Fedratinib with Fluvoxamine Interaction Details
Brand Names Associated with Fluvoxamine
- Fluvoxamine
- Luvox®
- Luvox® CR
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Dec 27, 2023
Interaction Effect
Increased fedratinib exposure and an increased risk of fedratinib-related adverse reactions
Interaction Summary
Fedratinib is metabolized by CYP3A4 and CYP2C19 and coadministration with a dual CYP3A4 and CYP2C19 inhibitor increases fedratinib exposure, and may increase the risk for adverse effects. Coadministration of fluconazole (dual CYP3A4 and CYP2C19 inhibitor) 200 mg once daily with a single dose of fedratinib (100 mg; 0.25 times the recommended dose) increased AUC (0 to inf) by 1.7-fold in a clinical study. Pharmacokinetic modeling predicts steady-state fedratinib AUC to be increased by approximately 1.5-fold with a concurrent fluconazole 200 mg once daily and fedratinib 400 mg once daily. Due to potential increase of exposure, patients taking concomitant dual CYP3A4 and CYP2C19 inhibitors require more intensive safety monitoring and, if necessary, dose modifications of fedratinib based on adverse reactions.
Severity
Major
Onset
Unspecified
Evidence
Probable
How To Manage Interaction
Coadministration of fedratinib with a dual CYP3A4 and CYP2C19 inhibitor increases fedratinib exposure. Increased exposure may increase the risk of adverse reactions. Due to potential increase of exposure, patients taking concomitant dual CYP3A4 and CYP2C19 inhibitors require more intensive safety monitoring and, if necessary, dose modifications of fedratinib based on adverse reactions.
Mechanism Of Interaction
Inhibition of CYP3A4-mediated metabolism of fedratinib; inhibition of CYP2C19-mediated metabolism of fedratinib
Literature Reports
A) Coadministration of fluconazole (dual CYP3A4 and CYP2C19 inhibitor) 200 mg once daily with a single dose of fedratinib (100 mg; 0.25 times the recommended dose) increased AUC (0 to inf) by 1.7-fold. Coadministration of fluconazole (200 mg once daily) with fedratinib 400 mg once daily is predicted to increase fedratinib AUC at steady state by approximately 1.5-fold .
Fluvoxamine Overview
-
Fluvoxamine is used to treat obsessive-compulsive disorder (bothersome thoughts that won't go away and the need to perform certain actions over and over) and social anxiety disorder (extreme fear of interacting with others or performing in front of others that interferes with normal life). Fluvoxamine is in a class of medications called selective serotonin reuptake inhibitors (SSRIs). It works by increasing the amount of serotonin, a natural substance in the brain that helps maintain mental balance.
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Definitions
Severity Categories
Contraindicated
These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.
Major
This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.
Moderate
This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.
Minor
While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.
Onset
Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.
Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.
Evidence
Level of documentation of the interaction.
Established: The interaction is documented and substantiated in peer-reviewed medical literature.
Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.
How To Manage The Interaction
Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.
It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.
Mechanism Of Interaction
The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.
Where Does Our Information Come From?
Information for our drug interactions is compiled from several drug compendia, including:
The prescribing information for each drug, as published on DailyMED, is also used.
Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.
The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.