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What the FDA labels say about taking them together

Fluvoxamine and ketoconazole

Fluvoxamine's FDA label of June 27, 2026 names ketoconazole in its drug interactions section; the ketoconazole label PlainMeds reads does not name fluvoxamine. The fluvoxamine label: “Pimozide is metabolized by the CYP3A4 isozyme and it has been demonstrated that ketoconazole, a potent inhibitor of CYP3A4, blocks the metabolism of this drug, resulting in increased plasma concentrations of parent drug.”

Check it at the source: the fluvoxamine FDA label on DailyMed (effective June 27, 2026, Zydus Pharmaceuticals USA Inc.); the ketoconazole FDA label on DailyMed (effective January 28, 2026, E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC).

What does the fluvoxamine label say about ketoconazole?

Fluvoxamine label, drug interactions

The metabolism of fluvoxamine has not been fully characterized and the effects of potent cytochrome P450 isoenzyme inhibition, such as the ketoconazole inhibition of CYP3A4, on fluvoxamine metabolism have not been studied.

Fluvoxamine label, warnings and precautions

Pimozide is metabolized by the CYP3A4 isozyme and it has been demonstrated that ketoconazole, a potent inhibitor of CYP3A4, blocks the metabolism of this drug, resulting in increased plasma concentrations of parent drug.

Source: FDA drug label (Fluvoxamine Maleate, NDA021519), ANI Pharmaceuticals, Inc., effective August 4, 2025 (SPL set 7ecd83ec-88f5-4f85-9cc2-9068375d8820), via openFDA

Source: FDA drug label (Fluvoxamine maleate extended-release), Zydus Pharmaceuticals USA Inc., effective June 27, 2026 (SPL set 6c71d4f6-54b5-4d3a-8d2f-b7773c92c32e), via openFDA; the full label on DailyMed

What does the ketoconazole label say about fluvoxamine?

Ketoconazole's label (effective January 28, 2026) does not name fluvoxamine in these sections. A label lists what its studies and reports found; it is not a complete list.

Source: FDA drug label (ketoconazole), E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC, effective January 28, 2026 (SPL set cad7c647-34a9-4e4e-83b3-8d78e58f588f), via openFDA; the full label on DailyMed

These are the labels' own sentences. PlainMeds does not grade interactions; a pharmacist or prescriber can say what they mean for one person's medicines.

Both medicines on the record

16Fluvoxamine generic labelers
30Ketoconazole generic labelers
FluvoxamineKetoconazole
Labeled forn/aFungal infections
Boxed warningYesNo
Pharmacy cost (NADAC)$4.08 per capsule 100 mg capsule$0.249 per gram 2% cream
Shortage nowNo current entryNo current entry

Source: FDA NDC Directory, CMS NADAC of October 7, 2026 and the FDA Drug Shortage Database (FDA files October 8, 2026)

What next?