Fluoxetine with Vinblastine Interaction Details

Brand Names Associated with Fluoxetine

Brand Names Associated with Vinblastine

Medical Content Editor Dr. Brian Staiger, PharmD
Last updated Nov 11, 2023

Interaction Effect

Increased vinBLAStine exposure and an increased risk of vinBLAStine-related adverse events

Interaction Summary

Coadministration of FLUoxetine (a strong CYP2D6 inhibitor) with vinBLAStine (a CYP2D6 substrate) may increase the vinBLAStine exposure Therapy with medications that are predominantly metabolized by the CYP2D6 and that have a relatively narrow therapeutic index such as vinBLAStine should be initiated at the low end of the dose range if a patient is receiving FLUoxetine concurrently or has taken it in the previous 5 weeks. If FLUoxetine is added to the treatment regimen of a patient already receiving a CYP2D6 substrate, the need for decreased dose of the original medication should be considered. Use caution during coadministration.

Severity

Major

Onset

Unspecified

Evidence

Theoretical

How To Manage Interaction

Coadministration of FLUoxetine (a strong CYP2D6 inhibitor) with vinBLAStine (a CYP2D6 substrate) may increase the vinBLAStine exposure Therapy with medications that are predominantly metabolized by the CYP2D6 and that have a relatively narrow therapeutic index such as vinBLAStine should be initiated at the low end of the dose range if a patient is receiving FLUoxetine concurrently or has taken it in the previous 5 weeks. If FLUoxetine is added to the treatment regimen of a patient already receiving a CYP2D6 substrate, the need for decreased dose of the original medication should be considered. Use caution during coadministration.

Mechanism Of Interaction

Inhibition of CYP2D6-mediated metabolism of vinBLAStine by FLUoxetine

Fluoxetine Overview

• Fluoxetine is used to treat depression, obsessive-compulsive disorder (bothersome thoughts that won't go away and the need to perform certain actions over and over), some eating disorders, and panic attacks (sudden, unexpected attacks of extreme fear and worry about these attacks). Fluoxetine is also used to relieve the symptoms of premenstrual dysphoric disorder, including mood swings, irritability, bloating, and breast tenderness. It is also used along with olanzapine (Zyprexa) to treat depression that did not respond to other medications and episodes of depression in people with bipolar I disorder (manic-depressive disorder; a disease that causes episodes of depression, episodes of mania, and other abnormal moods). Fluoxetine 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.

Vinblastine Overview

• Vinblastine is used in combination with other chemotherapy drugs to treat Hodgkin's lymphoma (Hodgkin's disease) and non-Hodgkin's lymphoma (types of cancer that begin in a type of white blood cell that normally fights infection), and cancer of the testicles. It is also used to treat Langerhans cell histiocytosis (histiocytosis X; Letterer-Siwe disease; a condition in which too many of a certain type of white blood cell grows in parts of the body). It may also be used to treat breast cancer that has not improved after treatment with other medications and gestational trophoblastic tumors (a type of tumor that forms inside a woman's uterus while she is pregnant) that has not improved after surgery or treatment with other medications. Vinblastine is in a class of medications called vinca alkaloids. It works by slowing or stopping the growth of cancer cells in your body.

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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:

• Gold Standard Drug Database
• Micromedex
• Lexicomp
• DrugBank

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.