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Fluvoxamine-methadone interaction
1Repatriation General Hospital, South Australia, Australia. saldecp@rgh.sa.gov.au
Objective:
The aim of this paper is to report a case of symptomatic methadone toxicity associated with fluvoxamine treatment.
Clinical Picture:
A 28-year-old woman was admitted to hospital with severe hypoxaemia and hypercapnia indicating hypoventilation. Medication prior to admission had been stable and included methadone 70 mg daily and diazepam 2 mg twice daily. Three weeks before admission she had commenced treatment with fluvoxamine.
Treatment:
Methadone was decreased to 50 mg daily and diazepam was tapered to zero.
Outcome:
The serum methadone concentration decreased and oxygenation improved considerably.
Conclusions:
Clinicians should be aware of the potential for a significant drug interaction between fluvoxamine and methadone.