Moderate
Probable
Mô tả
Fluoxetine inhibits CYP2D6 and CYP3A4, increasing quetiapine plasma concentrations and potentially enhancing both therapeutic and adverse effects.
Cơ chế
Fluoxetine is a potent CYP2D6 inhibitor and moderate CYP3A4 inhibitor, reducing quetiapine clearance; combined serotonergic tone also modestly increases.
Ý nghĩa lâm sàng
Quetiapine levels may rise by 25–75%; increased sedation, metabolic effects, and QTc prolongation have been observed in clinical practice.
Xử trí
Reduce quetiapine dose when adding fluoxetine; monitor for sedation, metabolic changes, and QT prolongation.