Luvox and Pirfenidone

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.

FluvoxaMINE may significantly increase the blood levels of pirfenidone. This can increase the risk and/or severity of side effects such as liver problems, sensitivity to sunlight, rash, dizziness, diarrhea, nausea, vomiting, and upset stomach. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. You should seek immediate medical attention if you develop fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, dark colored urine, light colored stools, and/or yellowing of the skin or eyes, as these may be signs and symptoms of liver damage. 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.

GENERALLY AVOID: Coadministration with potent inhibitors of CYP450 1A2 may significantly increase the plasma concentrations of pirfenidone, which is primarily (70% to 80%) metabolized by the isoenzyme. Other CYP450 isoenzymes also contribute to a minor extent, including CYP450 2C9, 2C19, 2D6, and 2E1. In 25 healthy nonsmokers and 25 smokers who were administered a single dose of pirfenidone with the potent CYP450 1A2 inhibitor fluvoxamine (50 mg at bedtime for 3 days; 50 mg twice a day for 3 days; then 50 mg in the morning and 100 mg at bedtime for 4 days), pirfenidone systemic exposure (AUC) increased approximately 4-fold in nonsmoking subjects and 7-fold in smoking subjects. Fluvoxamine also inhibits CYP450 2C9, 2C19 and 2D6, although the extent to which these effects contribute to the interaction has not been established.

MANAGEMENT: Concomitant use of pirfenidone with potent CYP450 1A2 inhibitors such as fluvoxamine and enoxacin should generally be avoided. These drugs should be discontinued prior to the initiation of pirfenidone and avoided during therapy. If coadministration is required, pirfenidone maintenance dosage should be reduced to 267 mg three times a day. Patients should be closely monitored for adverse reactions such as hepatotoxicity, photosensitivity, rash, nausea, diarrhea, vomiting and dyspepsia, and consideration be given to brief interruption or permanent discontinuation of pirfenidone if clinically necessary in accordance with the product labeling. Canadian and some European health authorities consider the concomitant use of pirfenidone and fluvoxamine to be contraindicated.

Luvox

Generic Name: fluvoxamine

Brand name: Luvox, Luvox CR

Synonyms: n.a.

What is Luvox?

Pirfenidone

Generic Name: pirfenidone

Brand name: Esbriet

Synonyms: n.a.

What is Pirfenidone?