MAJOR — Use With Caution
DANGEROUS — Fluvoxamine causes extreme DXM level elevation
Evidence level: STRONG
Luvox massively increases DXM blood levels and adds serotonin toxicity risk.
Fluvoxamine is a potent CYP1A2 and moderate CYP2D6 inhibitor plus SSRI. Dramatically increases DXM levels and adds serotonin risk.
Absolutely avoid DXM with fluvoxamine.
Take Fluvoxamine at the same time each day — morning is most common to avoid sleep disruption. Dextromethorphan follows its prescribed schedule. SSRIs have a long half-life, so consistency matters more than the exact hour.
Any dose of fluvoxamine, CYP2D6 poor metabolizers
Agitation, confusion, rapid heart rate, dilated pupils, muscle rigidity, hyperthermia, seizures
Critical to avoid all DXM products on fluvoxamine.
Discuss this combination with your prescriber. They may adjust timing, dosing, or switch to an alternative with fewer interaction risks. Never stop an antidepressant abruptly — taper under medical guidance.
Luvox massively increases DXM blood levels and adds serotonin toxicity risk.
Take Fluvoxamine at the same time each day — morning is most common to avoid sleep disruption. Dextromethorphan follows its prescribed schedule. SSRIs have a long half-life, so consistency matters more than the exact hour.
Agitation, confusion, rapid heart rate, dilated pupils, muscle rigidity, hyperthermia, seizures
Discuss this combination with your prescriber. They may adjust timing, dosing, or switch to an alternative with fewer interaction risks. Never stop an antidepressant abruptly — taper under medical guidance.
Critical to avoid all DXM products on fluvoxamine.
Or browse the full interaction database (121,000+ pairs).