inhib. serotonin uptake by platelets.ketorolac intranasalMonitor Closely (1)sertraline, ketorolac intranasal. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.L-tryptophanMonitor Closely (1)sertraline and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.lamotrigineMonitor Closely (1)lamotrigine increases toxicity of sertraline by unspecified interaction mechanism. Modify Therapy/Monitor Closely. CNS depressants may increase the toxic effects of selective serotonin reuptake inhibitors; psychomotor impairment may be enhanced.lapatinibMonitor Closely (1)sertraline and lapatinib both increase QTc interval. Use Caution/Monitor.lasmiditanMonitor Closely (2)lasmiditan, sertraline. Either increases effects of the other by sedation. Use Caution/Monitor. Coadministration of lasmiditan and other CNS depressant drugs, including alcohol have not been evaluated in clinical studies. Lasmiditan may cause sedation, as well as other cognitive and/or neuropsychiatric adverse reactions. sertraline increases effects of lasmiditan by serotonin levels. Use Caution/Monitor. Coadministration may increase risk of serotonin syndrome.lefamulinMonitor Closely (1)sertraline will increase the level or effect of lefamulin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Monitor for adverse effects if lefamulin is coadministered with moderate CYP3A inhibitors.Serious - Use Alternative (1)lefamulin and sertraline both increase QTc interval. Avoid or Use Alternate Drug.lemborexantMonitor Closely (1)lemborexant, sertraline. Either increases effects of the other by sedation. Modify Therapy/Monitor Closely. Dosage adjustment may be necessary if lemborexant is coadministered with other CNS depressants because of potentially additive effects.Serious - Use Alternative (1)sertraline will increase the level or effect of lemborexant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of lemborexant with moderate or strong CYP3A inhibitors.lenvatinibSerious - Use Alternative (1)sertraline and lenvatinib both increase QTc interval. Avoid or Use Alternate Drug.letermovirMonitor Closely (1)letermovir increases levels of sertraline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.leuprolideMonitor Closely (1)sertraline and leuprolide both increase QTc interval. Use Caution/Monitor.levamlodipineMonitor Closely (1)sertraline will increase the level or effect of levamlodipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Coadministration with moderate and strong CYP3A inhibitors results in increased systemic exposure to amlodipine and may require dose reduction. Monitor for symptoms of hypotension and edema when amlodipine is coadministered with CYP3A inhibitors to determine the need for dose adjustment.levofloxacinMonitor Closely (1)sertraline and levofloxacin both increase QTc interval. Use Caution/Monitor.levomilnacipranSerious - Use Alternative (1)levomilnacipran and sertraline both increase serotonin levels. Avoid or Use Alternate Drug.linezolidSerious - Use Alternative (1)linezolid and sertraline both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.lisdexamfetamineMonitor Closely (1)sertraline, lisdexamfetamine. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Initiate with lower doses and monitor for signs and symptoms of serotonin syndrome, particularly during initiation or dosage increase. If serotonin syndrome occurs, discontinue along with concomitant serotonergic drug(s).lithiumMonitor Closely (2)lithium and sertraline both increase QTc interval. Use Caution/Monitor. sertraline and lithium both increase serotonin levels. Modify Therapy/Monitor Closely.Minor (1)sertraline, lithium. Mechanism: unknown. Minor/Significance Unknown. Risk of neurotoxicity.lofepramineMonitor Closely (1)sertraline will increase the level or effect of lofepramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)sertraline and lofepramine both increase serotonin levels. Avoid or Use Alternate Drug.lofexidineSerious - Use Alternative (1)sertraline and lofexidine both increase QTc interval. Avoid or Use Alternate Drug.lomitapideContraindicated (1)sertraline increases levels of lomitapide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Increases lomitapide levels several folds.lonafarnibContraindicated (1)sertraline will increase the level or effect of lonafarnib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Lonafarnib is a sensitive CYP3A4 substrate. Coadministration with strong or moderate CYP3A4 inhibitors is contraindicated. loperamideMonitor Closely (1)sertraline and loperamide both increase QTc interval. Use Caution/Monitor.lopinavirMonitor Closely (1)lopinavir increases levels of sertraline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Potential for increased toxicity.Serious - Use Alternative (1)sertraline and lopinavir both increase QTc interval. Avoid or Use Alternate Drug.loratadineMinor (1)sertraline will increase the level or effect of loratadine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.lorcaserinMonitor Closely (1)lorcaserin will increase the level or effect of sertraline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)sertraline and lorcaserin both increase serotonin levels. Avoid or Use Alternate Drug.lornoxicamMonitor Closely (1)sertraline, lornoxicam. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.lsdMonitor Closely (1)sertraline and lsd both increase serotonin levels. Modify Therapy/Monitor Closely.lumacaftor/ivacaftorMonitor Closely (2)lumacaftor/ivacaftor will decrease the level or effect of sertraline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. A higher dose of sertraline may be required to obtain desired therapeutic effect. Sertraline is a substrate of CYP3A4, CYP2C19, CYP2C9, CYP2D6, and CYP2B6. Lumacaftor/ivacaftor is a strong inducer of CYP3A and lumacaftor has the potential to induce CYP2C19, CYP2C9, CYP2D6, and CYP2B6. lumacaftor/ivacaftor, sertraline. affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. In vitro studies suggest that lumacaftor may induce and ivacaftor may inhibit CYP2C19 substrates. .lumateperoneMonitor Closely (1)sertraline will increase the level or effect of lumateperone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce lumateperone dose to 21 mg/day if coadministered with moderate CYP3A4 inhibitors.lurasidoneMonitor Closely (1)lurasidone, sertraline. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Potential for increased CNS depressant effects when used concurrently; monitor for increased adverse effects and toxicity.lurbinectedinSerious - Use Alternative (1)sertraline will increase the level or effect of lurbinectedin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.macimorelinSerious - Use Alternative (1)macimorelin and sertraline both increase QTc interval. Avoid or Use Alternate Drug. Macimorelin causes an increase of ~11 msec in the corrected QT interval. Avoid coadministration with drugs that prolong QT interval, which could increase risk for developing torsade de pointes-type ventricular tachycardia. Allow sufficient washout time of drugs that are known to prolong the QT interval before administering macimorelin.maprotilineMonitor Closely (1)sertraline and maprotiline both increase QTc interval. Use Caution/Monitor.Serious - Use Alternative (1)sertraline and maprotiline both increase serotonin levels. Avoid or Use Alternate Drug.maravirocMonitor Closely (1)maraviroc increases levels of sertraline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Potential for increased toxicity. .mavacamtenContraindicated (1)sertraline will increase the level or effect of mavacamten by affecting hepatic enzyme CYP2C19 metabolism. Contraindicated. Strong or moderate CYP2C19 inhibitors may increase mavacamten systemic exposure, resulting in heart failure due to systolic dysfunction. Monitor Closely (1)sertraline will increase the level or effect of mavacamten by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Inititiation of moderate CYP3A4 inhibitors may require decreased mavacamten dose. meclofenamateMonitor Closely (1)sertraline, meclofenamate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.mefenamic acidMonitor Closely (1)sertraline, mefenamic acid. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.mefloquineMonitor Closely (1)sertraline will increase the level or effect of mefloquine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)mefloquine increases toxicity of sertraline by QTc interval. Avoid or Use Alternate Drug. Mefloquine may enhance the QTc prolonging effect of high risk QTc prolonging agents.meloxicamMonitor Closely (1)sertraline, meloxicam. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.meperidineSerious - Use Alternative (2)sertraline and meperidine both increase serotonin levels. Avoid or Use Alternate Drug. meperidine, sertraline. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.metforminMonitor Closely (1)sertraline increases effects of metformin by pharmacodynamic synergism. Use Caution/Monitor.methadoneSerious - Use Alternative (1)sertraline and methadone both increase QTc interval. Avoid or Use Alternate Drug.methamphetamineMonitor Closely (1)sertraline will increase the level or effect of methamphetamine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.methylene blueSerious - Use Alternative (1)methylene blue and sertraline both increase serotonin levels. Avoid or Use Alternate Drug. Methylene blue may increase serotonin as a result of MAO-A inhibition. If methylene blue must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last methylene blue dose or after 2 weeks of monitoring, whichever comes first.methylphenidate transdermalMonitor Closely (1)methylphenidate transdermal will increase the level or effect of sertraline by decreasing metabolism. Modify Therapy/Monitor Closely. Consider decreasing the dose of these drugs when given coadministered with methylphenidate. Monitor for drug toxiticities when initiating or discontinuing methylphenidate. metoclopramideSerious - Use Alternative (1)metoclopramide and sertraline both increase serotonin levels. Avoid or Use Alternate Drug. Additive effects; increased risk for serotonin syndrome, neuroleptic malignant syndrome, dystonia, or other extrapyramidal reactionsmetoclopramide intranasalSerious - Use Alternative (1)sertraline, metoclopramide intranasal. Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient.metoprololMonitor Closely (1)sertraline will increase the level or effect of metoprolol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.mexiletineMinor (1)sertraline will increase the level or effect of mexiletine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.midazolam intranasalMonitor Closely (1)midazolam intranasal, sertraline. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Concomitant use of barbiturates, alcohol, or other CNS depressants may increase the risk of hypoventilation, airway obstruction, desaturation, or apnea and may contribute to profound and/or prolonged drug effect.Serious - Use Alternative (1)sertraline will increase the level or effect of midazolam intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of moderate CYP3A4 inhibitors with midazolam intranasal causes higher midazolam systemic exposure, which may prolong sedation.midostaurinSerious - Use Alternative (1)sertraline and midostaurin both increase QTc interval. Avoid or Use Alternate Drug.mifepristoneMonitor Closely (1)mifepristone, sertraline. QTc interval. Modify Therapy/Monitor Closely. Use alternatives if available.milnacipranSerious - Use Alternative (1)milnacipran and sertraline both increase serotonin levels. Avoid or Use Alternate Drug.mipomersenMonitor Closely (1)mipomersen, sertraline. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Both drugs have potential to increase hepatic enzymes; monitor LFTs.mirabegronMonitor Closely (1)mirabegron will increase the level or effect of sertraline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.mirtazapineMonitor Closely (2)sertraline and mirtazapine both increase serotonin levels. Modify Therapy/Monitor Closely. mirtazapine and sertraline both increase QTc interval. Use Caution/Monitor.mobocertinibSerious - Use Alternative (2)sertraline will increase the level or effect of mobocertinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If use of moderate CYP3A4 inhibitor unavoidable, reduce mobocertinib dose by ~50% (eg, 160 to 80 mg); closely monitor QTc interval. mobocertinib and sertraline both increase QTc interval. Avoid or Use Alternate Drug. If coadministration unavoidable, reduce mobocertinib dose and monitor QTc interval more frequently.morphineMonitor Closely (2)sertraline will increase the level or effect of morphine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. sertraline and morphine both increase serotonin levels. Modify Therapy/Monitor Closely.Serious - Use Alternative (1)morphine, sertraline. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.moxifloxacinSerious - Use Alternative (1)sertraline and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.nabumetoneMonitor Closely (1)sertraline, nabumetone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.naldemedineMonitor Closely (1)sertraline increases levels of naldemedine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Monitor naldemedine for potential adverse effects if coadministered with strong or moderate CYP3A4 inhibitors.naloxegolSerious - Use Alternative (1)sertraline will increase the level or effect of naloxegol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministation of naloxegol with moderate CYP3A4 inhibitors is unavoidable, reduce naloxegol dose to 12.5 mg qDaynaproxenMonitor Closely (1)sertraline, naproxen. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.naratriptanMonitor Closely (1)naratriptan and sertraline both increase serotonin levels. Modify Therapy/Monitor Closely.Minor (1)sertraline, naratriptan. Mechanism: unknown. Minor/Significance Unknown. Risk of weakness, dyspnea, chest pain.nebivololMonitor Closely (1)sertraline will increase the level or effect of nebivolol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.nefazodoneSerious - Use Alternative (1)nefazodone and sertraline both increase serotonin levels. Avoid or Use Alternate Drug.nelfinavirMonitor Closely (1)nelfinavir increases levels of sertraline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Potential for increased toxicity. .neratinibSerious - Use Alternative (1)sertraline will increase the level or effect of neratinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of neratinib with strong/moderate CYP3A4 inhibitors.netupitant/palonosetronSerious - Use Alternative (1)netupitant/palonosetron, sertraline. Either increases toxicity of the other by