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Selected Xanthine Derivatives/Fluvoxamine

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

Fluvoxamine slows down how quickly your body removes medicines called xanthine derivatives. Xanthine derivatives include aminophylline, caffeine, oxtriphylline, and theophylline.

What might happen:

The amount of these medicines in your blood may increase and cause toxic effects. Symptoms of toxicity include loss of appetite, nausea, vomiting, nervousness, agitation, headache, fast and/or irregular heartbeat, and/or seizures.

What you should do about this interaction:

Let your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medications together. Your doctor may want to check the amount of medicine in your blood. Your doctor may want to change the dose of your medicine. Let your healthcare professionals know if you any symptoms of toxicity. While you are taking fluvoxamine, you should limit your intake of caffeine from beverages and medicines.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

References:

1.Rasmussen BB, Jeppesen U, Gaist D, Brosen K. Griseofulvin and fluvoxamine interactions with the metabolism of theophylline. Ther Drug Monit 1997 Feb;19(1):56-62.
2.Rasmussen BB, Maenpaa J, Pelkonen O, Loft S, Poulsen HE, Lykkesfeldt J, Brosen K. Selective serotonin reuptake inhibitors and theophylline metabolism in human liver microsomes: potent inhibition by fluvoxamine. Br J Clin Pharmacol 1995 Feb;39(2):151-9.
3.Luvox (fluvoxamine maleate) US prescribing information. ANI Pharmaceuticals November, 2012.
4.Sperber AD. Toxic interaction between fluvoxamine and sustained release theophylline in an 11-year-old boy. Drug Saf 1991 Nov-Dec;6(6):460-2.
5.Diot P, Jonville AP, Gerard F, Bonnelle M, Autret E, Breteau M, Lemarie E, Lavandier M. Possible interaction between theophylline and fluvoxamine. Therapie 1991 Mar-Apr;46(2):170-1.
6.van den Brekel AM, Harrington L. Toxic effects of theophylline caused by fluvoxamine. CMAJ 1994 Nov 1;151(9):1289-90.
7.DeVane CL, Markowitz JS, Hardesty SJ, Mundy S, Gill HS. Fluvoxamine-induced theophylline toxicity. Am J Psychiatry 1997 Sep; 154(9):1317-8.
8.Jeppesen U, Loft S, Poulsen HE, Brsen K. A fluvoxamine-caffeine interaction study. Pharmacogenetics 1996 Jun;6(3):213-22.
9.Culm-Merdek KE, von Moltke LL, Harmatz JS, Greenblatt DJ. Fluvoxamine impairs single-dose caffeine clearance without altering caffeine pharmacodynamics. Br J Clin Pharmacol 2005 Nov;60(5):486-93.

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