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Drug Interactions between fluvoxamine and mexiletine

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

mexiletine fluvoxaMINE

Applies to: mexiletine and fluvoxamine

MONITOR: Coadministration with fluvoxamine may increase the serum concentrations of mexiletine. The proposed mechanism is decreased clearance of mexiletine due to inhibition of the CYP450 1A2 and possibly 2D6 isoenzymes by fluvoxamine. In a randomized, crossover study consisting of six healthy subjects, fluvoxamine (50 mg orally twice a day for 7 days) increased the peak serum concentration (Cmax) and area under the concentration-time curve (AUC) of a single dose of mexiletine (200 mg) by 16% and 55%, respectively. The oral clearance decreased by 38%.

MANAGEMENT: Caution is advised during concomitant therapy with fluvoxamine and mexiletine. Serum mexiletine levels and electrocardiographic readings should be monitored closely and the dosage adjusted accordingly, particularly following initiation or discontinuation of fluvoxamine in patients who are stabilized on their antiarrhythmic regimen.

References

  1. Kusumoto M, Ueno K, Oda A, Takeda K, Mashimo K, Takaya K, Fujimura Y, Nishihori T, Tanaka K (2001) "Effect of fluvoxamine on the pharmacokinetics of mexiletine in healthy Japanese men." Clin Pharmacol Ther, 69, p. 104-7

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Drug and food interactions

Moderate

fluvoxaMINE food

Applies to: fluvoxamine

GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

MANAGEMENT: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

References

  1. Warrington SJ, Ankier SI, Turner P (1986) "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology, 15, p. 31-7
  2. Gilman AG, eds., Nies AS, Rall TW, Taylor P (1990) "Goodman and Gilman's the Pharmacological Basis of Therapeutics." New York, NY: Pergamon Press Inc.
  3. (2012) "Product Information. Fycompa (perampanel)." Eisai Inc
  4. (2015) "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc
View all 4 references

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Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

See also

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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