psychomotor performance and cause daytime impairment. omaveloxolonesertraline 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. ondansetronondansetron 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.oxaliplatinoxaliplatin and sertraline both increase QTc interval. Avoid or Use Alternate Drug.ozanimodozanimod 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.pacritinibsertraline will increase the level or effect of pacritinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.paliperidonesertraline and paliperidone both increase QTc interval. Avoid or Use Alternate Drug.palonosetronpalonosetron, sertraline. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.panobinostatsertraline and panobinostat both increase QTc interval. Avoid or Use Alternate Drug.paroxetinesertraline will increase the level or effect of paroxetine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.paroxetine and sertraline both increase serotonin levels. Avoid or Use Alternate Drug.pazopanibsertraline and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.pemigatinibsertraline 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.pentamidinesertraline and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.pexidartinibsertraline 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.phenterminesertraline, phentermine. Either increases toxicity of the other by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of serotonin syndrome.pimavanserinsertraline and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug.pimozidesertraline and pimozide both increase QTc interval. Contraindicated.pitolisantsertraline and pitolisant both increase QTc interval. Avoid or Use Alternate Drug.ponesimodsertraline and ponesimod both increase QTc interval. Avoid or Use Alternate Drug.procainamidesertraline and procainamide both increase QTc interval. Avoid or Use Alternate Drug.protriptylinesertraline and protriptyline both increase serotonin levels. Avoid or Use Alternate Drug.sertraline and protriptyline both increase QTc interval. Avoid or Use Alternate Drug.quetiapinesertraline and quetiapine both increase QTc interval. Avoid or Use Alternate Drug.rasagilinerasagiline 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.remifentanilremifentanil, sertraline. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.ribociclibribociclib increases toxicity of sertraline by QTc interval. Avoid or Use Alternate Drug.saquinavirsertraline and saquinavir both increase QTc interval. Avoid or Use Alternate Drug.selegiline transdermalselegiline transdermal and sertraline both increase serotonin levels. Avoid or Use Alternate Drug.selinexorselinexor, sertraline. unspecified interaction mechanism. Avoid or Use Alternate Drug. Patients treated with selinexor may experience neurological toxicities. Avoid taking selinexor with other medications that may cause dizziness or confusion.selumetinibsertraline will increase the level or effect of selumetinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration with strong or moderate CYP3A4 inhibitors cannot be avoided, reduce selumetinib dosage (refer to selumetinib monograph for further information). After discontinuation of the strong or moderate CYP3A4 inhibitor for 3 elimination half-lives, resume selumetinib dose that was taken before initiating the inhibitor.sevofluranesevoflurane and sertraline both increase QTc interval. Avoid or Use Alternate Drug.siponimodsertraline will increase the level or effect of siponimod by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of siponimod with a moderate or strong CYP3A4 inhibitor PLUS a moderate or strong CYP2C9 inhibitor is not recommended.sertraline and siponimod both increase QTc interval. Avoid or Use Alternate Drug.siponimod and sertraline both increase QTc interval. Avoid or Use Alternate Drug.St John's Wortsertraline and St John's Wort both increase serotonin levels. Avoid or Use Alternate Drug.sufentanilsufentanil, sertraline. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.tazemetostatsertraline will increase the level or effect of tazemetostat by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of tazemetostat with moderate CYP3A4 inhibitors. If coadministration is unavoidable, reduce tazemetostat current dose (see drug monograph Dosage Modifications). tedizolidtedizolid, sertraline. Either increases effects of the other by Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. both increase serotonin levels; increased risk of serotonin syndrome.tetrabenazinesertraline and tetrabenazine both increase QTc interval. Avoid or Use Alternate Drug.thioridazinesertraline will increase the level or effect of thioridazine by affecting hepatic enzyme CYP2D6 metabolism. Contraindicated.toremifenesertraline and toremifene both increase QTc interval. Avoid or Use Alternate Drug.trazodonesertraline and trazodone both increase serotonin levels. Avoid or Use Alternate Drug.sertraline and trazodone both increase QTc interval. Avoid or Use Alternate Drug.trimipraminesertraline and trimipramine both increase serotonin levels. Avoid or Use Alternate Drug.sertraline and trimipramine both increase QTc interval. Avoid or Use Alternate Drug.umeclidinium bromide/vilanterol inhaledsertraline increases toxicity of umeclidinium bromide/vilanterol inhaled by QTc interval. Avoid or Use Alternate Drug. Exercise extreme caution when vilanterol coadministered with drugs that prolong QTc interval; adrenergic agonist effects on the cardiovascular system may be potentiated.vandetanibsertraline and vandetanib both increase QTc interval. Avoid or Use Alternate Drug.vemurafenibsertraline and vemurafenib both increase QTc interval. Avoid or Use Alternate Drug.venetoclaxsertraline will increase the level or effect of venetoclax by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If a moderate CYP3A inhibitor must be used, reduce the venetoclax dose by at least 50%. Monitor more closely for signs of venetoclax toxicities.venlafaxinesertraline and venlafaxine both increase serotonin levels. Avoid or Use Alternate Drug.sertraline and venlafaxine both decrease QTc interval. Avoid or Use Alternate Drug.vilanterol/fluticasone furoate inhaledsertraline increases toxicity of vilanterol/fluticasone furoate inhaled by QTc interval. Avoid or Use Alternate Drug. Exercise extreme caution when vilanterol coadministered with drugs that prolong QTc interval; adrenergic agonist effects on the cardiovascular system may be potentiated.vilazodonesertraline, vilazodone. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. .vortioxetinesertraline, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.Monitor Closely (260)5-HTPsertraline and 5-HTP both increase serotonin levels. Modify Therapy/Monitor Closely.abirateroneabiraterone increases levels of sertraline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Avoid coadministration of abiraterone with substrates of CYP2D6. If alternative therapy cannot be used, exercise caution and consider a dose reduction of the CYP2D6 substrate.acalabrutinibsertraline will increase the level or effect of acalabrutinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Decrease acalabrutinib dose to 100 mg once daily if coadministered with a moderate CYP3A inhibitor.aceclofenacsertraline, aceclofenac. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.acemetacinsertraline, acemetacin. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.albuterolalbuterol and sertraline both increase QTc interval. Use Caution/Monitor.alfuzosinsertraline and alfuzosin both increase QTc interval. Use Caution/Monitor.alfuzosin and sertraline both increase QTc interval. Use Caution/Monitor.almotriptanalmotriptan and sertraline both increase serotonin levels. Modify Therapy/Monitor Closely.amifampridinesertraline increases toxicity of amifampridine by Other (see comment). Modify Therapy/Monitor Closely. Comment: Amifampridine can cause seizures. Coadministration with drugs that lower seizure threshold may increase this risk.amitriptylinesertraline and amitriptyline both increase QTc interval. Use Caution/Monitor.amoxapinesertraline and amoxapine both increase QTc interval. Use Caution/Monitor.apixabansertraline and apixaban both increase anticoagulation. Use Caution/Monitor. SSRIs may inhibit platelet aggregation, thus increase bleeding risk when coadministered with anticoagulants.apomorphineapomorphine and sertraline both increase QTc interval. Use Caution/Monitor.arformoterolarformoterol and sertraline both increase QTc interval. Use Caution/Monitor.aripiprazolesertraline will increase the level or effect of aripiprazole by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.aripiprazole and sertraline both increase QTc interval. Use Caution/Monitor.aspirinsertraline, aspirin. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.aspirin rectalsertraline, aspirin rectal. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.aspirin/citric acid/sodium bicarbonatesertraline, aspirin/citric acid/sodium bicarbonate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.atazanaviratazanavir increases levels of sertraline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Potential for increased toxicity. .atogepantsertraline will increase the level or effect of atogepant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.atomoxetinesertraline will increase the level or effect of atomoxetine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.atomoxetine and sertraline both increase QTc interval. Use Caution/Monitor.avanafilsertraline will increase the level or effect of avanafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. CYP3A4 inhibitors may reduce avanafil clearance increasing systemic exposure to avanafil; increased levels may result in increased associated adverse events; the maximum recommended dose of STENDRA is 50 mg, not to exceed once every 24 hours for patients taking concomitant moderate CYP3A4 inhibitorsbedaquilinesertraline and bedaquiline both increase QTc interval. Modify Therapy/Monitor Closely. ECG should be monitored closelybenzhydrocodone/acetaminophensertraline will increase the level or effect of benzhydrocodone/acetaminophen by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Hydromorphone (<3% of the circulating parent hydrocodone [benzhydrocodone is prodrug of hydrocodone]) is mainly formed by CYP2D6 mediated O-demethylation of hydrocodone. Hydromorphone may contribute to the total analgesic effect of hydrocodone.benzhydrocodone/acetaminophen, sertraline. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment.betrixabansertraline, betrixaban. Either increases levels of the other by anticoagulation. Use Caution/Monitor. SSRIs may inhibit platelet aggregation, thus increase bleeding risk when coadministered with anticoagulants.brexpiprazolesertraline will increase the level or effect of brexpiprazole by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Administer a quarter of brexpiprazole dose if coadministered with a moderate CYP2D6 inhibitor PLUS a strong/moderate CYP3A4 inhibitor.sertraline will increase the level or effect of brexpiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Administer a quarter of brexpiprazole dose if coadministered with a moderate CYP3A4 inhibitor PLUS a strong/moderate CYP2D6 inhibitor.buprenorphine subdermal implantsertraline will increase the level or effect of buprenorphine subdermal implant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Monitor patients already on buprenorphine subdermal implant who require newly-initiated treatment with CYP3A4 inhibitors for signs and symptoms of overmedication. If the dose of the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, implant removal may be necessary and the patient should then be treated with a buprenorphine dosage form that permits dose adjustments. If a CYP3A4 inhibitor is discontinued in a patient who has been stabilized on buprenorphine, monitor the patient for withdrawal.sertraline, buprenorphine subdermal implant. Either increases toxicity of the other by serotonin levels. Use Caution/Monitor. Concomitant use could result in life-threatening serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation, and during dose adjustment of the serotonergic drug. Discontinue buprenorphine if serotonin syndrome is suspected.buprenorphine, long-acting injectionsertraline will increase the level or effect of buprenorphine, long-acting injection by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Patients who transfer to buprenorphine long-acting injection from transmucosal buprenorphine coadministered with CYP3A4 inhibitors should be monitored to ensure buprenorphine plasma levels are adequate. Within 2 weeks, if signs and symptoms of buprenorphine toxicity or overdose occur and the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, transition the patient back to a buprenorphine formulation that permits dose adjustments.sertraline, buprenorphine, long-acting injection. Either increases toxicity of the other by serotonin levels. Use Caution/Monitor. Concomitant use could result in life-threatening serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation, and during dose adjustment of