This article describes possible interactions with fluoxetine oral capsule. Interactions can cause a drug to have a different effect on the body than expected. Interactions can occur due to medications, alcohol, or certain health conditions.
Fluoxetine comes as capsules that you swallow. It’s also available as tablets and a solution that you swallow.
Boxed warning: Risk of suicidal thoughts and behaviors
Fluoxetine has a boxed warning for the risk of suicidal thoughts and behaviors. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).
See the end of this article for more information about this warning.
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Other drugs and fluoxetine
The drugs in the list below may interact with fluoxetine oral capsule. This article doesn’t include all drugs that may interact with fluoxetine.
Drug classes or drugs that may interact with fluoxetine oral capsule include:
- nonsteroidal anti-inflammatory drugs (NSAIDs)
- drug examples: ibuprofen (Advil, Motrin), nabumetone
- what might happen: can increase the risk of bleeding as a side effect of fluoxetine or the NSAID
- anticoagulants
- drug examples: warfarin (Jantoven), dabigatran (Pradaxa)
- what might happen: can increase the risk of bleeding as a side effect of fluoxetine or the anticoagulant
- monoamine oxidase inhibitors (MAOIs)*
- opioids
- drug examples: fentanyl (Fentora, others), morphine (MS Contin)
- what might happen: can increase the risk of serotonin syndrome as a side effect of fluoxetine or the opioid
- serotonin-norepinephrine reuptake inhibitors (SNRIs)
- drug examples: duloxetine (Cymbalta), venlafaxine (Effexor XR)
- what might happen: can increase the risk of serotonin syndrome as a side effect of fluoxetine or the SNRI
- certain antifungal drugs
- drug examples: ketoconazole, fluconazole (Diflucan)
- what might happen: can increase the risk of heart-related side effects of fluoxetine or the antifungal drug
- certain antiarrhythmic drugs
- drug examples: quinidine, amiodarone (Pacerone)
- what might happen: can increase the risk of heart-related side effects of fluoxetine or the antiarrhythmic drug
- certain antiepileptic drugs
- drug examples: carbamazepine (Tegretol, others), phenytoin (Dilantin)
- what might happen: can increase the effect and risk of side effects of the antiepileptic drug
- certain antipsychotics
- drug examples: thioridazine*, ziprasidone (Geodon)
- what might happen: can increase the risk of heart-related side effects of fluoxetine or the antipsychotic drug
- pimozide*
- what might happen: can increase the risk of heart-related side effects of pimozide and fluoxetine
*This interaction is contraindicated with fluoxetine. To learn more, see the “When to avoid” section in this article.
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Other interactions and fluoxetine
Interactions can occur with foods, supplements, vaccines, and some lab tests. Below you can learn whether fluoxetine oral capsule has these interactions.
The information below doesn’t include all other possible interactions with fluoxetine.
Fluoxetine and food
Fluoxetine oral capsule does not have interactions with foods. But this doesn’t mean interactions with foods can’t happen or won’t be identified later.
Because of this, talk with your doctor or pharmacist about what foods to avoid while taking fluoxetine oral capsule.
Fluoxetine and supplements
Before taking fluoxetine oral capsule, tell your doctor and pharmacist about any herbs you take, as well as vitamins and supplements. Doing so may help you avoid interactions.
If you have questions about interactions that may affect you, talk with your doctor or pharmacist.
Fluoxetine interactions with herbal supplements
Fluoxetine oral capsule may interact with St. John’s wort. This herb is often used to ease symptoms of depression.
Taking fluoxetine and St. John’s wort can increase the risk of serotonin syndrome as a side effect of fluoxetine or St. John’s wort.
Fluoxetine oral capsule may interact with valerian (also called valerian root). People use this herb to help them sleep better. Taking fluoxetine and valerian can increase the risk of drowsiness as a side effect of fluoxetine or valerian.
Because of this, ask your doctor or pharmacist before taking these or other herbs while taking fluoxetine oral capsule.
Fluoxetine interactions with vitamins
Fluoxetine oral capsule isn’t known to interact with vitamins. But this doesn’t mean interactions with vitamins can’t happen or won’t be identified later.
Because of this, ask your doctor or pharmacist before taking any vitamins while taking fluoxetine oral capsule.
Fluoxetine and vaccines
Fluoxetine oral capsule isn’t known to interact with vaccines. But this doesn’t mean interactions with vaccines can’t happen or won’t be identified later.
Because of this, talk with your doctor or pharmacist before receiving any vaccines while taking fluoxetine oral capsule.
Fluoxetine and lab tests
Fluoxetine oral capsule isn’t known to interact with lab tests. But this doesn’t mean interactions with lab tests can’t happen or won’t be identified later.
Because of this, talk with your doctor or pharmacist before having any tests while taking fluoxetine oral capsule.
Fluoxetine and cannabis or CBD
Reports have shown cannabis (commonly called marijuana) and cannabis products may interact with fluoxetine. Cannabidiol (CBD) is an example of a cannabis product.
Taking fluoxetine and using cannabis can increase the risk of side effects of cannabis.
Before you take fluoxetine, tell your doctor and pharmacist if you use cannabis. Doing so may help prevent possible interactions.
Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.
Alcohol and fluoxetine
Fluoxetine oral capsule is known to interact with alcohol. It’s recommended to avoid alcohol while taking fluoxetine.
Taking fluoxetine oral capsule and drinking alcohol may cause:
- problems with balance, coordination, and decision-making
- drowsiness, which can be severe
If you drink alcohol and have concerns about fluoxetine interactions with alcohol, talk with your doctor.
When to avoid fluoxetine
Certain health conditions or other factors could increase some risks with fluoxetine oral capsule. Because of this, doctors may not prescribe fluoxetine in these cases. These health conditions or other factors are called contraindications.
Here’s a list of contraindications for fluoxetine oral capsule:
- monoamine oxidase inhibitor (MAOI) drugs: Taking fluoxetine if you take an MAOI drug or have taken one within the past 14 days increases the risk of serotonin syndrome as a side effect. You should also avoid taking an MAOI for at least 5 weeks after your last dose of fluoxetine.
- pimozide or thioridazine: Taking fluoxetine with pimozide or thioridazine increases the risk of long QT syndrome as a side effect of fluoxetine and pimozide or thioridazine.
- past allergic reaction to fluoxetine: If you’ve ever had an allergic reaction to fluoxetine oral capsule, taking it again may cause another allergic reaction.
Before you start taking fluoxetine, tell your doctor if anything listed above relates to you. They can recommend whether you should take fluoxetine.
Health factors and fluoxetine
Certain medical conditions or other health factors may increase the risk of interactions with fluoxetine oral capsule. Keep in mind that interactions could lead to side effects or affect how well the drug works. Before taking fluoxetine, tell your doctor about your health history. They’ll determine whether fluoxetine is right for you.
These health conditions or other factors might interact with fluoxetine oral capsule:
* Fluoxetine has a boxed warning for the risk of suicidal thoughts and behaviors. A boxed warning is the most serious warning from the FDA. See the end of this article for more information about this warning and suicide prevention.
Preventing fluoxetine interactions
You may be able to help avoid certain interactions with fluoxetine oral capsule. Before taking this drug, you may want to discuss possible interactions with your doctor and pharmacist.
Things to consider include:
- Whether you drink alcohol or use cannabis.
- Other medications and herbs you take, as well as vitamins and supplements. Your doctor or pharmacist can help you fill out a medication list.
- What to do if you’re prescribed a new drug while taking fluoxetine oral capsule.
Taking fluoxetine exactly as prescribed can also help prevent interactions.
What to ask your doctor
If you have questions about fluoxetine and possible interactions, talk with your doctor.
Questions you may want to ask your doctor include:
- Does fluoxetine have similar interactions as other SSRI drugs, such as sertraline?
- If I stop treatment with fluoxetine, how long do I need to be concerned about drug interactions after my last dose?
- What should I do if I think I’m having a side effect caused by an interaction?
Boxed warning for fluoxetine
Fluoxetine has a boxed warning for the risk of suicidal thoughts and behaviors. A boxed warning is the most serious warning from the FDA.
Antidepressant drugs, including fluoxetine, can increase short-term risk of suicidal thoughts and behaviors in children and adults up to ages 24 years. It’s not known whether this risk applies when an antidepressant is used long term. This is based on studies of different antidepressant drugs, including fluoxetine and other SSRIs.
During treatment, your doctor will monitor you closely for symptoms of suicidal thoughts or behaviors. If you’re comfortable doing so, it’s also helpful to let a close friend or family member know you’re taking fluoxetine. They can help watch for changes to your behaviors, moods, or thoughts.
Some symptoms to watch for include:
- wishing you could stop living or believing you don’t deserve to keep living
- making plans to give away your possessions or money
- withdrawing from family and friends
- losing interest in activities you usually enjoy
To learn more, talk with your doctor.
Suicide prevention
If you or someone you know is in crisis and considering suicide or self-harm, please seek support:
If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.
If you are not in the same household, stay on the phone with them until help arrives.
Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
