level or effect of mexiletine by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug.milnacipranfluvoxamine and milnacipran both increase serotonin levels. Avoid or Use Alternate Drug.mirtazapinemirtazapine and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.mobocertinibfluvoxamine will increase the level or effect of mobocertinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If use of moderate CYP3A4 inhibitor unavoidable, reduce mobocertinib dose by ~50% (eg, 160 to 80 mg); closely monitor QTc interval.nefazodonefluvoxamine and nefazodone both increase serotonin levels. Avoid or Use Alternate Drug.neratinibfluvoxamine will increase the level or effect of neratinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.netupitant/palonosetronfluvoxamine increases toxicity of netupitant/palonosetron by serotonin levels. Avoid or Use Alternate Drug.nortriptylinefluvoxamine and nortriptyline both increase serotonin levels. Avoid or Use Alternate Drug.olanzapinefluvoxamine will increase the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug.olanzapine and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.olopatadine intranasalfluvoxamine and olopatadine intranasal both increase sedation. Avoid or Use Alternate Drug. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment. omaveloxolonefluvoxamine will increase the level or effect of omaveloxolone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If unavoidable, reduce omaveloxolone dose to 100 mg/day. Closely monitor for adverse effects. If adverse effects emerge, further reduce to 50 mg/day. omeprazolefluvoxamine will increase the level or effect of omeprazole by affecting hepatic enzyme CYP2C19 metabolism. Avoid or Use Alternate Drug.ondansetronfluvoxamine and ondansetron both increase serotonin levels. Avoid or Use Alternate Drug.oxaliplatinoxaliplatin and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.ozanimodozanimod increases toxicity of fluvoxamine by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Because active metabolite of ozanimod inhibits MAO-B in vitro, there is 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. .pacritinibfluvoxamine will increase the level or effect of pacritinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.palonosetronfluvoxamine and palonosetron both increase serotonin levels. Avoid or Use Alternate Drug.paroxetinefluvoxamine and paroxetine both increase serotonin levels. Avoid or Use Alternate Drug.pazopanibfluvoxamine will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If it must be coadminister, decrease pazotinib dose to 400 mg/daypentamidinefluvoxamine and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.pexidartinibfluvoxamine will increase the level or effect of pexidartinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration with strong or moderate CYP3A4 inhibitors is unavoidable, reduce pexidartinib dose (refer to drug monograph dosage modifications). After discontinuing the CYP3A4 inhibitor for 3 elimination half-lives, may resume previous pexidartinib dose.phenelzinefluvoxamine and phenelzine both increase serotonin levels. Contraindicated.phenterminefluvoxamine and phentermine both increase serotonin levels. Avoid or Use Alternate Drug.pimozidefluvoxamine increases toxicity of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.fluvoxamine and pimozide both increase QTc interval. Avoid or Use Alternate Drug.pirfenidonefluvoxamine will increase the level or effect of pirfenidone by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug. Use of strong CYP1A2 inhibitors should be discontinued before initiating treatment and avoided during treatment; if strong CYP1A2 inhibitor is only option, dosage reduction recommendedpomalidomidefluvoxamine will increase the level or effect of pomalidomide by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug.procainamidefluvoxamine and procainamide both increase QTc interval. Avoid or Use Alternate Drug.procarbazinefluvoxamine and procarbazine both increase serotonin levels. Contraindicated.protriptylinefluvoxamine and protriptyline both increase serotonin levels. Avoid or Use Alternate Drug.quinidinefluvoxamine and quinidine both increase QTc interval. Avoid or Use Alternate Drug.ranolazinefluvoxamine will increase the level or effect of ranolazine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.rasagilinefluvoxamine and rasagiline both increase serotonin levels. Avoid or Use Alternate Drug. Severe CNS toxicity associated with hyperpyrexia reported with combined treatment of antidepressant and rasagiline; avoid combination within 14 days of MAOI useremifentanilfluvoxamine and remifentanil both increase serotonin levels. Avoid or Use Alternate Drug.ropinirolefluvoxamine will increase the level or effect of ropinirole by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug.selegilinefluvoxamine and selegiline both increase serotonin levels. Contraindicated. At least 14 days should elapse between discontinuation of either drug and initiation of the other oneselegiline transdermalfluvoxamine and selegiline transdermal both increase serotonin levels. Avoid or Use Alternate Drug.selinexorselinexor, fluvoxamine. 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.sertralinefluvoxamine and sertraline both increase serotonin levels. Avoid or Use Alternate Drug.sertraline and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.sevofluranesevoflurane and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.siponimodfluvoxamine will increase the level or effect of siponimod by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration with a moderate or strong CYP3A4 inhibitor PLUS a moderate or strong CYP2C9 inhibitor not recommendedsiponimod and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.sotalolfluvoxamine and sotalol both increase QTc interval. Avoid or Use Alternate Drug.St John's Wortfluvoxamine and St John's Wort both increase serotonin levels. Avoid or Use Alternate Drug.tazemetostatfluvoxamine will increase the level or effect of tazemetostat 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 Modificationstedizolidfluvoxamine and tedizolid both increase serotonin levels. Avoid or Use Alternate Drug.tetrabenazinetetrabenazine and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.theophyllinefluvoxamine will increase the level or effect of theophylline by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug.thioridazinefluvoxamine will increase the level or effect of thioridazine by affecting hepatic enzyme CYP1A2 metabolism. Contraindicated.fluvoxamine and thioridazine both increase QTc interval. Contraindicated.tipranavirtipranavir will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.tizanidinefluvoxamine will increase the level or effect of tizanidine by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug.tolvaptanfluvoxamine will increase the level or effect of tolvaptan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.tranylcyprominefluvoxamine and tranylcypromine both increase serotonin levels. Contraindicated.trazodonefluvoxamine and trazodone both increase serotonin levels. Avoid or Use Alternate Drug.trimipraminefluvoxamine will increase the level or effect of trimipramine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.venlafaxinefluvoxamine and venlafaxine both increase serotonin levels. Avoid or Use Alternate Drug.vilazodonefluvoxamine and vilazodone both increase serotonin levels. Avoid or Use Alternate Drug. Discontinue concomitant therapy immediately if signs and symptoms of serotonin syndrome emerge and supportive sympathomimetic treatment should be initiatedvortioxetinefluvoxamine, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.Monitor Closely (322)5-HTPfluvoxamine and 5-HTP both increase serotonin levels. Modify Therapy/Monitor Closely.abirateroneabiraterone 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 substrateabrocitinibfluvoxamine 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.acalabrutinibfluvoxamine 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 inhibitoraceclofenacfluvoxamine, 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.acemetacinfluvoxamine, 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.alfentanilfluvoxamine will increase the level or effect of alfentanil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.alfuzosinfluvoxamine and alfuzosin both increase QTc interval. Use Caution/Monitor.almotriptanfluvoxamine and almotriptan both increase serotonin levels. Modify Therapy/Monitor Closely.alosetronfluvoxamine will increase the level or effect of alosetron by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.alprazolamfluvoxamine will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.amifampridinefluvoxamine 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.amiodaronefluvoxamine and amiodarone both increase QTc interval. Use Caution/Monitor.amitriptylinefluvoxamine and amitriptyline both increase QTc interval. Modify Therapy/Monitor Closely.amoxapinefluvoxamine and amoxapine both increase QTc interval. Modify Therapy/Monitor Closely.antipyrinefluvoxamine will increase the level or effect of antipyrine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.apixabanfluvoxamine increases effects of apixaban by anticoagulation. Use Caution/Monitor. SSRIs may inhibit platelet aggregation, thus increase bleeding risk when coadministered with anticoagulants.asenapinefluvoxamine will increase the level or effect of asenapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. Dose reduction may be necessaryasenapine transdermalfluvoxamine will increase the level or effect of asenapine transdermal by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. Dose reduction may be necessaryaspirinfluvoxamine, 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 rectalfluvoxamine, 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.atogepantfluvoxamine will increase the level or effect of atogepant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.avanafilfluvoxamine 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 inhibitorsaxitinibfluvoxamine will increase the level or effect of axitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.belzutifanfluvoxamine will increase the level or effect of belzutifan by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Belzutifan is a CYP2C19 substrate. Coadministration with CYP2C19 inhibitors may increase incidence or severity of adverse effects. Monitor for anemia and hypoxia and reduce belzutifan dose as recommended. bendamustinefluvoxamine will increase the level or effect of bendamustine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. Decreased conversion of bendamustine to active metabolite. May decrease concentration of active metabolitesbenzhydrocodone/acetaminophenfluvoxamine, benzhydrocodone/acetaminophen. Either increases toxicity of the other by serotonin levels. Use Caution/Monitor. If concomitant use warranted, carfully observe patient, particularly during treatment initiation and dose adjustment.betrixabanfluvoxamine, betrixaban. Either increases toxicity of the other by anticoagulation. Use Caution/Monitor.bexarotenefluvoxamine will increase the level or effect of bexarotene by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.bortezomibfluvoxamine will increase the level or effect of bortezomib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.bosentanfluvoxamine will increase the level or effect of bosentan by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.budesonidefluvoxamine will increase the level or effect of budesonide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.buprenorphine subdermal implantfluvoxamine and buprenorphine subdermal implant both increase serotonin levels. Use Caution/Monitor. If concomitant use warranted, carefully observe patient, particularly during treatment initiation, and during dose adjustment of serotonergic drug. Discontinue buprenorphine if serotonin syndrome suspectedbuprenorphine, long-acting injectionfluvoxamine and buprenorphine, long-acting injection both increase serotonin levels. Use Caution/Monitor. If concomitant use warranted, carefully observe patient, particularly during treatment initiation, and during dose adjustment of serotonergic drug. Discontinue buprenorphine if serotonin syndrome suspectedbupropionfluvoxamine will increase the level or effect of bupropion by affecting hepatic enzyme CYP2B6 metabolism. Use Caution/Monitor.buspironefluvoxamine will increase the level or effect of buspirone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.caffeinefluvoxamine will increase the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.cannabidiolfluvoxamine will increase the level or effect of cannabidiol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Consider reducing cannabidiol dose when coadministered with a moderate CYP3A4 inhibitorcarbamazepinefluvoxamine will increase the level or effect of carbamazepine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Monitor plasma levels when used concomitantlycarvedilolfluvoxamine will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.celecoxibfluvoxamine will increase the level or effect of celecoxib by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.chlorpromazinefluvoxamine and chlorpromazine both increase QTc interval. Modify Therapy/Monitor Closely.choline magnesium trisalicylatefluvoxamine, choline magnesium trisalicylate. Either decreases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding SSRIs inhib. serotonin uptake by platelets.cilostazolfluvoxamine will increase the level or effect of cilostazol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.cimetidinecimetidine will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP2D6 metabolism. Use