Also indexed as: Faurin, Luvox
Fluvoxamine is a selective serotonin reuptake inhibitor (SSRI) drug, related to Prozac®. It is used primarily to treat
obsessive-compulsive disorder and is under investigation to treat depression.
Summary of
Interactions with Vitamins, Herbs, and Foods
In some cases, an herb or supplement may appear in more than one category, which may seem
contradictory. For clarification, read the full article for details about the summarized
interactions.
 May Be Beneficial: Side effect
reduction/prevention—Taking these supplements may help reduce the likelihood and/or
severity of a potential side effect caused by the medication. |
Ginkgo biloba
|
| May Be Beneficial: Supportive
interaction—Taking these supplements may support or otherwise help your medication
work better. |
Yohimbe*
|
Avoid: Adverse interaction—Avoid these supplements when taking this
medication because taking them together may cause undesirable or dangerous results. |
5-HTP
Grapefruit/grapefruit juice
L-tryptophan
St. John’s wort*
Tobacco
|
Check: Other—Before taking any of these supplements or eating any of
these foods with your medication, read this article in full for details. |
Melatonin
|
| Depletion or interference |
None known
|
| Reduced drug
absorption/bioavailability |
None known
|
An asterisk (*) next to an item in the summary indicates that the
interaction is supported only by weak, fragmentary, and/or contradictory scientific
evidence.
Interactions with Dietary Supplements
5-Hydroxytryptophan
(5-HTP) and L-tryptophan
Fluvoxamine works by increasing serotonin activity in the brain. 5-HTP and L-tryptophan are
converted to serotonin in the brain, and taking them with fluvoxamine may increase
fluvoxamine-induced side effects. Until more is known, 5-HTP and L-tryptophan should not be
taken with any SSRI drug, including fluvoxamine.
Melatonin
Fluvoxamine has been shown to significantly raise the amount of melatonin in the blood after
oral administration.1 Researchers suggest that fluvoxamine may inhibit elimination
of melatonin, but the clinical significance of this finding is as yet unclear.
Interactions with Herbs
Ginkgo
biloba
Ginkgo biloba extract (GBE) may reduce the side effects experienced by some persons
taking SSRIs such as fluoxetine or sertraline. An open-label study with elderly,
depressed persons found that 200–240 mg of GBE daily was effective in alleviating sexual
side effects in both men and women taking SSRIs.2
One case study reported that 180–240 mg of GBE daily reduced genital anesthesia and
sexual side effects secondary to fluoxetine use in a 37-year-old woman.3
St. John’s
wort (Hypericum perforatum)
One report describes a case of serotonin syndrome in a patient who took St. John’s wort
and trazodone, a weak SSRI drug.4
The patient experienced mental confusion, muscle twitching, sweating, flushing, and ataxia. In
another case, a patient experienced grogginess, lethargy, nausea, weakness, and fatigue after
taking one dose of paroxetine (Paxil®, an
SSRI drug related to fluvoxamine) after ten days of St. John’s wort.5 Until
more is known about interactions and adverse actions, people taking any SSRI drugs, including
fluvoxamine, should avoid St. John’s wort, unless they are being closely monitored by a
doctor.
Yohimbe
(Pausinystalia yohimbe)
The alkaloid yohimbine from the African yohimbe tree affects the nervous system in a way that
may complement fluvoxamine. One report studied
depressed people who had not responded to fluvoxamine. When 5 mg of yohimbine was added
three times each day, there was significant improvement. Some people required higher amounts
of yohimbine before their depression improved. Because yohimbine can have side effects, it
should only be taken under a doctor’s supervision. Yohimbine is a prescription drug, but
standardized extracts of yohimbe that contain yohimbine are available as a supplement.
Interactions with Foods and Other Compounds
Alcohol
SSRI drugs, including fluvoxamine, may cause dizziness or drowsiness.6 Alcohol may
intensify the drowsiness and increase the risk of accidental injury. People should avoid
alcohol-containing products during fluvoxamine treatment.
Grapefruit
In a study of healthy volunteers, ingestion of 250 ml (approximately 8 ounces) of grapefruit
juice along with fluvoxamine increased the blood level of fluvoxamine by 60%, compared with
ingestion of fluvoxamine with water.7 Because a higher concentration of the drug
could increase its adverse effects, individuals should not consume grapefruit or grapefruit
juice around the same time they take fluvoxamine.
Tobacco (Nicotiana species)
Smoking increases the metabolism of fluvoxamine, which may reduce effectiveness.8
People should avoid smoking while taking fluvoxamine.
References:1. Härtter S, Grözinger M, Weigmann H, et al. Increased
bioavailability of oral melatonin after fluvoxamine coadministration. Clin Pharmacol
Ther 2000;67:1–6.
2. Cohen AJ, Bartlik B. Ginkgo biloba for antidepressant-induced
sexual dysfunction. J Sex Marital Ther 1998;24:139–45.
3. Ellison JM, DeLuca P. Fluoxetine-induced genital anesthesia relieved
by Ginkgo biloba extract. J Clin Psychiatry 1998;59:199–200.
4. Demott K. St. John’s wort tied to serotonin syndrome. Clin
Psychiatr News 1998;26:28.
5. Gordon JB. SSRIs and St. John’s wort: possible toxicity? Am
Fam Physician 1998;57:950.
6. Threlkeld DS, ed. Central Nervous System Drugs, Antidepressants,
Selective Serotonin Reuptake Inhibitors. In Facts and Comparisons Drug Information.
St. Louis, MO: Facts and Comparisons, Apr 1997, 264s.
7. Hori H, Yoshimura R, Ueda N, et al. Grapefruit juice-fluvoxamine
interaction: is it risky or not? J Clin Psychopharmacol 2003;23:422–4
[Letter].
8. Spigset O, Carleborg L, Hedenmalm K, Dahlqvist R. Effect of cigarette
smoking on fluvoxamine pharmacokinetics in humans. Clin Pharmacol Ther
1995;58:399–403.