Summary
An 11-year-old boy with asthma had been receiving a controlled release theophylline preparation. He was prescribed fluvoxamine for a depressive disorder and within a week complained of severe headaches, tiredness and vomiting. His serum theophylline concentration had increased from 14.2 mg/L (shortly before fluvoxamine was started) to 27.4 mg/L. Fluvoxamine was withdrawn and theophylline concentrations decreased. Clomipramine was substituted for fluvoxamine with no further problems, and a later theophylline concentration was 13.7 mg/L. Competitive inhibition of hepatic microsomal enzymes by fluvoxamine may have been responsible for the elevated theophylline concentrations and toxicity observed in this case.
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Sperber, A.D. Toxic Interaction Between Fluvoxamine and Sustained Release Theophylline in an 11-Year-Old Boy. Drug-Safety 6, 460–462 (1991). https://doi.org/10.2165/00002018-199106060-00006
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DOI: https://doi.org/10.2165/00002018-199106060-00006