serotonin levels. Avoid or Use Alternate Drug.nevirapineMonitor Closely (1)nevirapine will decrease the level or effect of sertraline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.nilotinibSerious - Use Alternative (1)sertraline and nilotinib both increase QTc interval. Avoid or Use Alternate Drug.norgestrelMonitor Closely (1)sertraline will increase the level or effect of norgestrel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Strong or moderate CYP3A4 inhibitors may increase systemic concentration of norgestrel, which may increase risk for adverse effects nortriptylineMonitor Closely (1)sertraline will increase the level or effect of nortriptyline by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely.Serious - Use Alternative (2)sertraline and nortriptyline both increase serotonin levels. Avoid or Use Alternate Drug. sertraline and nortriptyline both increase QTc interval. Avoid or Use Alternate Drug.octreotideMonitor Closely (1)sertraline and octreotide both increase QTc interval. Use Caution/Monitor.ofloxacinMonitor Closely (1)sertraline and ofloxacin both increase QTc interval. Use Caution/Monitor.olanzapineMonitor Closely (1)olanzapine and sertraline both increase QTc interval. Use Caution/Monitor.olaparibSerious - Use Alternative (1)sertraline will increase the level or effect of olaparib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration with moderate CYP3A inhibitors cannot be avoided, reduce olaparib dose to 200 mg (capsule) or 150 mg (tablet) PO BID. Do not substitute tablets with capsules.oliceridineMonitor Closely (3)sertraline will increase the level or effect of oliceridine by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. If concomitant use is necessary, may require less frequent oliceridine dosing. Closely monitor for respiratory depression and sedation and titrate subsequent doses accordingly. If inhibitor is discontinued, consider increase oliceridine dosage until stable drug effects are achieved. Monitor for signs of opioid withdrawal. sertraline will increase the level or effect of oliceridine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. If concomitant use is necessary, may require less frequent oliceridine dosing. Closely monitor for respiratory depression and sedation and titrate subsequent doses accordingly. If inhibitor is discontinued, consider increase oliceridine dosage until stable drug effects are achieved. Monitor for signs of opioid withdrawal. sertraline, oliceridine. Either increases toxicity of the other by serotonin levels. Modify Therapy/Monitor Closely.olopatadine intranasalSerious - Use Alternative (1)sertraline and olopatadine intranasal both increase sedation. Avoid or Use Alternate Drug. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment. omaveloxoloneSerious - Use Alternative (1)sertraline will increase the level or effect of omaveloxolone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If unavoidable, reduce omaveloxolone dose to 100 mg/day. Closely monitor for adverse effects. If adverse effects emerge, further reduce to 50 mg/day. ondansetronSerious - Use Alternative (2)ondansetron and sertraline both increase QTc interval. Avoid or Use Alternate Drug. Avoid with congenital long QT syndrome; ECG monitoring recommended with concomitant medications that prolong QT interval, electrolyte abnormalities, CHF, or bradyarrhythmias. ondansetron, sertraline. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.osilodrostatMonitor Closely (1)osilodrostat and sertraline both increase QTc interval. Use Caution/Monitor.osimertinibMonitor Closely (1)osimertinib and sertraline both increase QTc interval. Use Caution/Monitor. Conduct periodic monitoring with ECGs and electrolytes in patients taking drugs known to prolong the QTc interval.oxaliplatinSerious - Use Alternative (1)oxaliplatin and sertraline both increase QTc interval. Avoid or Use Alternate Drug.oxaprozinMonitor Closely (1)sertraline, oxaprozin. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.oxycodoneMonitor Closely (2)sertraline will increase the level or effect of oxycodone by affecting hepatic enzyme CYP2B6 metabolism. Use Caution/Monitor. oxycodone increases effects of sertraline by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Opioids may enhance the serotonergic effects of SSRIs and increase risk for serotonergic syndrome.oxymorphoneMonitor Closely (1)sertraline will increase the level or effect of oxymorphone by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.ozanimodMonitor Closely (1)ozanimod and sertraline both increase QTc interval. Modify Therapy/Monitor Closely. The potential additive effects on heart rate, treatment with ozanimod should generally not be initiated in patients who are concurrently treated with QT prolonging drugs with known arrhythmogenic properties.Serious - Use Alternative (1)ozanimod increases toxicity of sertraline by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Because the active metabolite of ozanimod inhibits MAO-B in vitro, there is a potential for serious adverse reactions, including hypertensive crisis. Therefore, coadministration of ozanimod with drugs that can increase norepinephrine or serotonin is not recommended. Monitor for hypertension with concomitant use.pacritinibSerious - Use Alternative (1)sertraline will increase the level or effect of pacritinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.palbociclibMonitor Closely (1)sertraline will increase the level or effect of palbociclib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.paliperidoneSerious - Use Alternative (1)sertraline and paliperidone both increase QTc interval. Avoid or Use Alternate Drug.palonosetronSerious - Use Alternative (1)palonosetron, sertraline. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.panax ginsengMinor (1)panax ginseng increases effects of sertraline by pharmacodynamic synergism. Minor/Significance Unknown.panobinostatSerious - Use Alternative (1)sertraline and panobinostat both increase QTc interval. Avoid or Use Alternate Drug.parecoxibMonitor Closely (1)sertraline, parecoxib. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.paroxetineMonitor Closely (1)sertraline and paroxetine both increase QTc interval. Use Caution/Monitor.Serious - Use Alternative (2)paroxetine and sertraline both increase serotonin levels. Avoid or Use Alternate Drug. sertraline will increase the level or effect of paroxetine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.pasireotideMonitor Closely (1)sertraline and pasireotide both increase QTc interval. Modify Therapy/Monitor Closely.pazopanibSerious - Use Alternative (1)sertraline and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.peginterferon alfa 2bMonitor Closely (1)peginterferon alfa 2b, sertraline. Other (see comment). Use Caution/Monitor. Comment: When patients are administered peginterferon alpha-2b with CYP2D6 substrates, the therapeutic effect of these drugs may be altered. Peginterferon alpha-2b may increase or decrease levels of CYP2D6 substrate.pemigatinibSerious - Use Alternative (1)sertraline will increase the level or effect of pemigatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration with strong or moderate CYP3A4 inhibitors is unavoidable, reduce pemigatinib dose (refer to drug monograph dosage modifications). After discontinuing the CYP3A4 inhibitor for 3 elimination half-lives, may resume previous pemigatinib dose.pentamidineSerious - Use Alternative (1)sertraline and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.pentazocineMonitor Closely (1)sertraline and pentazocine both increase serotonin levels. Modify Therapy/Monitor Closely.perhexilineMinor (1)sertraline will increase the level or effect of perhexiline by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.perphenazineMonitor Closely (1)sertraline and perphenazine both increase QTc interval. Use Caution/Monitor.Minor (1)sertraline will increase the level or effect of perphenazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.pexidartinibSerious - Use Alternative (1)sertraline will increase the level or effect of pexidartinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration with strong or moderate CYP3A4 inhibitors is unavoidable, reduce pexidartinib dose (refer to drug monograph dosage modifications). After discontinuing the CYP3A4 inhibitor for 3 elimination half-lives, may resume previous pexidartinib dose.phenelzineContraindicated (1)phenelzine and sertraline both increase serotonin levels. Contraindicated.phentermineSerious - Use Alternative (1)sertraline, phentermine. Either increases toxicity of the other by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of serotonin syndrome.phenytoinMonitor Closely (1)sertraline increases levels of phenytoin by decreasing metabolism. Use Caution/Monitor.pimavanserinSerious - Use Alternative (1)sertraline and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug.pimozideContraindicated (1)sertraline increases levels of pimozide by decreasing metabolism. Contraindicated. Risk of prolonged QTc interval.Serious - Use Alternative (1)sertraline and pimozide both increase QTc interval. Contraindicated.piroxicamMonitor Closely (1)sertraline, piroxicam. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.pitolisantSerious - Use Alternative (1)sertraline and pitolisant both increase QTc interval. Avoid or Use Alternate Drug.pleurisy rootMinor (1)pleurisy root decreases effects of sertraline by unspecified interaction mechanism. Minor/Significance Unknown. Theoretical interaction.ponesimodSerious - Use Alternative (1)sertraline and ponesimod both increase QTc interval. Avoid or Use Alternate Drug.posaconazoleMonitor Closely (1)sertraline and posaconazole both increase QTc interval. Use Caution/Monitor.pregabalinMonitor Closely (1)pregabalin, sertraline. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.primaquineMonitor Closely (2)primaquine and sertraline both increase QTc interval. Use Caution/Monitor. sertraline and primaquine both increase QTc interval. Use Caution/Monitor.procainamideSerious - Use Alternative (1)sertraline and procainamide both increase QTc interval. Avoid or Use Alternate Drug.procarbazineContraindicated (1)procarbazine and sertraline both increase serotonin levels. Contraindicated. Combination is contraindicated within 2 weeks of MAOI use.prochlorperazineMonitor Closely (1)sertraline and prochlorperazine both decrease QTc interval. Use Caution/Monitor.Minor (1)sertraline will increase the level or effect of prochlorperazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.promazineMinor (1)sertraline will increase the level or effect of promazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.promethazineMonitor Closely (1)sertraline and promethazine both decrease QTc interval. Use Caution/Monitor.Minor (1)sertraline will increase the level or effect of promethazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.propafenoneMinor (1)sertraline will increase the level or effect of propafenone by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown. Monitor the EKG in patients receiving concurrent propafenone and sertraline. Doses of propafenone may need to be reduced.propranololMonitor Closely (1)sertraline will increase the level or effect of propranolol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Sertraline is a moderate to weak inhibitor of the hepatic (CYP2D6) which may be involved in the metabolism of propranolol. Monitor patients receiving propranolol and sertraline cotherapy for an increased incidence of chest pain. This effect may be more pronounced in patients with preexisting coronary artery disease.protriptylineSerious - Use Alternative (2)sertraline and protriptyline both increase serotonin levels. Avoid or Use Alternate Drug. sertraline and protriptyline both increase QTc interval. Avoid or Use Alternate Drug.quetiapineSerious - Use Alternative (1)sertraline and quetiapine both increase QTc interval. Avoid or Use Alternate Drug.quinineMonitor Closely (1)sertraline and quinine both increase QTc interval. Use Caution/Monitor.ranolazineMonitor Closely (1)sertraline and ranolazine both increase QTc interval. Use Caution/Monitor.rasagilineSerious - Use Alternative (1)rasagiline and sertraline both increase serotonin levels. Avoid or Use Alternate Drug. Severe CNS toxicity associated with hyperpyrexia has been reported with the combined treatment of an antidepressant and rasagiline. Avoid combination within 14 days of MAOI use.remifentanilSerious - Use Alternative (1)remifentanil, sertraline. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.remimazolamMonitor Closely (1)remimazolam, sertraline. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely. Coadministration may result in profound sedation, respiratory depression, coma, and/or death. Continuously monitor vital signs during sedation and recovery period if coadministered. Carefully titrate remimazolam dose if administered with opioid analgesics and/or sedative/hypnotics.ribociclibSerious - Use Alternative (1)ribociclib increases toxicity of sertraline by QTc interval. Avoid or Use Alternate Drug.rilpivirineMonitor Closely (1)sertraline and rilpivirine both increase QTc interval. Use Caution/Monitor.rimegepantMonitor Closely (1)sertraline will increase the level or effect of rimegepant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Avoid repeating rimegepant dose within 48 hr if coadministered with a moderate CYP3A4 inhibitor.risperidoneMonitor Closely (2)sertraline will increase the level or effect of risperidone by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. sertraline and risperidone both increase QTc interval. Use Caution/Monitor.ritonavirMonitor Closely (1)ritonavir increases levels of sertraline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Increased risk of serotonin syndrome.rivaroxabanMonitor Closely (1)sertraline increases effects of rivaroxaban by pharmacodynamic synergism. Use Caution/Monitor. Combination may increase risk of bleeding.rizatriptanMonitor Closely (1)rizatriptan and sertraline both increase serotonin levels. Modify Therapy/Monitor Closely.Minor (1)sertraline, rizatriptan. Mechanism: unknown. Minor/Significance Unknown. Risk of weakness, dyspnea, chest pain.rolapitantMonitor Closely (1)rolapitant will increase the level or effect of sertraline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Rolapitant may increase plasma concentrations of CYP2D6 substrates for at least 28 days following rolapitant administration.romidepsinMonitor Closely (1)sertraline and romidepsin both increase QTc interval. Use Caution/Monitor.rucaparibMonitor Closely (1)rucaparib will increase the level or effect of sertraline by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Adjust dosage of CYP2C19 substrates, if clinically indicated.ruxolitinibMonitor Closely (1)sertraline will increase the level or effect of ruxolitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.ruxolitinib topicalMonitor Closely (1)sertraline will increase the level or effect of ruxolitinib topical by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.safinamideMonitor Closely (1)sertraline, safinamide. Either increases toxicity of the other by serotonin levels. Use Caution/Monitor. Monitor patients for symptoms of serotonin syndrome if SSRIs are coadministered with safinamide.salicylates (non-asa)Monitor Closely (1)sertraline, salicylates (non-asa). Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.salsalateMonitor Closely (1)sertraline, salsalate. Either