Can you take Fluoxetine with Osimertinib?
1 drug interaction and 34 additional warnings found for the following 2 drugs:
- fluoxetine
- osimertinib
Drug interactions
Major drug interactions
Major:
FLUoxetine osimertinib
Applies to: fluoxetine and osimertinib
Using osimertinib together with FLUoxetine can increase the risk of an irregular heart rhythm that may be serious and potentially life-threatening, although it is a relatively rare side effect.
You may be more susceptible if you have:
- a heart condition called congenital long QT syndrome
- other cardiac diseases
- conduction abnormalities
- electrolyte disturbances (for example, magnesium or potassium loss due to severe or prolonged diarrhea or vomiting)
Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications.
You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with these medications, whether together or alone.
It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Food/lifestyle interactions
Moderate food/lifestyle interactions
Moderate:
FLUoxetine Food/Lifestyle
Applies to: fluoxetine
Alcohol can increase the nervous system side effects of FLUoxetine such as:
- dizziness
- drowsiness
- difficulty concentrating
Some people may also experience impairment in thinking and judgment.
You should avoid or limit the use of alcohol while being treated with FLUoxetine.
Do not use more than the recommended dose of FLUoxetine, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you.
Talk to your doctor or pharmacist if you have any questions or concerns.
Disease interactions
33 potential interactions Applies to: 28 conditions, including Depression, Bipolar Disorder, Heart Failure, Seizures, and Arrhythmia.
Anorexia/Feeding Problems
Minor:
fluoxetine
FLUoxetine has a minor potential interaction with 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.
Arrhythmia
Major:
osimertinib
Osimertinib has a major potential interaction with Arrhythmia.
QT prolongation was observed in patients treated with certain EGFR inhibitors. These agents should be administered with caution in patients with congenital long QTc syndrome, congestive heart failure, electrolyte abnormalities, or those who are taking medications known to prolong the QTc interval. Serum electrolytes should be corrected prior to initiating therapy with these agents. Periodic monitoring of ECGs and electrolytes is recommended in these patients. Permanently discontinue the use of these agents in patients who develop QTc interval prolongation with signs/symptoms of life-threatening arrhythmia.
Bipolar Disorder
Moderate:
fluoxetine
FLUoxetine has a moderate potential interaction with Bipolar Disorder.
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.
Bleeding Disorder
Moderate:
fluoxetine
FLUoxetine has a moderate potential interaction with Bleeding Disorder.
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.
Coagulation Defects and Disorders
Moderate:
fluoxetine
FLUoxetine has a moderate potential interaction with Coagulation Defects and Disorders.
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.
Dehydration
Moderate:
fluoxetine
FLUoxetine has a moderate potential interaction with Dehydration.
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.
Depression
Major:
fluoxetine
FLUoxetine has a major potential interaction with Depression.
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
FLUoxetine has a moderate potential interaction with 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.
Dermatitis, Drug-Induced
Major:
osimertinib
Osimertinib has a major potential interaction with Dermatitis, Drug-Induced.
Cutaneous reactions, in some cases severe, have been reported with the use of EGFR inhibitors. Monitor patients who develop dermatologic or soft tissue toxicities while receiving these agents for the development of inflammatory or infectious sequelae. It is recommended to withhold treatment, and appropriate measures should be instituted as appropriate or discontinue the use of these agents for dermatologic or soft tissue toxicity associated with severe or life-threatening inflammatory or infectious complications. Advise patients to wear sunscreen and hats and limit sun exposure while receiving therapy with these agents as exposure to sunlight can exacerbate dermatologic toxicities.
Diabetes Mellitus
Moderate:
fluoxetine
FLUoxetine has a moderate potential interaction with 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.
Eye Conditions
Major:
osimertinib
Osimertinib has a major potential interaction with Eye Conditions.
Some epidermal growth factor receptor (EGFR) inhibitors should be administered cautiously in patients with ocular disorders such as primary keratitis, ulcerative keratitis, or conjunctivitis. It is recommended to interrupt or discontinue treatment with these agents if patients present with acute or worsening ocular disorders.
Failure to Thrive
Minor:
fluoxetine
FLUoxetine has a minor potential interaction with Failure to Thrive.
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.
Fever
Major:
osimertinib
Osimertinib has a major potential interaction with Fever.
The use of certain EGFR inhibitors has been associated with pulmonary toxicity. Serious cases of interstitial lung disease (ILD), including fatal cases and interstitial pneumonitis or pulmonary fibrosis have been reported. Caution is recommended when using these agents in patients with a history of interstitial pneumonitis or pulmonary fibrosis or those patients presenting with acute onset of new or progressive unexplained pulmonary symptoms such as dyspnea, cough, and fever pending diagnostic evaluation. If ILD is confirmed, permanently discontinue these agents and institute appropriate measures.
Glaucoma, Narrow Angle
Moderate:
fluoxetine
FLUoxetine has a moderate potential interaction with 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.
Heart Failure
Major:
osimertinib
Osimertinib has a major potential interaction with Heart Failure.
QT prolongation was observed in patients treated with certain EGFR inhibitors. These agents should be administered with caution in patients with congenital long QTc syndrome, congestive heart failure, electrolyte abnormalities, or those who are taking medications known to prolong the QTc interval. Serum electrolytes should be corrected prior to initiating therapy with these agents. Periodic monitoring of ECGs and electrolytes is recommended in these patients. Permanently discontinue the use of these agents in patients who develop QTc interval prolongation with signs/symptoms of life-threatening arrhythmia.
Hyponatremia
Moderate:
fluoxetine
FLUoxetine has a moderate potential interaction with Hyponatremia.
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.
Moderate:
fluoxetine
FLUoxetine has a moderate potential interaction with 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.
Liver Disease
Moderate:
fluoxetine
FLUoxetine has a moderate potential interaction with 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.
Moderate:
osimertinib
Osimertinib has a moderate potential interaction with Liver Disease.
No formal pharmacokinetic studies of osimertinib have been conducted in patients with renal or hepatic impairment. Based on population pharmacokinetic (PK) analysis of osimertinib, no dose adjustment is recommended in patients with mild (CrCl 60-89 mL/min) or moderate (CrCl 30-59 mL/min) renal impairment, or mild hepatic impairment (total bilirubin
Long QT Syndrome
Moderate:
fluoxetine
FLUoxetine has a moderate potential interaction with Long QT Syndrome.
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.
Malnourishment
Minor:
fluoxetine
FLUoxetine has a minor potential interaction with Malnourishment.
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.
Mania
Moderate:
fluoxetine
FLUoxetine has a moderate potential interaction with Mania.
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.
Psychosis
Major:
fluoxetine
FLUoxetine has a major potential interaction with 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.
Pulmonary Impairment
Major:
osimertinib
Osimertinib has a major potential interaction with Pulmonary Impairment.
The use of certain EGFR inhibitors has been associated with pulmonary toxicity. Serious cases of interstitial lung disease (ILD), including fatal cases and interstitial pneumonitis or pulmonary fibrosis have been reported. Caution is recommended when using these agents in patients with a history of interstitial pneumonitis or pulmonary fibrosis or those patients presenting with acute onset of new or progressive unexplained pulmonary symptoms such as dyspnea, cough, and fever pending diagnostic evaluation. If ILD is confirmed, permanently discontinue these agents and institute appropriate measures.
Renal Dysfunction
Moderate:
osimertinib
Osimertinib has a moderate potential interaction with Renal Dysfunction.
No formal pharmacokinetic studies of osimertinib have been conducted in patients with renal or hepatic impairment. Based on population pharmacokinetic (PK) analysis of osimertinib, no dose adjustment is recommended in patients with mild (CrCl 60-89 mL/min) or moderate (CrCl 30-59 mL/min) renal impairment, or mild hepatic impairment (total bilirubin
Minor:
fluoxetine
FLUoxetine has a minor potential interaction with 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.
Seizures
Moderate:
fluoxetine
FLUoxetine has a moderate potential interaction with 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.
SIADH
Moderate:
fluoxetine
FLUoxetine has a moderate potential interaction with 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.
Thrombocytopathy
Moderate:
fluoxetine
FLUoxetine has a moderate potential interaction with Thrombocytopathy.
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.
Thrombocytopenia
Moderate:
fluoxetine
FLUoxetine has a moderate potential interaction with Thrombocytopenia.
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.
Ventricular Arrhythmia
Major:
osimertinib
Osimertinib has a major potential interaction with Ventricular Arrhythmia.
Cardiomyopathy was observed in clinical trials of certain EGFR inhibitors. Assess Left Ventricular Ejection Fraction (LVEF) by echocardiogram or multigated acquisition (MUGA) scan before initiation of these agents and then at 3 month intervals while on treatment. Caution is recommended when prescribing these agents to patients with conditions that could impair left ventricular function and it is recommended to withhold treatment with these agents if ejection fraction drops below the established lower limit of normal. For symptomatic congestive heart failure or persistent, asymptomatic LV dysfunction that does not resolve within 4 weeks, permanently discontinue these agents.
Moderate:
fluoxetine
FLUoxetine has a moderate potential interaction with 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.
Vitamin K Deficiency
Moderate:
fluoxetine
FLUoxetine has a moderate potential interaction with 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.
More resources
fluoxetine
A total of 707 drugs are known to interact with fluoxetine.
- Fluoxetine is in the drug class selective serotonin reuptake inhibitors.
-
Fluoxetine is used to treat the following conditions:
- Agoraphobia (off-label)
- Anxiety and Stress
- Binge Eating Disorder (off-label)
- Body Dysmorphic Disorder (off-label)
- Borderline Personality Disorder (off-label)
- Bulimia
- Depression
- Dissociative Identity Disorder (off-label)
- Dysautonomia (off-label)
- Excoriation Disorder (off-label)
- Fibromyalgia (off-label)
- Hot Flashes (off-label)
- Intermittent Explosive Disorder (off-label)
- Major Depressive Disorder
- Obsessive Compulsive Disorder
- PANDAS Syndrome (off-label)
- Panic Disorder
- Persistent Depressive Disorder (off-label)
- Postpartum Depression
- Premature Ejaculation (off-label)
- Premenstrual Dysphoric Disorder
- Schizoaffective Disorder
- Somatoform Pain Disorder (off-label)
- Trichotillomania (off-label)
- Vulvodynia (off-label)
osimertinib
A total of 655 drugs are known to interact with osimertinib.
- Osimertinib is in the drug class EGFR inhibitors.
- Osimertinib is used to treat Non Small Cell Lung Cancer.
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| 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. | |
| No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.