Medication·Interactions & depletion·Reviewed June 9, 2026
Fluoxetine interactions.
Fluoxetine has 10 documented interactions in the NutriStack database, including 4 flagged to avoid or as a serious conflict. Prolonged use is also associated with lower Sodium and Folate. The full interaction list, depletion table, and replacement suggestions are below. None of this is a substitute for your prescriber's advice.
Fluoxetine at a glance.
A quick, data-grounded summary. The full tables are below.
Fluoxetine has 10 documented interactions in the NutriStack database, including 4 flagged to avoid or as a serious conflict. Prolonged use is also associated with lower Sodium and Folate. The full interaction list, depletion table, and replacement suggestions are below. None of this is a substitute for your prescriber's advice.
Substances that interact with fluoxetine.
Every supplement and medication in the NutriStack database with a documented interaction with this drug, highest-severity first. Open any pair for the mechanism and sources.
| Substance | Interaction | What happens |
|---|---|---|
| 5-HTP | Contraindicated | 5-HTP directly increases serotonin synthesis, while fluoxetine blocks serotonin reuptake. This combination can lead to serotonin syndrome. The risk... details → |
| MDMA | Contraindicated | MDMA produces its effects by reversing the serotonin transporter; fluoxetine blocks that transporter. The result is unpredictable blunting of MDMA's... details → |
| St. John's Wort | Contraindicated | Combining fluoxetine with St. John's Wort creates a high risk of serotonin syndrome. Fluoxetine has a long half-life (including its active... details → |
| Tramadol | Contraindicated | Fluoxetine combined with tramadol creates dual serotonin syndrome risk. Additionally, fluoxetine inhibits CYP2D6, reducing tramadol conversion to... details → |
| Fish Oil | Caution | Fluoxetine depletes platelet serotonin and impairs aggregation, while high-dose fish oil adds modest antiplatelet activity. Observational data show... details → |
| Ginkgo Biloba | Caution | Fluoxetine depletes platelet serotonin and impairs aggregation; ginkgo's ginkgolides inhibit platelet-activating factor. The combination compounds... details → |
| L-Tryptophan | Caution | L-Tryptophan supplementation increases serotonin synthesis, and combined with fluoxetine's potent, long-lasting serotonin reuptake inhibition, can... details → |
| Psilocybin | Caution | Fluoxetine substantially blunts psilocybin's psychedelic effects through chronic 5-HT2A receptor downregulation, and its very long half-life means... |
| Rhodiola Rosea | Caution | Fluoxetine is serotonergic. Rhodiola has preclinical monoamine and MAO-related findings, but direct human evidence for serotonin syndrome with... |
| SAMe | Caution | SAMe increases serotonergic activity through multiple mechanisms. Combined with fluoxetine's potent and long-lasting SERT inhibition, the risk of... details → |
What fluoxetine can deplete.
Nutrients this medication is associated with lowering over time, with the mechanism, a suggested replacement where one applies, and the biomarker to monitor. Discuss any replacement with your prescriber first.
| Nutrient | Severity | How it happens | Replace with | Monitor |
|---|---|---|---|---|
| Sodium | Significant | SSRI-induced SIADH can lower serum sodium, especially in older adults and during the first weeks of therapy. | – | Serum sodium |
| Folate | Mild | Lower folate status is associated with poorer SSRI response and may be reduced in some chronic users through altered one-carbon metabolism. | Methylfolate | Serum folate or RBC folate |
The full fluoxetine profile.
Uses, typical dosing, side effects, and the cited evidence for this medication.
Common fluoxetine questions.
Quick answers drawn from the tables above.
What interacts with Fluoxetine?
In the NutriStack database, Fluoxetine has 10 documented interactions. The most notable include 5-HTP, MDMA, St. John's Wort, Tramadol, and Fish Oil. Check any specific combination before taking it and confirm with your prescriber.
Which substances should I avoid with Fluoxetine?
Fluoxetine is flagged against 4 substances in the database, including 5-HTP, MDMA, St. John's Wort, and Tramadol. These pairings carry a higher risk and should be reviewed with a clinician before combining.
Does Fluoxetine deplete any nutrients?
Fluoxetine is associated with lowering Sodium and Folate with prolonged use. Useful biomarkers to monitor include Serum sodium and Serum folate or RBC folate. Ask your prescriber before adding any replacement supplement.
Is it safe to take 5-HTP with Fluoxetine?
NutriStack classifies the 5-HTP and Fluoxetine pairing as contraindicated: 5-HTP directly increases serotonin synthesis, while fluoxetine blocks serotonin reuptake. This combination can lead to serotonin syndrome. The risk is compounded by... Do not combine 5-HTP with fluoxetine. Due to fluoxetine's long half-life, wait at least 5 weeks after discontinuing fluoxetine before starting 5-HTP. Always confirm with your prescriber.
Check your whole stack
See how fluoxetine fits your supplements.
NutriStack screens your full routine for interactions and depletions, and updates the moment you change it.