Does Fluvoxamine interact with caffeine? (+3 effects)

In this article, we will discuss the interaction between Fluvoxamine and caffeine. We will figure out the impact of caffeine on Fluoxamine-treated individuals. We will discuss the potential effects of taking this combination and discuss some ways to manage it.

Does Fluvoxamine interact with caffeine? 

Yes, Fluvoxamine can interact with caffeine. The interaction between Fluoxamine and caffeine can be dose-dependent. This interaction may induce some additive side effects which may excite the brain. 

Fluvoxamine is a selective serotonin reuptake inhibitor (SSRI) antidepressant that works by blocking the reuptake of serotonin in the brain thus alleviating obsessive-compulsive disorder, depression, anxiety, and related conditions (1). 

On the other hand, caffeine is a central nervous system (CNS) stimulant and a psychoactive agent. It is used to reduce fatigue and increase alertness. It possesses numerous pharmacological and physiological effects (2). 

This interaction of Fluvoxamine and caffeine may increase the serotonin levels in the brain. Both Fluvoxamine and caffeine exert their effects by altering brain chemistry. 

However, the interaction severity may vary from person to person. It is, therefore, important to contact your healthcare provider in case of any adverse drug interaction between Fluvoxamine and caffeine. 

What does research suggest?

According to research, among other SSRI antidepressant agents, only Fluvoxamine is a potent inhibitor of the CYP1A2 enzyme which majorly catalyzes the biotransformation of caffeine (3). 

A randomized study was conducted on the drug interaction between caffeine and Fluvoxamine. For which, 8 healthy individuals were given 200mg of caffeine orally to conduct the first part of the study (3).

For the second part of the study, the same 8 subjects were given 50mg of Fluvoxamine for 4 days. Continuing the study, they were given 100mg of Fluvoxamine for the other 8 days (3).

On the 8th day, the volunteers were given 200m of caffeine and their blood and urine samples were collected. The results indicate that the combination of caffeine with Fluoxamine may lead to caffeine intoxication (3). 

Taking Fluvoxamine and caffeine together impairs the clearance of caffeine and increases its half-life. This action takes place due to the inhibition of CYP1A2 through the mechanism of Fluvoxamine (4). 

The study indicated that there is a pharmacokinetic interaction between Fluvoxamine and a single dose of caffeine. However, repeated caffeine dosing along with Fluvoxamine treatment can cause caffeine accumulation and pharmacodynamic effects (4). 

What are the potential side effects of taking Fluvoxamine and caffeine?

Following are a few potential interactions while taking Fluvoxamine and caffeine together:

Serotonin syndrome

This is a condition that can occur as a result of Fluvoxamine intake along with caffeine. Both these products increase the levels of serotonin, and a surge of serotonin may lead to serotonin syndrome which is a rare life-threatening condition (5).

 

Gastrointestinal distress

The disturbances in the digestive and gastrointestinal (GI) system are common with the intake of caffeine and SSRI medication. 

Caffeine can increase your GI motility and cause acid reflux, nausea, and diarrhoea. Similarly, Fluvoxamine is also associated with side effects such as nausea, diarrhoea, stomach pain, and indigestion (6). Taking these two together may exacerbate GI side effects. 

 

Increased anxiety and nervousness

Caffeine exhibits its CNS stimulant properties along with Fluoxetine. Taking these together increases restlessness, nervousness, and anxiety among patients. 

 

Increased cardiac effects

Caffeine and Fluvoxamine together can exacerbate cardiac effects in patients including increased heart rate, palpitations, and blood pressure. 

 

What are the ways to avoid interaction between Fluvoxamine and caffeine?

To avoid an interaction between Fluvoxamine and caffeine, it is important to figure out an appropriate time to consume both. If you take Fluvoxamine in the morning, then consume caffeine or any caffeinated beverage with a few hours gap. 

Maintaining a safe time distance between the consumption of caffeine and Fluvoxamine can save you from facing adverse drug interactions. 

Consult your doctor before changing the timing of your medication. You can discuss and get an expert opinion about the consumption of caffeine along with Fluvoxamine from your doctor to avoid adversities. 

Human responses to drugs always vary. Each patient taking Fluvoxamine along with caffeine can have varying effects. Therefore, carefully examine your side effects to seek proper medical help. 

However, if you have severe interaction with the coadministration of caffeine and Fluvoxamine, your doctor may switch you from Fluoxetine to any other SSRI medication such as Sertraline and Citalopram which are not very interactive with caffeine consumption. 

Conclusion

Based on the information mentioned in the article below, it is understood that Fluxoxamine and caffeine coadministration may cause drug interactions due to their metabolisms in the body. 

However, I would recommend always following your doctor’s prescription, and upon exhibiting any harmful side effects with this drug combination, report to your doctor and seek medical help. 

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References

1.-

Irons J. Fluvoxamine in the treatment of anxiety disorders. Neuropsychiatr Dis Treat. 2005 Dec;1(4):289-99. PMID: 18568110; PMCID: PMC2424117. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2424117/

2.-

Institute of Medicine (US) Committee on Military Nutrition Research. Caffeine for the Sustainment of Mental Task Performance: Formulations for Military Operations. Washington (DC): National Academies Press (US); 2001. 2, Pharmacology of Caffeine. Available from: https://www.ncbi.nlm.nih.gov/books/NBK223808/

3.-

Jeppesen U, Loft S, Poulsen HE, Brśen K. A fluvoxamine-caffeine interaction study. Pharmacogenetics. 1996 Jun;6(3):213-22. doi: 10.1097/00008571-199606000-00003. PMID: 8807660. https://pubmed.ncbi.nlm.nih.gov/8807660/

4.-

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. doi: 10.1111/j.1365-2125.2005.02467.x. PMID: 16236038; PMCID: PMC1884944. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1884944/

5.-

Ohta R, Sano C. Serotonin Syndrome Triggered by Overuse of Caffeine and Complicated With Neuroleptic Malignant Syndrome: A Case Report. Cureus. 2022 Feb 21;14(2):e22468. doi: 10.7759/cureus.22468. PMID: 35345760; PMCID: PMC8942071. https://pubmed.ncbi.nlm.nih.gov/35345760/

6.-

AHFS Patient Medication Information [Internet]. Bethesda (MD): American Society of Health-System Pharmacists, Inc.; c2019. Fluvoxamine; [updated 2020 Jun 24; reviewed 2018 Jul 5; cited 2020 Jul 1]; [about 5 p.]. Available from: https://medlineplus.gov/druginfo/meds/a695004.html

 

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