ModerateCalcium channel blockers (dihydropyridines)×Selective serotonin reuptake inhibitors
Updated · Methodology
Mechanism
Fluoxetine and its active metabolite norfluoxetine moderately block CYP3A4 – the main amlodipine metabolic route. Amlodipine plasma levels may rise modestly. In older patients: additive hypotension.
Symptoms
Lower blood pressure, postural dizziness, fatigue. Older patients: fall risk.
Management
The combination is acceptable in most patients without dose change. In older patients, monitor blood pressure and hypotension symptoms 2 weeks after start.
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Sources
- FDA: Prozac (fluoxetine) prescribing information (2017)– ; DailyMed setid c88f33ed-6dfb-4c5e-bc01-d8e36dd97299
- AEMPS: Ficha técnica: Amlodipino (nº registro 65461), sección 4.5 (2025)– AEMPS, CIMA, nº registro 65461, revisión 08/2025, sección 4.5