Clozapine and Fluvoxamine: Drug Interaction Guide
Quick answer: This is a major interaction — avoid combining Clozapine and Fluvoxamine unless specifically directed by your doctor.
How Clozapine interacts with Fluvoxamine
Fluvoxamine potently inhibits CYP1A2, the primary enzyme metabolizing clozapine, leading to substantial increases in clozapine levels and risk of seizures, hypotension, and agranulocytosis.
What you should do
Avoid combination. If clinically necessary, reduce clozapine dose substantially (often by two-thirds) and monitor clozapine levels.
Key facts
Severity
Major — avoid combination
Mechanism
Fluvoxamine potently inhibits CYP1A2, the primary enzyme metabolizing clozapine, leading to substantial increases in clo...
Action
Avoid combination. If clinically necessary, reduce clozapine dose substantially (often by two-thirds) and monitor clozap...
Frequently asked questions
Can I take Clozapine and Fluvoxamine together?
No — this combination should generally be avoided. Avoid combination. If clinically necessary, reduce clozapine dose substantially (often by two-thirds) and monitor clozapine levels.
What is the severity of this interaction?
The interaction between Clozapine and Fluvoxamine is classified as Major — avoid combination. Fluvoxamine potently inhibits CYP1A2, the primary enzyme metabolizing clozapine, leading to substantial increases in clozapine levels and risk of seizures, hypotension, and agranulocytosis.
What should I do if I'm prescribed both?
Avoid combination. If clinically necessary, reduce clozapine dose substantially (often by two-thirds) and monitor clozapine levels. Always consult your prescribing clinician — do not stop or change medications without medical guidance.
Last reviewed: by iMedic Medical Editorial Team. Our editorial process.