Fluvoxamine and Ramelteon: Drug Interaction Guide
Quick answer: This is a major interaction — avoid combining Fluvoxamine and Ramelteon unless specifically directed by your doctor.
How Fluvoxamine interacts with Ramelteon
Fluvoxamine strongly inhibits CYP1A2, the primary enzyme metabolizing ramelteon, increasing ramelteon AUC up to 190-fold and causing excessive sedation.
What you should do
Combination is contraindicated. Use an alternative hypnotic such as zolpidem or a different SSRI such as sertraline.
Key facts
Severity
Major — avoid combination
Mechanism
Fluvoxamine strongly inhibits CYP1A2, the primary enzyme metabolizing ramelteon, increasing ramelteon AUC up to 190-fold...
Action
Combination is contraindicated. Use an alternative hypnotic such as zolpidem or a different SSRI such as sertraline.
Frequently asked questions
Can I take Fluvoxamine and Ramelteon together?
No — this combination should generally be avoided. Combination is contraindicated. Use an alternative hypnotic such as zolpidem or a different SSRI such as sertraline.
What is the severity of this interaction?
The interaction between Fluvoxamine and Ramelteon is classified as Major — avoid combination. Fluvoxamine strongly inhibits CYP1A2, the primary enzyme metabolizing ramelteon, increasing ramelteon AUC up to 190-fold and causing excessive sedation.
What should I do if I'm prescribed both?
Combination is contraindicated. Use an alternative hypnotic such as zolpidem or a different SSRI such as sertraline. Always consult your prescribing clinician — do not stop or change medications without medical guidance.
Last reviewed: by iMedic Medical Editorial Team. Our editorial process.