MAJOR — Use With Caution
🟡 USE CAUTION — Melatonin and Fluvoxamine may interact. Talk to your doctor before combining.
Evidence level: STRONG
Fluvoxamine increases melatonin levels in your body by approximately 12 times. Even a small dose of melatonin will have an extremely powerful effect. You must dramatically reduce your melatonin dose (to 0.5mg or less) or stop it entirely.
Fluvoxamine is the most potent CYP1A2 inhibitor among SSRIs. Melatonin is primarily metabolized by CYP1A2. Fluvoxamine increases melatonin AUC by 12-fold and peak levels by 12-fold, creating dramatically elevated melatonin exposure.
If you must take melatonin with fluvoxamine, reduce melatonin dose to 0.25-0.5mg maximum. A normal 3-5mg dose would effectively become 36-60mg in your body. Expect extreme drowsiness, vivid dreams, and morning grogginess at standard doses.
Take Fluvoxamine at the same time each day as prescribed. Melatonin can be taken at any convenient time — morning with breakfast is typical. If the supplement has serotonergic properties (5-HTP, SAMe, tryptophan), use extreme caution or avoid entirely, as combining with an SSRI risks serotonin syndrome. Fish oil, CoQ10, and probiotics are generally safe alongside SSRIs.
Higher risk with: liver impairment, genetic CYP enzyme variations (poor or ultra-rapid metabolizers), older age, polypharmacy (many medications).
Extreme daytime drowsiness, morning grogginess lasting hours, vivid/disturbing dreams, headache, dizziness, nausea. At very high effective levels: hypothermia, hormonal disruption.
Mention this combination at your next appointment. Ask: "Should I adjust timing or doses of Melatonin and Fluvoxamine?" Your doctor may want to monitor specific lab values.
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.
Fluvoxamine increases melatonin levels in your body by approximately 12 times. Even a small dose of melatonin will have an extremely powerful effect. You must dramatically reduce your melatonin dose (to 0.5mg or less) or stop it entirely.
Take Fluvoxamine at the same time each day as prescribed. Melatonin can be taken at any convenient time — morning with breakfast is typical. If the supplement has serotonergic properties (5-HTP, SAMe, tryptophan), use extreme caution or avoid entirely, as combining with an SSRI risks serotonin syndrome. Fish oil, CoQ10, and probiotics are generally safe alongside SSRIs.
Extreme daytime drowsiness, morning grogginess lasting hours, vivid/disturbing dreams, headache, dizziness, nausea. At very high effective levels: hypothermia, hormonal disruption.
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.
Mention this combination at your next appointment. Ask: "Should I adjust timing or doses of Melatonin and Fluvoxamine?" Your doctor may want to monitor specific lab values.
Or browse the full interaction database (121,000+ pairs).