Compatibility «Fluvoxamine» and «Clozapine»

• Interactions Fluvoxamine with Clozapine

  • Dangerous interactions
    • ⓘ When used concomitantly with fluoxetine, paroxetine, sertraline, fluvoxamine, it is possible to increase the concentration of clozapine in blood plasma, which in some patients is accompanied by manifestations of toxicity.
  • Negative interactions
    • ⓘ Increases plasma concentrations of propranolol (5 times), metoprolol and other beta-blockers, indirect anticoagulants, warfarin (98%), carbamazepine, clozapine (3 times), tricyclic antidepressants (amitriptyline, clomipramine, imipramine).
    • ⓘ Taking fluvoxamine simultaneously with antipsychotics of the butyrophenone group, including haloperidol, leads to an increase in their plasma concentration or to a 2-10-fold increase in fluvoxamine content.
    • ⓘ With the simultaneous use of fluvoxamine, an increase in plasma concentrations of tricyclic antidepressants (for example, clomipramine, imipramine, amitriptyline) and neuroleptics (for example, clozapine, olanzapine, quetiapine) was observed, which are largely metabolized by the cytochrome P4501A2 isoenzyme.
    • ⓘ Concomitant use with drugs that inhibit the activity of cytochrome CYP450 isoenzymes, such as cimetidine (inhibitor of CYP1A2, 3A4, and 2D6 isoenzymes) or erythromycin (inhibitor of CYP3A4 isoenzyme), clarithromycin, azithromycin, fluvoxamine (1A2), perazine (1A2) or ciprofloxacin (1A2) and hormonal oral contraceptives (1A2, 3A4, 2C19) with clozapine in high doses led to an increase in the concentration of clozapine in blood plasma and the occurrence of adverse reactions.
    • ⓘ In patients receiving clozapine simultaneously with fluvoxamine, an inhibitor of CYP3A4 and CYP1A2 isoenzymes, an increase in the concentration of the former in blood plasma (up to 10 times) or other selective serotonin reuptake inhibitors, such as paroxetine (inhibitor of CYP1A2 and CYP2D6 isoenzymes), sertraline (inhibitor of CYP2C8/9 and CYP2D6 isoenzymes), fluoxetine ( inhibitor CYP2D6 isoenzyme, increased up to 2 times) or citalopram (possibly a weak inhibitor of the CYP1A2 isoenzyme, which most likely has the weakest ability among all serotonin reuptake inhibitors, causing the development of clinically significant interaction).
  • Unclear interactions
    • ⓘ Tricyclic antidepressants and antipsychotics.

Decoding the colors of interactions and contraindications

Dangerous	—	a pronounced negative interaction or contraindication.
Negative	—	negative interaction or side effect that may reduce effectiveness.
Positive	—	the interaction can SOMETIMES be used as a positive (often a dose adjustment is needed), or it is an indication.
No	—	the drugs do NOT interact, which is separately indicated in the instructions.
Unclear	—	the system failed to pre-assess the danger.

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Additional information

• Kiberis checks interactions and evaluates drug compatibility for free online right in the instructions thanks to the latest artificial intelligence technologies. The accuracy of finding is more than 95%, the accuracy of the hazard assessment is more than 80%. The online medical service takes into account all the drug groups of the selected drugs and all their components. And since the database contains 25,000 drugs with detailed instructions, not every pharmacologist can compete with our artificial intelligence. List of popular interactions.
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• The use of information about interactions is only possible as an introduction. This information should not be used to adjust therapy without consulting a specialist.
• The article is written: artificial intelligence Kiberis
• Sources: official instructions for medicines and their active substances, as well as inter-group interactions described in medical studies and textbooks.
• Total analyzed: 170,039,738 possible combinations of drugs and their components were found 412,575 interacting combinations.
• Medicine section: Standard evidence-based medicine
• The date of the last update of the interaction database: 2026-05-28

Category - medicine