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Rapiflux (fluoxetine) Disease Interactions

There are 12 disease interactions with Rapiflux (fluoxetine):

Major

Ssri Antidepressants (Includes Rapiflux) ↔ Depression

Severe Potential Hazard, Moderate plausibility

Applies to: Bipolar Disorder, Depression, Psychosis

Adult and pediatric patients with depression and other psychiatric disorders may experience worsening of their symptoms and may have the emergence of suicidal thoughts and behavior. Patients should be monitored appropriately and observed closely for worsening of their symptoms, suicidality or changes in their behavior, especially during the first few months of treatment, and at times of dose changes. Families and caregivers should be advised of the need for close observation and communication with the treating physician. Discontinuing the medication should be considered if symptoms are persistently worse, or abrupt in onset. It may be prudent to refrain from dispensing large quantities of medication to these patients.

Moderate

Fluoxetine (Includes Rapiflux) ↔ Diabetes

Moderate Potential Hazard, Moderate plausibility

Applies to: Diabetes Mellitus

Fluoxetine may alter blood glucose control in patients with diabetes. Hypoglycemia may occur during therapy with fluoxetine, and hyperglycemia may occur following discontinuation of the drug. Dosage adjustments in insulin and/or oral hypoglycemic medications may be necessary in patients with diabetes whenever fluoxetine therapy is initiated or discontinued.

References

  1. "Product Information. Prozac (fluoxetine)." Dista Products Company, Indianapolis, IN.
Moderate

Ssri (Includes Rapiflux) ↔ Hyponatremia

Moderate Potential Hazard, Moderate plausibility

Applies to: Hyponatremia

Treatment with SSRI antidepressants can cause hyponatremia. Caution should be used when treating patients with hyponatremia or at greater risk of hyponatremia such as the elderly, patients taking diuretics or who are volume depleted.

Moderate

Ssris (Includes Rapiflux) ↔ Glaucoma

Moderate Potential Hazard, Moderate plausibility

Applies to: Glaucoma/Intraocular Hypertension, Glaucoma (Narrow Angle)

Some SSRI antidepressants such as fluoxetine, paroxetine and sertraline may have an effect on pupil size causing dilation. This effect can potentially narrow the eye angle resulting in increased intraocular pressure and angle closure glaucoma, especially in predisposed patients. These drugs should be used with caution in patients with angle-closure glaucoma or history of glaucoma.

Moderate

Ssris (Includes Rapiflux) ↔ Liver Disease

Moderate Potential Hazard, High plausibility

Applies to: Liver Disease

Selective serotonin reuptake inhibitors (SSRIs) are primarily metabolized by the liver. The plasma concentrations of SSRIs and their metabolites may be increased and the half-lives prolonged in patients with impaired hepatic function. Dosage adjustments may be necessary in accordance with the individual product package labeling.

References

  1. Guthrie SK "Sertraline: a new specific serotonin reuptake blocker." DICP 25 (1991): 952-61
  2. "Product Information. Celexa (citalopram)." Forest Pharmaceuticals, St. Louis, MO.
  3. Finley PR "Selective serotonin reuptake inhibitors: pharmacologic profiles and potential therapeutic distinctions." Ann Pharmacother 28 (1994): 1359-69
View all 17 references
Moderate

Ssris (Includes Rapiflux) ↔ Mania

Moderate Potential Hazard, Moderate plausibility

Applies to: Mania, Bipolar Disorder, Depression

Selective serotonin reuptake inhibitors (SSRIs), like other antidepressants, may occasionally cause or activate mania or hypomania. The reported incidence ranged from 0.1% to 2% in premarketing testing of several SSRIs. Patients with bipolar disorder are generally more likely to experience mania from antidepressants. Therapy with SSRIs should be administered cautiously in patients with a history of mania or bipolar disorder. Prior to initiating treatment it is recommended to adequately screen patients for bipolar disorder, including a family history of suicide, bipolar disorder, and depression.

References

  1. Peet M "Induction of mania with selective serotonin re-uptake inhibitors and tricyclic antidepressants." Br J Psychiatry 164 (1994): 549-50
  2. "Product Information. Zoloft (sertraline)." Roerig Division, New York, NY.
  3. Guthrie SK "Sertraline: a new specific serotonin reuptake blocker." DICP 25 (1991): 952-61
View all 27 references
Moderate

Ssris (Includes Rapiflux) ↔ Platelet Function

Moderate Potential Hazard, High plausibility

Applies to: Bleeding, Coagulation Defect, Thrombocytopathy, Thrombocytopenia, Vitamin K Deficiency

The use of selective serotonin reuptake inhibitors (SSRIs) has been associated with altered platelet function. Petechiae, purpura, ecchymosis, increased bleeding times, epistaxis and gastrointestinal hemorrhage have been reported. Therapy with SSRIs should be administered cautiously in patients with severe active bleeding or a hemorrhagic diathesis.

References

  1. Hergovich N, Aigner M, Eichler HG, Entlicher J, Drucker C, Jilma B "Paroxetine decreases platelet serotonin storage and platelet function in human beings." Clin Pharmacol Ther 68 (2000): 435-42
  2. "Product Information. Zoloft (sertraline)." Roerig Division, New York, NY.
  3. Messiha FS "Fluoxetine - adverse effects and drug-drug interactions." J Toxicol Clin Toxicol 31 (1993): 603-30
View all 18 references
Moderate

Ssris (Includes Rapiflux) ↔ Qt Prolongation

Moderate Potential Hazard, Moderate plausibility

Applies to: Long QT Syndrome, Ventricular Arrhythmia

Some SSRI antidepressants such as fluoxetine and citalopram have shown to cause QT interval prolongation and ventricular arrhythmias including Torsade de Pointes. These drugs should be used with caution in patients with congenital QT syndrome, a previous personal or family history of QT prolongation, and ventricular arrhythmia. Consider periodic EKG assessment on these patients. Treatment should be discontinued and a cardiac evaluation should be considered if a patient develops signs or symptoms of ventricular arrhythmia.

Moderate

Ssris (Includes Rapiflux) ↔ Seizure Disorders

Moderate Potential Hazard, Moderate plausibility

Applies to: Seizures

Selective serotonin reuptake inhibitors (SSRIs) may trigger seizures in approximately 0.2% of patients, and some of them are not recommended in patients with unstable epilepsy. Therapy with SSRIs should be administered cautiously in patients with seizure disorders.

References

  1. Marshall RD, Printz D, Cardenas D, Abbate L, Liebowitz MR "Adverse events in PTSD patients taking fluoxetine." Am J Psychiatry 152 (1995): 1238-9
  2. Hargrave R, Martinez D, Bernstein AJ "Fluoxetine-induced seizures." Psychosomatics 33 (1992): 236-9
  3. Messiha FS "Fluoxetine - adverse effects and drug-drug interactions." J Toxicol Clin Toxicol 31 (1993): 603-30
View all 21 references
Moderate

Ssris (Includes Rapiflux) ↔ Siadh

Moderate Potential Hazard, Moderate plausibility

Applies to: Dehydration, Hyponatremia, SIADH

The use of selective serotonin reuptake inhibitors (SSRIs) has rarely been associated with hyponatremia, sometimes secondary to development of the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). These events have generally been reversible following discontinuation of SSRI therapy and/or medical intervention. SSRI-related hyponatremia may be more common in elderly female patients and those who are volume-depleted or receiving concomitant diuretic therapy. Caution may be warranted when SSRI therapy is administered in these patients and patients with preexisting hyponatremia or SIADH. Serum electrolytes, especially sodium as well as BUN and plasma creatinine, should be monitored regularly.

References

  1. Schattner A, Skurnik Y "Fluoxetine-induced SIADH." J Am Geriatr Soc 44 (1996): 1413
  2. Kessler J, Samuels SC "Sertraline and hyponatremia." N Engl J Med 335 (1996): 524
  3. Baliga RR, McHardy KC "Syndrome of inappropriate antidiuretic hormone secretion due to fluvoxamine therapy [published erratum appears in Br J Clin Pract 1993 May-Jun;47(3):119]." Br J Clin Pract 47 (1993): 62-3
View all 30 references
Moderate

Fluoxetine (Includes Rapiflux) ↔ Renal Dysfunction

Minor Potential Hazard, Low plausibility

Applies to: Renal Dysfunction

Fluoxetine is primarily metabolized by the liver. All but one metabolites are inactive, and they are excreted by the kidney. The clearance of norfluoxetine, the active metabolite, is not dependent on renal function. Dosage adjustments are generally not deemed necessary in patients with impaired renal function, although the clinical significance of possible metabolite accumulation is unknown. Caution may be warranted when fluoxetine therapy is administered in patients with severe renal dysfunction.

References

  1. Aronoff GR, Bergstrom RF, Pottratz ST, Sloan RS, Wolen RL, Lemberger L "Fluoxetine kinetics and protein binding in normal and impaired renal function." Clin Pharmacol Ther 36 (1984): 138-44
  2. "Product Information. Prozac (fluoxetine)." Dista Products Company, Indianapolis, IN.
Moderate

Ssris (Includes Rapiflux) ↔ Weight Loss

Minor Potential Hazard, Moderate plausibility

Applies to: Weight Loss/Failure to Thrive, Malnourished, Anorexia/Feeding Problems

The use of selective serotonin reuptake inhibitors (SSRIs) may occasionally cause significant weight loss, which may be undesirable in patients suffering from anorexia, malnutrition or excessive weight loss. Anorexia may occur in approximately 5% to 10% of patients. Weight change should be monitored during therapy if an SSRI is used in these patients.

References

  1. "Product Information. Celexa (citalopram)." Forest Pharmaceuticals, St. Louis, MO.
  2. Wagner W, Plekkenpol B, Gray TE, Vlaskamp H, Essers H "Review of fluvoxamine safety database." Drugs 43 Suppl 2 (1992): 48-53;disc. 53-4
  3. Fernstrom MH, Massoudi M, Kupfer DJ "Fluvoxamine and weight loss." Biol Psychiatry 24 (1988): 948-9
View all 11 references

Rapiflux (fluoxetine) drug Interactions

There are 1029 drug interactions with Rapiflux (fluoxetine)

Rapiflux (fluoxetine) alcohol/food Interactions

There is 1 alcohol/food interaction with Rapiflux (fluoxetine)

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.

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.

Do not stop taking any medications without consulting your healthcare provider.

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