Drug Interactions
Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor or pharmacist first. This drug should not be used with the following medications because very serious interactions may occur: alosetron, cisapride, diazepam, pimozide, ramelteon, sibutramine, thioridazine, tizanidine. Avoid taking MAO inhibitors (e.g., furazolidone, isocarboxazid, linezolid, moclobemide, phenelzine, procarbazine, rasagiline, selegiline, tranylcypromine) within 2 weeks before, during, and after treatment with this medication. In some cases a serious, possibly fatal drug interaction may occur. If you are currently using any of these medications listed above, tell your doctor or pharmacist before starting fluvoxamine. Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially: antipsychotics (e.g., olanzapine, clozapine), "water pills"/diuretics (e.g., furosemide), drugs that can cause bleeding/bruising (e.g., "blood thinners" such as heparin or warfarin, anti-platelet drugs including aspirin, NSAIDs such as ibuprofen), drugs removed from your body by certain liver enzymes (e.g., methadone, mexiletine, melatonin, tacrine, theophylline, certain benzodiazepines such as alprazolam/triazolam, certain anti-seizure drugs such as carbamazepine/phenytoin, certain beta blockers such as metoprolol/propranolol). Check all prescription and nonprescription medicine labels carefully since many medications contain pain relievers/fever reducers (NSAIDs such as aspirin, ibuprofen, naproxen) that may increase your risk for bleeding if taken together with this drug. Low-dose aspirin should be continued if prescribed by your doctor for specific medical reasons such as heart attack or stroke prevention (usually at dosages of 81-325 milligrams per day). Consult your doctor or pharmacist for more details. Also tell your doctor if you take any other drugs that increase serotonin, such as amphetamines (e.g., dextroamphetamine), bromocriptine, buspirone, dextromethorphan, lithium, meperidine, propoxyphene, phentermine, tramadol, tryptophan, St. John's wort, drugs used to treat migraines (e.g., dihydroergotamine, "triptans" such as sumatriptan), street drugs such as MDMA/"ecstasy," certain antidepressants including other SSRIs (e.g., citalopram, paroxetine) and SNRIs (e.g., duloxetine, venlafaxine). Also report the use of drugs that might increase seizure risk when combined with fluvoxamine such as isoniazid (INH), tramadol, bupropion, or tricyclic antidepressants (e.g., amitriptyline, clomipramine), among others. Consult your doctor or pharmacist for details. This medication can increase the side effects of caffeine. Avoid drinking large amounts of beverages containing caffeine (coffee, tea, colas) or eating large amounts of chocolate. Tell your doctor or pharmacist if you also take drugs that cause drowsiness such as: certain antihistamines (e.g., diphenhydramine), medicine for sleep or anxiety (e.g., lorazepam, zolpidem), muscle relaxants, narcotic pain relievers (e.g., codeine). Check the labels on all your medicines (e.g., cough-and-cold products) because they may contain dextromethorphan, caffeine, or ingredients that cause drowsiness. Ask your pharmacist about using those products safely. Cigarette smoking decreases blood levels of this medication. Tell your doctor if you smoke or if you have recently stopped smoking. This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.