may cause sedation, as well as other cognitive and/or neuropsychiatric adverse reactions.fluoxetine increases effects of lasmiditan by serotonin levels. Use Caution/Monitor. Coadministration may increase risk of serotonin syndrome.lemborexantfluoxetine will increase the level or effect of lemborexant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Lower nightly dose of lemborexant recommended if coadministered with weak CYP3A4 inhibitors. See drug monograph for specific dosage modification.lemborexant, fluoxetine. Either increases effects of the other by sedation. Modify Therapy/Monitor Closely. Dosage adjustment may be necessary if lemborexant is coadministered with other CNS depressants because of potentially additive effects.lenvatinibfluoxetine and lenvatinib both increase QTc interval. Use Caution/Monitor. Lenvatinib prescribing information recommends monitoring ECG closely when coadministered with QT prolonging drugs.levalbuterolfluoxetine and levalbuterol 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 systemlevofloxacinfluoxetine and levofloxacin both increase QTc interval. Use Caution/Monitor.levoketoconazolefluoxetine and levoketoconazole both increase QTc interval. Modify Therapy/Monitor Closely.lisdexamfetaminefluoxetine, lisdexamfetamine. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Initiate with lower doses and monitor for signs and symptoms of serotonin syndrome, particularly during initiation or dosage increase. If serotonin syndrome occurs, discontinue along with concomitant serotonergic drug(s).lithiumfluoxetine and lithium both increase serotonin levels. Modify Therapy/Monitor Closely.lithium and fluoxetine both increase QTc interval. Use Caution/Monitor.lofexidinefluoxetine will increase the level or effect of lofexidine by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Concomitant use of lofexidine with strong CYP2D6 inhibitors may increase lofexidine plasma levels. Monitor for symptoms of orthostasis and bradycardia if coadministered with a CYP2D6 inhibitor. Consider lofexidine dose reduction.fluoxetine and lofexidine both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended.lomitapidefluoxetine increases levels of lomitapide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Lomitapide dose should not exceed 30 mg/day.loratadinefluoxetine will increase the level or effect of loratadine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.lorcaserinlorcaserin will increase the level or effect of fluoxetine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.lornoxicamfluoxetine, lornoxicam. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.losartanfluoxetine will increase the level or effect of losartan by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. May inhibit the conversion of losartan to its active metabolite E-3174. Importance of interaction not established; monitor individual therapeutic response to determine losartan dosage.lsdfluoxetine and lsd both increase serotonin levels. Modify Therapy/Monitor Closely.lumacaftor/ivacaftorlumacaftor/ivacaftor, fluoxetine. affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. In vitro studies suggest that lumacaftor may induce and ivacaftor may inhibit CYP2C9 substrates. .lumefantrinefluoxetine and lumefantrine both increase QTc interval. Modify Therapy/Monitor Closely.lurasidonelurasidone, fluoxetine. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Potential for increased CNS depressant effects when used concurrently; monitor for increased adverse effects and toxicity.maprotilinemaprotiline and fluoxetine both increase QTc interval. Modify Therapy/Monitor Closely.meclofenamatefluoxetine, meclofenamate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.mefenamic acidfluoxetine, mefenamic 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.meloxicamfluoxetine will increase the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.fluoxetine, meloxicam. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.metforminfluoxetine increases effects of metformin by pharmacodynamic synergism. Use Caution/Monitor.methadonefluoxetine and methadone both increase QTc interval. Use Caution/Monitor.methylphenidate transdermalmethylphenidate transdermal will increase the level or effect of fluoxetine by decreasing metabolism. Modify Therapy/Monitor Closely. Consider decreasing the dose of these drugs when given coadministered with methylphenidate. Monitor for drug toxiticities when initiating or discontinuing methylphenidate. midazolam intranasalfluoxetine will increase the level or effect of midazolam intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration of mild CYP3A4 inhibitors with midazolam intranasal may cause higher midazolam systemic exposure, which may prolong sedation.midazolam intranasal, fluoxetine. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Concomitant use of barbiturates, alcohol, or other CNS depressants may increase the risk of hypoventilation, airway obstruction, desaturation, or apnea and may contribute to profound and/or prolonged drug effect.mifepristonemifepristone, fluoxetine. QTc interval. Modify Therapy/Monitor Closely. Use alternatives if available.mipomersenmipomersen, fluoxetine. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Both drugs have potential to increase hepatic enzymes; monitor LFTs.mirabegronmirabegron will increase the level or effect of fluoxetine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.mirtazapinefluoxetine and mirtazapine both increase serotonin levels. Modify Therapy/Monitor Closely.morphinefluoxetine and morphine both increase serotonin levels. Modify Therapy/Monitor Closely.moxifloxacinfluoxetine and moxifloxacin both increase QTc interval. Modify Therapy/Monitor Closely.nabumetonefluoxetine, nabumetone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.naproxenfluoxetine, naproxen. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.naratriptannaratriptan and fluoxetine both increase serotonin levels. Modify Therapy/Monitor Closely.nateglinidefluoxetine will increase the level or effect of nateglinide by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.nifedipinefluoxetine will increase the level or effect of nifedipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Consider initiating nifedipine at the lowest dose available if given concomitantly with this medicationnilotinibfluoxetine and nilotinib both increase QTc interval. Modify Therapy/Monitor Closely.nitisinonenitisinone will increase the level or effect of fluoxetine by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Nitisinone inhibits CYP2C9. Caution if CYP2C9 substrate coadministered, particularly those with a narrow therapeutic index.nortriptylinenortriptyline and fluoxetine both increase QTc interval. Modify Therapy/Monitor Closely.octreotidefluoxetine and octreotide both increase QTc interval. Modify Therapy/Monitor Closely.octreotide (Antidote)fluoxetine and octreotide (Antidote) both increase QTc interval. Modify Therapy/Monitor Closely.ofloxacinfluoxetine and ofloxacin both increase QTc interval. Use Caution/Monitor.olanzapineolanzapine and fluoxetine both increase QTc interval. Use Caution/Monitor.oliceridinefluoxetine will increase the level or effect of oliceridine by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. If concomitant use is necessary, may require less frequent oliceridine dosing. Closely monitor for respiratory depression and sedation and titrate subsequent doses accordingly. If inhibitor is discontinued, consider increase oliceridine dosage until stable drug effects are achieved. Monitor for signs of opioid withdrawal. fluoxetine, oliceridine. Either increases toxicity of the other by serotonin levels. Modify Therapy/Monitor Closely.olodaterol inhaledfluoxetine and olodaterol inhaled 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 systemosilodrostatosilodrostat and fluoxetine both increase QTc interval. Use Caution/Monitor.osimertinibosimertinib and fluoxetine both increase QTc interval. Use Caution/Monitor. Conduct periodic monitoring with ECGs and electrolytes in patients taking drugs known to prolong the QTc interval.oxaprozinfluoxetine, 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.ozanimodozanimod 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.paliperidonefluoxetine and paliperidone both increase QTc interval. Use Caution/Monitor.parecoxibfluoxetine 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.paroxetinefluoxetine and paroxetine both increase QTc interval. Use Caution/Monitor.pasireotidefluoxetine and pasireotide both increase QTc interval. Modify Therapy/Monitor Closely.peginterferon alfa 2bpeginterferon 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.pentazocinefluoxetine and pentazocine both increase serotonin levels. Modify Therapy/Monitor Closely.pentoxifyllinepentoxifylline increases toxicity of fluoxetine by anticoagulation. Use Caution/Monitor. May increase bleeding.perhexilinefluoxetine will increase the level or effect of perhexiline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.phenytoinfluoxetine will increase the level or effect of phenytoin by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.pirbuterolfluoxetine 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 systempiroxicamfluoxetine 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.pitolisantfluoxetine 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.posaconazolefluoxetine and posaconazole both increase QTc interval. Use Caution/Monitor.pregabalinpregabalin, 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.primaquineprimaquine and fluoxetine both increase QTc interval. Use Caution/Monitor.prochlorperazinefluoxetine will increase the level or effect of prochlorperazine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.prochlorperazine and fluoxetine both increase QTc interval. Use Caution/Monitor.promazinefluoxetine will increase the level or effect of promazine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.promazine and fluoxetine both increase QTc interval. Modify Therapy/Monitor Closely.promethazinepromethazine and fluoxetine both increase QTc interval. Use Caution/Monitor.protriptylineprotriptyline and fluoxetine both increase QTc interval. Modify Therapy/Monitor Closely.quetiapinequetiapine, 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.quininefluoxetine and quinine both increase QTc interval. Use Caution/Monitor.ramelteonfluoxetine will increase the level or effect of ramelteon by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.ranolazinefluoxetine and ranolazine both increase QTc interval. Use Caution/Monitor.remifentanilremifentanil, fluoxetine. Either increases toxicity of the other by serotonin levels. Modify Therapy/Monitor Closely.remimazolamremimazolam, 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.rilpivirinerilpivirine 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.risperidonefluoxetine and risperidone both increase QTc interval. Use Caution/Monitor.rivaroxabanfluoxetine increases effects of rivaroxaban by pharmacodynamic synergism. Use Caution/Monitor. Combination may increase risk of bleeding.rizatriptanrizatriptan and fluoxetine both increase serotonin levels. Modify Therapy/Monitor Closely.rolapitantrolapitant 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.romidepsinfluoxetine and romidepsin both increase QTc interval. Use Caution/Monitor.rucaparibrucaparib 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.safinamidefluoxetine, 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)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.salmeterolfluoxetine 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 systemsalsalatefluoxetine, salsalate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk