Drug & supplement interaction

Evodia + Fluvoxamine

Fluvoxamine brand name: Luvox.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Fluvoxamine falls into 3 drug categories that Evodia can interact with; the most serious is rated moderate. Evodia might reduce the levels and clinical effects of CYP1A2 substrates through induction of CYP1A2.

Read the full interaction report
SeverityModerate
LikelihoodProbable
Interactions3
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Evodia and Fluvoxamine

These two interact in 3 distinct ways. Each one is explained separately below.

Why Are There 3 Interactions?

Evodia interacts with whole categories of medication. Fluvoxamine falls into 3 of those categories, so it can interact with Evodia in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

1 of 3

Why this applies to Fluvoxamine

Fluvoxamine falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES — the group Evodia interacts with.

Evodia might reduce the levels and clinical effects of CYP1A2 substrates through induction of CYP1A2.
Evodia extract and the evodia constituent rutaecarpine induce hepatic CYP1A2 enzyme activity. Evodia decreases levels of theophylline and caffeine, CYP1A2 substrates, by about 70% in animal models.
Severity Moderate Likelihood Probable Evidence D

Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist with fluvoxamine (Luvox): your liver uses an enzyme called CYP1A2 to clear it from your body. Evodia, and especially its compound rutaecarpine, appears to speed that enzyme up. When the enzyme works faster, fluvoxamine can be broken down more quickly, which may lower its levels and weaken how well it controls your OCD or social anxiety symptoms. Fluvoxamine isn't a prodrug, so faster clearance simply means less benefit, not more.

I want to be honest about the evidence though, this comes only from lab and animal studies (it dropped caffeine and theophylline levels in animals), so we don't truly know how big the effect is in people. Before adding evodia, please check with your pharmacist or doctor rather than changing anything on your own.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Ueng YF, Tsai TH, Don MJ, et al. Alteration of the pharmacokinetics of theophylline by rutaecarpine, an alkaloid of the medicinal herb Evodia rutaecarpa, in rats. J Pharm Pharmacol 2005;57:227-32.
  2. Ueng YF, Jan WC, Lin LC, et al. The alkaloid rutaecarpine is a selective inhibitor of cytochrome P450 1A in mouse and human liver microsomes. Drug Metab Dispos 2002;30:349-53. PubMed
  3. Tsai TH, Chang CH, Lin LC. Effects of Evodia rutaecarpa and rutaecarpine on the pharmacokinetics of caffeine in rats. Planta Med 2005;71:640-5.
  4. Lee SK, Kim NH, Lee J, et al. Induction of cytochrome P450s by rutaecarpine and metabolism of rutaecarpine by cytochrome P450s. Planta Med 2004;70:753-7. PubMed
Moderate

CYTOCHROME P450 3A4 (CYP3A4) INHIBITORS

2 of 3

Fluvoxamine also falls under CYTOCHROME P450 3A4 (CYP3A4) INHIBITORS.

Theoretically, CYP3A4 inhibitors might increase the levels and clinical effects of evodia.
Animal research shows that concomitant administration of ketoconazole, a known CYP3A4 inhibitor, with the alkaloid constituents of evodia significantly increases the area under the curve (AUC), maximum concentration (Cmax), and half-life of these constituents.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist for this pairing: fluvoxamine is a fairly strong blocker of a liver enzyme called CYP3A4, and that same enzyme helps clear evodia's active compounds (like evodiamine and rutaecarpine) from your body. So in theory, taking them together could slow the breakdown of evodia and let its levels build up. The concern isn't really about fluvoxamine becoming stronger here, it's about evodia hanging around longer than expected.

I want to be honest about the evidence, though. This is based on lab and animal studies, not real people, so it's more of a theoretical caution than a proven problem. We also don't fully know what higher evodia levels do in humans. Since evodia is poorly studied to begin with, I'd run it by your pharmacist or doctor before combining the two.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Zhang W, Guo J, Wang D, et al. Effect of CYP3A inducer/inhibitor on pharmacokinetics of five alkaloids in Evodiae Fructus. Chem Biol Interact 2020;327:109146. PubMed
Moderate

CYTOCHROME P450 1A2 (CYP1A2) INHIBITORS

3 of 3

Fluvoxamine also falls under CYTOCHROME P450 1A2 (CYP1A2) INHIBITORS.

Theoretically, drugs that inhibit CYP1A2 might increase the levels and clinical effects of evodia.
The evodia constituent rutaecarpine is metabolized by CYP1A2.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here the concern runs from your medicine toward the herb, not the other way around. Fluvoxamine is one of the strongest blockers of a liver enzyme called CYP1A2, and that same enzyme is what your body uses to break down rutaecarpine, an active compound in Evodia. So if you take them together, Evodia could build up more than expected, which may make its effects and any side effects stronger and harder to predict.

I'll be honest with you: this is a theoretical concern based on lab and animal work, not real patient cases, so we don't know how big a deal it is in everyday life. Still, since fluvoxamine is such a potent enzyme blocker, it's worth running Evodia past your pharmacist or doctor before adding it.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Lee SK, Kim NH, Lee J, et al. Induction of cytochrome P450s by rutaecarpine and metabolism of rutaecarpine by cytochrome P450s. Planta Med 2004;70:753-7. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Evodia Also Interacts With Other Medications

Evodia has 949 moderate known drug interactions in our database — the Fluvoxamine one above is among them. If you take anything else, check it against the full list below.

Moderate 949 No known interaction 1,881 (incl. Fluvoxamine)
Taking anything else?

Check Another of Your Medications Against Evodia

Covers the 2,830 medications we’ve checked against Evodia. Pick one to open its full report.

From our Q&A

Questions About Evodia or Fluvoxamine

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Evodia or Fluvoxamine, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Fluvoxamine

This page covers Evodia only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Fluvoxamine page lists 193 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Lithium (major), 1,3-dmaa (moderate), 5-htp (moderate) and Acacia Rigidula (moderate).

By severity: 2 major · 151 moderate · 40 minor.

From our pharmacist’s overview on the Fluvoxamine page

“Fluvoxamine (Luvox), an SSRI used for OCD and depression, carries an interaction list that deserves genuinely careful reading. Two entries matter most: lithium, which alongside a serotonin-raising drug like fluvoxamine can tip toward serotonin syndrome, a dangerous excess of serotonin, and activated charcoal, which can soak up the medi…”

Reviewed by 2 · Jul 18, 2026

Open the Fluvoxamine interaction page

One more smart check

Taking Evodia as Part of a Dietary Supplement Product? Check It for Interactions

We hold 182 real supplement products containing Evodia, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Evodia. Your product may carry other ingredients that interact with Fluvoxamine too, on top of Evodia — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Evodia and Fluvoxamine Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Evodia
Top half

#398 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Fluvoxamine
Steady interest

#1,595 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Evodia

What is Evodia?

  • Digestive upset and nausea
  • Headaches
  • Menstrual cramps
  • Abdominal pain
  • Diarrhea

Evodia is a fruit used in traditional Chinese medicine, most often for digestive complaints, headaches, and menstrual pain. Human evidence for these uses is very limited, and it is mostly studied in laboratory and animal research. Talk with a pharmacist or doctor before using it, and avoid it during pregnancy and breastfeeding.

Read the full Evodia monograph & all interactions
Medication

About Fluvoxamine

What Is Fluvoxamine Used For?

Brand name: Luvox

Both fluvoxamine maleate tablets and Fluvoxamine Maleate extended-release capsules are approved to treat obsessive-compulsive disorder (OCD) — a condition marked by unwanted, recurring thoughts (obsessions) and/or repetitive behaviors (compulsions) that cause significant distress or interfere with daily life.

Fluvoxamine maleate tablets are approved for adults and for children and adolescents ages 8 to 17. Fluvoxamine Maleate extended-release capsules are approved for adults with OCD; their use in pediatric patients naive to fluvoxamine requires special prescriber consideration regarding the lowest available dose.

See full Fluvoxamine drug information
Keep checking

Other Drugs & Evodia

Browse every other medication we’ve checked against Evodia — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
949Moderate
0Minor
1,880No known interaction
949 Moderate 1,880 No interaction
Moderate

949 interactions

Showing 60 of 949 moderate interactions — see all 949 on the Evodia page.

No interaction 1,880 drugs checked — show the list

We also checked Evodia against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 1,880 medications checked with no known interaction — see the full Evodia list.

See the full Evodia interactions page
See every supplement checked against Fluvoxamine, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Evodia monograph › Uses, safety, and every drug interaction in one place Fluvoxamine supplement interactions › Every supplement checked against Fluvoxamine, ranked by severity Fluvoxamine drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Evodia and Fluvoxamine Together: Common Questions

Can you take Evodia with Fluvoxamine?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 3 interactions listed for Evodia and Fluvoxamine?
Fluvoxamine belongs to more than one drug category, and Evodia interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Evodia and Fluvoxamine interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Fluvoxamine and Evodia?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.