Caffeine + fluvoxamine — CYP1A2
- Caffeine is largely CYP1A2-cleared
- Fluvoxamine strongly inhibits CYP1A2
- clearance falls ~80%
- exposure ≈ 5×; t½ greatly prolonged
- Caffeine can accumulate with daily use
- Reduce caffeine; expect jitter/insomnia
Interaction at a glance
- Fluvoxamine strongly inhibits CYP1A2
- clearance falls ~80%
- exposure ≈ 5×; t½ greatly prolonged
- Reduce caffeine; expect jitter/insomnia
Mechanism
- Caffeine is largely CYP1A2-cleared
Magnitude / time course
- Fluvoxamine strongly inhibits CYP1A2
- clearance falls ~80%
- exposure ≈ 5×; t½ greatly prolonged
Mechanism / modifiers
- Caffeine can accumulate with daily use
Management
- Reduce caffeine; expect jitter/insomnia
Self-check
- In Caffeine + fluvoxamine, what is the approximate magnitude of the exposure change?
clearance falls ~80%
- About how much does fluvoxamine reduce Caffeine clearance?
About 80%
Drugs in this interaction (2)
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