the level or effect of axitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.belzutifanMonitor Closely (1)fluvoxamine 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. bendamustineMonitor Closely (1)fluvoxamine 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/acetaminophenMonitor Closely (1)fluvoxamine, 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.betrixabanMonitor Closely (1)fluvoxamine, betrixaban. Either increases toxicity of the other by anticoagulation. Use Caution/Monitor.bexaroteneMonitor Closely (1)fluvoxamine will increase the level or effect of bexarotene by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.bortezomibMonitor Closely (1)fluvoxamine will increase the level or effect of bortezomib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.bosentanMonitor Closely (1)fluvoxamine will increase the level or effect of bosentan by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.budesonideMonitor Closely (1)fluvoxamine will increase the level or effect of budesonide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.buprenorphineSerious - Use Alternative (1)buprenorphine and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine buccalSerious - Use Alternative (1)buprenorphine buccal and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine subdermal implantMonitor Closely (1)fluvoxamine 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 suspectedSerious - Use Alternative (1)buprenorphine subdermal implant and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine transdermalSerious - Use Alternative (1)buprenorphine transdermal and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine, long-acting injectionMonitor Closely (1)fluvoxamine 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 suspectedSerious - Use Alternative (1)buprenorphine, long-acting injection and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.bupropionMonitor Closely (1)fluvoxamine will increase the level or effect of bupropion by affecting hepatic enzyme CYP2B6 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)fluvoxamine increases toxicity of bupropion by Other (see comment). Avoid or Use Alternate Drug. Comment: May lower seizure threshold; keep bupropion dose as low as possible.buspironeMonitor Closely (1)fluvoxamine will increase the level or effect of buspirone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)fluvoxamine and buspirone both increase serotonin levels. Avoid or Use Alternate Drug.caffeineMonitor Closely (1)fluvoxamine will increase the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.cannabidiolMonitor Closely (1)fluvoxamine 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 inhibitorcarbamazepineMonitor Closely (1)fluvoxamine will increase the level or effect of carbamazepine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Monitor plasma levels when used concomitantlycarvedilolMonitor Closely (1)fluvoxamine will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.celecoxibMonitor Closely (1)fluvoxamine will increase the level or effect of celecoxib by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.chlorpromazineMonitor Closely (1)fluvoxamine and chlorpromazine both increase QTc interval. Modify Therapy/Monitor Closely.choline magnesium trisalicylateMonitor Closely (1)fluvoxamine, 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.cilostazolMonitor Closely (1)fluvoxamine will increase the level or effect of cilostazol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)fluvoxamine increases toxicity of cilostazol by affecting hepatic enzyme CYP2C19 metabolism. Avoid or Use Alternate Drug. Decrease cilostazol dose by 50%; serum levels of 3,4-dehydrocilostazole (active metabolite) increased by strong CYP2C19 inhibitors.cimetidineMonitor Closely (1)cimetidine will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)fluvoxamine will increase the level or effect of cimetidine by affecting hepatic enzyme CYP2C19 metabolism. Avoid or Use Alternate Drug.cinacalcetMonitor Closely (1)fluvoxamine will increase the level or effect of cinacalcet by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.citalopramMonitor Closely (1)fluvoxamine will increase the level or effect of citalopram by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. Citalopram 20 mg/day is maximum recommended dose for patients taking CYP2C19 inhibitors because of the risk of QT prolongationSerious - Use Alternative (1)fluvoxamine and citalopram both increase serotonin levels. Avoid or Use Alternate Drug. Combinatiomay increase risk of serotonin syndrome or neuroleptic malignant syndromn e like reactions.clarithromycinMonitor Closely (1)fluvoxamine and clarithromycin both increase QTc interval. Modify Therapy/Monitor Closely.clobazamMonitor Closely (2)fluvoxamine will increase the level or effect of clobazam by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. Dosage adjustment may be necessary ; CYP2C19 inhibitors may result in increased exposure to N-desmethylclobazam (active metabolite) clobazam will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. May be necessary to admininister lower doses of drugs metabolized by CYP2D6 when used concomitantlyclomipramineMonitor Closely (1)fluvoxamine and clomipramine both increase QTc interval. Modify Therapy/Monitor Closely.Serious - Use Alternative (1)fluvoxamine and clomipramine both increase serotonin levels. Avoid or Use Alternate Drug.clonidineMonitor Closely (1)fluvoxamine, clonidine. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. CNS derpressant effects enhanced.clopidogrelMonitor Closely (1)fluvoxamine will increase the level or effect of clopidogrel by pharmacodynamic synergism. Use Caution/Monitor. SSRIs affect platelet activation; coadministration may increase risk of bleedingSerious - Use Alternative (1)fluvoxamine decreases effects of clopidogrel by affecting hepatic enzyme CYP2C19 metabolism. Avoid or Use Alternate Drug. Clopidogrel efficacy may be reduced by drugs that inhibit CYP2C19. Inhibition of platelet aggregation by clopidogrel is entirely due to an active metabolite. Clopidogrel is metaolized to this active metabolite in part by CYP2C19.clozapineMonitor Closely (1)fluvoxamine will increase the level or effect of clozapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.Serious - Use Alternative (1)fluvoxamine will increase the level or effect of clozapine by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug.cobicistatMonitor Closely (1)fluvoxamine will increase the level or effect of cobicistat by Other (see comment). Use Caution/Monitor. Carfully titrate dose of antidepressant to desired effect, including using lowest feasible initial or maintenance dose , and monitor its response during coadministration with SSRIs and cobicistatcocaine topicalMonitor Closely (1)fluvoxamine and cocaine topical both increase serotonin levels. Modify Therapy/Monitor Closely.colchicineSerious - Use Alternative (1)fluvoxamine will increase the level or effect of colchicine by Other (see comment). Avoid or Use Alternate Drug. Colchicine is a P-gp and CYP3A4 substrate. Avoid use with drugs that are both P-gp and strong CYP3A4 inhibitors. If coadministration is necessary, decrease colchicine dose or frequency as recommended in prescribing information. Use of any colchicine product in conjunction with strong CYP3A4 inhibitors is contraindicated in patients with renal or hepatic impairment. conivaptanMonitor Closely (1)fluvoxamine will increase the level or effect of conivaptan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.cortisoneMonitor Closely (1)fluvoxamine will increase the level or effect of cortisone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.cyclobenzaprineSerious - Use Alternative (1)fluvoxamine and cyclobenzaprine both increase serotonin levels. Avoid or Use Alternate Drug.cyclophosphamideMonitor Closely (1)fluvoxamine will increase the level or effect of cyclophosphamide by affecting hepatic enzyme CYP2B6 metabolism. Use Caution/Monitor.cyclosporineMonitor Closely (1)fluvoxamine will increase the level or effect of cyclosporine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.cyproheptadineMonitor Closely (1)cyproheptadine decreases effects of fluvoxamine by pharmacodynamic antagonism. Use Caution/Monitor. May deminish serotonergic effect of SSRIs.dacomitinibSerious - Use Alternative (1)fluvoxamine will increase the level or effect of dacomitinib by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Avoid use with CYP3D6 substrates where minimal increases in concentration of the CYP2D6 substrate may lead to serious or life-threatening toxicitiesdaridorexantMonitor Closely (2)fluvoxamine will increase the level or effect of daridorexant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Daridorexant dose should not exceed 25 mg per night when coadministered with moderate CYP3A4 inhibitors. fluvoxamine and daridorexant both increase sedation. Modify Therapy/Monitor Closely. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment. darifenacinMonitor Closely (1)fluvoxamine will increase the level or effect of darifenacin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.darunavirMonitor Closely (1)fluvoxamine will increase the level or effect of darunavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.dasatinibMonitor Closely (1)fluvoxamine and dasatinib both increase QTc interval. Modify Therapy/Monitor Closely.deferasiroxMonitor Closely (1)deferasirox will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.defibrotideMonitor Closely (1)defibrotide increases effects of fluvoxamine by Other (see comment). Use Caution/Monitor. Comment: Defibrotide may enhance effects of platelet inhibitors.deflazacortMonitor Closely (1)fluvoxamine will increase the level or effect of deflazacort by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Decrease deflazacort dose by one-third of recommended dose if coadministered with moderate or strong CYP3A4 inhibitorsdegarelixMonitor Closely (1)degarelix and fluvoxamine both increase QTc interval. Use Caution/Monitor.desfluraneSerious - Use Alternative (1)desflurane and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.desipramineMonitor Closely (1)fluvoxamine and desipramine both increase QTc interval. Modify Therapy/Monitor Closely.Serious - Use Alternative (1)fluvoxamine and desipramine both increase serotonin levels. Avoid or Use Alternate Drug.desvenlafaxineMonitor Closely (1)desvenlafaxine will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. With higher desvenlafaxine doses (eg, 400 mg) decrease CYP2D6 substrate dose by up to 50%; dose adjustment not necessary with desvenlafaxine doses <100mgSerious - Use Alternative (1)fluvoxamine and desvenlafaxine both increase serotonin levels. Avoid or Use Alternate Drug.deutetrabenazineMonitor Closely (1)deutetrabenazine and fluvoxamine both increase QTc interval. Use Caution/Monitor. At the maximum recommended dose, deutetrabenazine does not prolong QT interval to a clinically relevant extent. Certain circumstances may increase risk of torsade de pointes and/or sudden death in association with drugs that prolong the QTc interval (eg, bradycardia, hypokalemia or hypomagnesemia, coadministration with other drugs that prolong QTc interval, presence of congenital QT prolongation).dexfenfluramineMonitor Closely (1)fluvoxamine and dexfenfluramine both increase serotonin levels. Modify Therapy/Monitor Closely.dextroamphetamineMonitor Closely (1)fluvoxamine and dextroamphetamine both decrease serotonin levels. Modify Therapy/Monitor Closely.dextroamphetamine transdermalMonitor Closely (1)fluvoxamine, dextroamphetamine transdermal. Either increases effects of the other by serotonin levels. Modify Therapy/Monitor Closely. Initiate with lower doses and monitor for signs and symptoms of serotonin syndrome, particularly during initiation or dosage increase. If serotonin syndrome occurs, discontinue dextroamphetamine transdermal and concomitant serotonergic drug(s).dextromethorphanSerious - Use Alternative (1)fluvoxamine and dextromethorphan both increase serotonin levels. Avoid or Use Alternate Drug.diazepamMonitor Closely (1)fluvoxamine will increase the level or effect of diazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.diazepam intranasalMonitor Closely (1)fluvoxamine will increase the level or effect of diazepam intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. May decrease rate of diazepam elimination, causing a decrease in diazepam elimnation, thereby increasing adverse reactions to diazepamdichlorphenamideMonitor Closely (1)dichlorphenamide and fluvoxamine both decrease serum potassium. Use Caution/Monitor.diclofenacMonitor Closely (1)fluvoxamine, diclofenac. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.difelikefalinMonitor Closely (1)difelikefalin and fluvoxamine both increase sedation. Use Caution/Monitor.diflunisalMonitor Closely (1)fluvoxamine, diflunisal. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.dihydroergotamineContraindicated (1)fluvoxamine will increase the level or effect of dihydroergotamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.Monitor Closely (1)fluvoxamine and dihydroergotamine both increase serotonin levels. Modify Therapy/Monitor Closely.dihydroergotamine intranasalMonitor Closely (1)fluvoxamine and dihydroergotamine intranasal both increase serotonin levels. Modify Therapy/Monitor Closely.Serious - Use Alternative (1)fluvoxamine will increase the level or effect of dihydroergotamine intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.diltiazemMonitor Closely (1)fluvoxamine will increase the level or effect of diltiazem by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.disopyramideSerious - Use Alternative (1)fluvoxamine and disopyramide both increase QTc interval. Avoid or Use Alternate Drug.dofetilideMonitor Closely (1)fluvoxamine and dofetilide both increase QTc interval. Modify Therapy/Monitor Closely.dolasetronMonitor Closely (1)fluvoxamine and dolasetron both increase QTc interval. Use Caution/Monitor.Serious - Use Alternative (1)fluvoxamine and dolasetron both increase serotonin levels. Avoid or Use Alternate Drug.donepezilMonitor Closely (1)donepezil and fluvoxamine both increase QTc interval. Use Caution/Monitor.dosulepinSerious - Use Alternative (1)fluvoxamine and dosulepin both increase serotonin levels. Avoid or Use Alternate Drug.doxepinSerious - Use Alternative (1)fluvoxamine and doxepin both increase serotonin levels. Avoid or Use Alternate Drug.dronedaroneSerious - Use Alternative (2)dronedarone will increase the level or effect of fluvoxamine by affecting hepatic enzyme CYP2D6 metabolism. Avoid