvoxamine and alfuzosin both increase QTc interval. Use Caution/Monitor.almotriptanMonitor Closely (1)fluvoxamine and almotriptan both increase serotonin levels. Modify Therapy/Monitor Closely.Serious - Use Alternative (1)fluvoxamine will increase the level or effect of almotriptan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.alosetronContraindicated (1)fluvoxamine will increase the level or effect of alosetron by affecting hepatic enzyme CYP1A2 metabolism. Contraindicated.Monitor Closely (1)fluvoxamine will increase the level or effect of alosetron by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.alprazolamMonitor Closely (1)fluvoxamine will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.amifampridineMonitor Closely (1)fluvoxamine increases toxicity of amifampridine by Other (see comment). Modify Therapy/Monitor Closely. Comment: Amifampridine can cause seizures. Coadministration with drugs that lower seizure threshold may increase this risk.amiodaroneMonitor Closely (1)fluvoxamine and amiodarone both increase QTc interval. Use Caution/Monitor.amisulprideSerious - Use Alternative (1)amisulpride and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug. ECG monitoring is recommended if coadministered.amitriptylineMonitor Closely (1)fluvoxamine and amitriptyline both increase QTc interval. Modify Therapy/Monitor Closely.Serious - Use Alternative (1)fluvoxamine and amitriptyline both increase serotonin levels. Avoid or Use Alternate Drug.amoxapineMonitor Closely (1)fluvoxamine and amoxapine both increase QTc interval. Modify Therapy/Monitor Closely.Serious - Use Alternative (1)fluvoxamine and amoxapine both increase serotonin levels. Avoid or Use Alternate Drug.anagrelideSerious - Use Alternative (1)anagrelide and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.antipyrineMonitor Closely (1)fluvoxamine will increase the level or effect of antipyrine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.apixabanMonitor Closely (1)fluvoxamine increases effects of apixaban by anticoagulation. Use Caution/Monitor. SSRIs may inhibit platelet aggregation, thus increase bleeding risk when coadministered with anticoagulants.arsenic trioxideSerious - Use Alternative (1)fluvoxamine and arsenic trioxide both increase QTc interval. Avoid or Use Alternate Drug.asenapineMonitor Closely (1)fluvoxamine will increase the level or effect of asenapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. Dose reduction may be necessarySerious - Use Alternative (1)asenapine and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.asenapine transdermalMonitor Closely (1)fluvoxamine will increase the level or effect of asenapine transdermal by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. Dose reduction may be necessarySerious - Use Alternative (1)asenapine transdermal and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.aspirinMonitor Closely (1)fluvoxamine, aspirin. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding SSRIs inhib. serotonin uptake by platelets.aspirin rectalMonitor Closely (1)fluvoxamine, aspirin rectal. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding SSRIs inhib. serotonin uptake by platelets.atogepantMonitor Closely (1)fluvoxamine will increase the level or effect of atogepant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.avanafilMonitor Closely (1)fluvoxamine will increase the level or effect of avanafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Maximum recommended dose of STENDRA is 50mg, not to exceed once every 24hr for patients taking concomitant moderate CYP3A4 inhibitorsavapritinibSerious - Use Alternative (1)fluvoxamine will increase the level or effect of avapritinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of avapritinib with moderate CYP3A4 inhibitors. If unable to avoid, reduce avapritinib starting dose. See drug monograph Dosage ModificationsaxitinibMonitor Closely (1)fluvoxamine will increase