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Fluvoxamine ER Capsules and Irenka

Determining the interaction of Fluvoxamine ER Capsules and Irenka and the possibility of their joint administration.

Check result:

Fluvoxamine ER Capsules <> Irenka

Relevance: 28.06.2022 Reviewer: Shkutko P.M., M.D., in

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer:

Using DULoxetine together with fluvoxaMINE is not recommended. FluvoxaMINE can significantly increase the blood levels of DULoxetine and increase the risk of serious side effects, especially a condition called serotonin syndrome. Call your doctor immediately if you experience confusion, agitation, hallucinations, blurred vision, fast heartbeat, excessive sweating, fever, shivering, tremor, restlessness, weakness, overactive reflexes, loss of coordination, fainting, abdominal cramping, nausea, vomiting, and/or diarrhea during treatment with DULoxetine or fluvoxaMINE. You should also avoid activities requiring mental alertness such as driving or operating machinery until you know how these medications affect you. 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.

Professional:

GENERALLY AVOID: Coadministration with fluvoxamine may significantly increase the plasma concentrations of duloxetine. The mechanism is fluvoxamine inhibition of duloxetine metabolism via CYP450 1A2. In 14 male study subjects, fluvoxamine caused a 2.5-fold increase in duloxetine peak plasma concentration (Cmax), a nearly 6-fold increase in duloxetine systemic exposure (AUC), and an approximately 3-fold increase in duloxetine half-life. High plasma levels of duloxetine may increase the risk of serious cardiovascular effects such as hypertension, hypertensive crisis, increased heart rate, orthostatic hypotension, and syncope. In addition, the risk of serotonin syndrome may be potentiated, not just due to elevated levels of duloxetine but also because of additive serotonergic effects from coadministration with fluvoxamine, an SSRI. Serotonin syndrome is a rare but serious and potentially fatal condition thought to result from hyperstimulation of brainstem 5-HT1A and 2A receptors. Symptoms may include mental status changes such as irritability, altered consciousness, confusion, hallucinations, and coma; autonomic dysfunction such as tachycardia, hyperthermia, diaphoresis, shivering, blood pressure lability, and mydriasis; neuromuscular abnormalities such as hyperreflexia, myoclonus, tremor, and ataxia; and gastrointestinal symptoms such as abdominal cramping, nausea, vomiting, and diarrhea.

MANAGEMENT: Concomitant use of duloxetine with fluvoxamine should be avoided.

References

Nijhawan PK, Katz G, Winter S "Psychiatric illness and the serotonin syndrome: an emerging adverse drug effect leading to intensive care unit admission." Crit Care Med 24 (1996): 1086-9
Sternbach H "The serotonin syndrome." Am J Psychiatry 148 (1991): 705-13
Mackay FJ, Dunn NR, Mann RD "Antidepressants and the serotonin syndrome in general practice." Br J Gen Pract 49 (1999): 871-4
Martin TG "Serotonin syndrome." Ann Emerg Med 28 (1996): 520-6
Corkeron MA "Serotonin syndrome - a potentially fatal complication of antidepressant therapy." Med J Aust 163 (1995): 481-2
Nierenberg DW, Semprebon M "The central nervous system serotonin syndrome." Clin Pharmacol Ther 53 (1993): 84-8
Fischer P "Serotonin syndrome in the elderly after antidepressive monotherapy." J Clin Psychopharmacol 15 (1995): 440-2
"Product Information. Cymbalta (duloxetine)." Lilly, Eli and Company, Indianapolis, IN.
Insel TR, Roy BF, Cohen RM, Murphy DL "Possible development of the serotonin syndrome in man." Am J Psychiatry 139 (1982): 954-5
Mills KC "Serotonin syndrome: A clinical update." Crit Care Clin 13 (1997): 763

Fluvoxamine ER Capsules

Generic Name: fluvoxamine

Brand name: Luvox, Luvox CR

Synonyms: Fluvoxamine

What is Fluvoxamine ER Capsules?

Irenka

Generic Name: duloxetine

Brand name: Cymbalta, Irenka, Drizalma Sprinkle

Synonyms: n.a.

What is Irenka?

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In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

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