Fluvoxamine Extended-release

See Contraindications. Prolongation of QT interval with pimozide, thioridazine. Avoid alcohol. Increased risk of serotonin syndrome with other serotonergic drugs (eg, other SSRIs, SNRIs, triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, meperidine, methadone, tryptophan, buspirone, amphetamines, St. John's Wort) or with drugs that impair serotonin metabolism (eg, MAOIs, linezolid, IV methylene blue); monitor. Potentiates diazepam (not recommended), triazolam and alprazolam (reduce their doses by at least ½), midazolam, theophylline (reduce its dose by ⅔ and monitor), warfarin, carbamazepine, tricyclic antidepressants (reduce their doses and monitor), propranolol, metoprolol (reduce their doses), clozapine, methadone, tacrine. Caution with drugs that inhibit CYP2D6 (eg, quinidine) or CYP3A4, phenytoin, diltiazem. Increased risk of bleeding with concomitant NSAIDs, aspirin, warfarin, and others that affect coagulation. Monitor mexiletine levels. Smokers may have increased metabolism.