increase QTc interval. Avoid or Use Alternate Drug.clonidineMonitor Closely (1)clonidine, sertraline. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration enhances CNS depressant effects.clopidogrelMonitor Closely (1)sertraline increases effects of clopidogrel by pharmacodynamic synergism. Use Caution/Monitor. SSRIs affect platelet activation; coadministration of SSRIs with clopidogrel may increase the risk of bleeding.clozapineMonitor Closely (2)sertraline increases levels of clozapine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Plasma levels of clozapine may be increased, resulting in increased pharmacologic and toxic effects. Adjust clozapine dose as needed when initiating or discontinuing certain SSRIs. . clozapine and sertraline both increase QTc interval. Use Caution/Monitor.cobicistatMonitor Closely (1)cobicistat will increase the level or effect of sertraline by Other (see comment). Use Caution/Monitor. Carefully titrate dose of the antidepressant to the desired effect, including using the lowest feasible initial or maintenance dose, and monitor its response during coadministration with SSRIs and cobicistat. cobimetinibSerious - Use Alternative (1)sertraline will increase the level or effect of cobimetinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If concurrent short term (14 days or less) use of moderate CYP3A inhibitors is unavoidable for patients who are taking cobimetinib 60 mg, reduce the cobimetinib dose to 20 mg. After discontinuation of a moderate CYP3A inhibitor, resume cobimetinib 60 mg. Use an alternative to a moderate CYP3A inhibitor in patients who are taking a reduced dose of cobimetinib (40 or 20 mg daily).cocaine topicalMonitor Closely (1)sertraline and cocaine topical both increase serotonin levels. Modify Therapy/Monitor Closely.codeineMonitor Closely (1)sertraline decreases effects of codeine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Prevents conversion of codeine to its active metabolite morphine.Minor (1)sertraline decreases effects of codeine by decreasing metabolism. Minor/Significance Unknown. Decreased conversion of codeine to active metabolite morphine.crizotinibSerious - Use Alternative (1)crizotinib and sertraline both increase QTc interval. Avoid or Use Alternate Drug.cyclobenzaprineSerious - Use Alternative (1)sertraline and cyclobenzaprine both increase serotonin levels. Avoid or Use Alternate Drug.cyproheptadineMonitor Closely (1)cyproheptadine decreases effects of sertraline by pharmacodynamic antagonism. Use Caution/Monitor. Cyproheptadine may diminish the serotonergic effect of SSRIs.dacomitinibSerious - Use Alternative (1)dacomitinib will increase the level or effect of sertraline by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Avoid use with CYP2D6 substrates where minimal increases in concentration of the CYP2D6 substrate may lead to serious or life-threatening toxicities. daridorexantMonitor Closely (2)sertraline will increase the level or effect of daridorexant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Daridorexant dose should not exceed 25 mg per night when coadministered with moderate CYP3A4 inhibitors. sertraline and daridorexant both increase sedation. Modify Therapy/Monitor Closely. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment. darunavirMonitor Closely (2)darunavir decreases levels of sertraline by Mechanism: unspecified interaction mechanism. Use Caution/Monitor. Carefully titrate SSRI dose based on clinical assessment of antidepressant response. darunavir will increase the level or effect of sertraline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration with SSRIs, TCAs, or trazodone may require dose titration of antidepressant to desired effect (eg, using the lowest feasible initial or maintenance dose). Monitor for antidepressant response.dasatinibMonitor Closely (1)dasatinib and sertraline both increase QTc interval. Use Caution/Monitor.defibrotideMonitor Closely (1)defibrotide increases effects of sertraline by Other (see comment). Use Caution/Monitor. Comment: Defibrotide may enhance effects of platelet inhibitors.deflazacortMonitor Closely (1)sertraline will increase the level or effect of deflazacort by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Decrease deflazacort dose to one-third of the recommended dose if coadministered with moderate or strong CYP3A4 inhibitors.degarelixMonitor Closely (1)degarelix and sertraline both increase QTc interval. Use Caution/Monitor.desfluraneSerious - Use Alternative (1)desflurane and sertraline both increase QTc interval. Avoid or Use Alternate Drug.desipramineMonitor Closely (1)sertraline will increase the level or effect of desipramine by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely.Serious - Use Alternative (2)sertraline and desipramine both increase serotonin levels. Avoid or Use Alternate Drug. desipramine and sertraline both increase QTc interval. Avoid or Use Alternate Drug.desvenlafaxineSerious - Use Alternative (1)sertraline and desvenlafaxine both increase serotonin levels. Avoid or Use Alternate Drug.deutetrabenazineMonitor Closely (1)deutetrabenazine and sertraline both increase QTc interval. Use Caution/Monitor. At the maximum recommended dose, deutetrabenazine does not prolong QT interval to a clinically relevant extent. Certain circumstances may increase risk of torsade de pointes and/or sudden death in association with drugs that prolong the QTc interval (eg, bradycardia, hypokalemia or hypomagnesemia, coadministration with other drugs that prolong QTc interval, presence of congenital QT prolongation).dexfenfluramineMonitor Closely (1)sertraline and dexfenfluramine both increase serotonin levels. Modify Therapy/Monitor Closely.Minor (1)sertraline will increase the level or effect of dexfenfluramine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.dexmethylphenidateMinor (1)dexmethylphenidate increases effects of sertraline by decreasing metabolism. Minor/Significance Unknown.dextroamphetamineMonitor Closely (2)sertraline will increase the level or effect of dextroamphetamine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. sertraline and dextroamphetamine both increase serotonin levels. Modify Therapy/Monitor Closely.dextroamphetamine transdermalMonitor Closely (1)sertraline, dextroamphetamine transdermal. Either increases effects of the other by serotonin levels. Modify Therapy/Monitor Closely. Initiate with lower doses and monitor for signs and symptoms of serotonin syndrome, particularly during initiation or dosage increase. If serotonin syndrome occurs, discontinue dextroamphetamine transdermal and concomitant serotonergic drug(s).dextromethorphanSerious - Use Alternative (1)sertraline and dextromethorphan both increase serotonin levels. Avoid or Use Alternate Drug.Minor (1)sertraline will increase the level or effect of dextromethorphan by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.diazepam intranasalMonitor Closely (3)sertraline will increase the level or effect of diazepam intranasal by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. Strong or moderate CYP2C19 inhibitors may decrease rate of diazepam elimination, thereby increasing adverse reactions to diazepam. sertraline will increase the level or effect of diazepam intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Strong or moderate CYP3A4 inhibitors may decrease rate of diazepam elimination, thereby increasing adverse reactions to diazepam. diazepam intranasal, sertraline. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration may potentiate the CNS-depressant effects of each drug.diclofenacMonitor Closely (1)sertraline, diclofenac. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.difelikefalinMonitor Closely (1)difelikefalin and sertraline both increase sedation. Use Caution/Monitor.diflunisalMonitor Closely (1)sertraline, diflunisal. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.dihydroergotamineMonitor Closely (1)sertraline and dihydroergotamine both increase serotonin levels. Modify Therapy/Monitor Closely.dihydroergotamine intranasalMonitor Closely (1)sertraline and dihydroergotamine intranasal both increase serotonin levels. Modify Therapy/Monitor Closely.disopyramideSerious - Use Alternative (1)sertraline and disopyramide both increase QTc interval. Avoid or Use Alternate Drug.dofetilideSerious - Use Alternative (1)dofetilide increases toxicity of sertraline by QTc interval. Avoid or Use Alternate Drug.dolasetronMonitor Closely (1)dolasetron and sertraline both increase QTc interval. Use Caution/Monitor.Serious - Use Alternative (1)dolasetron, sertraline. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.donepezilMonitor Closely (1)donepezil and sertraline both increase QTc interval. Use Caution/Monitor.Minor (1)sertraline will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.dosulepinSerious - Use Alternative (1)sertraline and dosulepin both increase serotonin levels. Avoid or Use Alternate Drug.doxepinSerious - Use Alternative (2)sertraline and doxepin both increase serotonin levels. Avoid or Use Alternate Drug. doxepin and sertraline both increase QTc interval. Avoid or Use Alternate Drug.Minor (1)sertraline will increase the level or effect of doxepin by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.dronedaroneContraindicated (1)sertraline and dronedarone both increase QTc interval. Contraindicated.droperidolSerious - Use Alternative (1)sertraline and droperidol both increase QTc interval. Avoid or Use Alternate Drug.duloxetineSerious - Use Alternative (2)duloxetine and sertraline both increase serotonin levels. Avoid or Use Alternate Drug. sertraline will increase the level or effect of duloxetine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.edoxabanMonitor Closely (1)sertraline increases effects of edoxaban by pharmacodynamic synergism. Use Caution/Monitor. Combination may increase risk of bleeding.efavirenzMonitor Closely (2)efavirenz and sertraline both increase QTc interval. Use Caution/Monitor. efavirenz will decrease the level or effect of sertraline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.elacestrantSerious - Use Alternative (1)sertraline will increase the level or effect of elacestrant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.eletriptanMonitor Closely (1)eletriptan and sertraline both increase serotonin levels. Modify Therapy/Monitor Closely.Minor (1)sertraline, eletriptan. Mechanism: unknown. Minor/Significance Unknown. Risk of weakness, dyspnea, chest pain.eliglustatContraindicated (1)sertraline increases levels of eliglustat by affecting hepatic enzyme CYP2D6 metabolism. Contraindicated. If coadministered with strong or moderate CYP2D6 inhibitors, reduce eliglustat dose from 84 mg BID to 84 mg once daily in extensive and intermediate metabolizers; eliglustat is contraindiated if strong or moderate CYP2D6 inhibitors are given concomitantly with strong or moderate CYP3A inhibitors.Monitor Closely (2)sertraline and eliglustat both increase QTc interval. Use Caution/Monitor. eliglustat increases levels of sertraline by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Monitor therapeutic drug concentrations, as indicated, or consider reducing the dosage of the concomitant drug and titrate to clinical effect.Serious - Use Alternative (1)sertraline increases levels of eliglustat by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Moderate CYP3A4 inhibitors are not recommended with eliglustat poor or intermediate metabolizers; reduce eliglustat dose from 84 mg BID to 84 mg once daily in extensive metabolizers .elvitegravir/cobicistat/emtricitabine/tenofovir DFMonitor Closely (1)elvitegravir/cobicistat/emtricitabine/tenofovir DF increases levels of sertraline by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Cobicistat is a CYP2D6 inhibitor; caution with CYP2D6 substrates for which elevated plasma concentrations are associated with serious and/or life-threatening events.encainideMinor (1)sertraline will increase the level or effect of encainide by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.encorafenibSerious - Use Alternative (1)encorafenib and sertraline both increase QTc interval. Avoid or Use Alternate Drug.entrectinibSerious - Use Alternative (2)sertraline will increase the level or effect of entrectinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of moderate CYP3A4 inhibitors with entrectinib, a CYP3A4 substrate. If coadministration unavoidable, reduce dose to 200 mg/day for patients aged 12 y or older with BSA >1.50m2. Resume previous entrectinib dose after discontinuing moderate CYP3A inhibitor for 3-5 elimination half-lives. entrectinib and sertraline both increase QTc interval. Avoid or Use Alternate Drug.ergotamineMonitor Closely (1)sertraline and ergotamine both increase serotonin levels. Modify Therapy/Monitor Closely.eribulinSerious - Use Alternative (1)eribulin and sertraline both increase QTc interval. Avoid or Use Alternate Drug.erythromycin baseSerious - Use Alternative (1)sertraline and erythromycin base both increase QTc interval. Avoid or Use Alternate Drug.erythromycin ethylsuccinateSerious - Use Alternative (1)sertraline and erythromycin ethylsuccinate both increase QTc interval. Avoid or Use Alternate Drug.erythromycin lactobionateMonitor Closely (1)sertraline and erythromycin lactobionate both increase QTc interval. Use Caution/Monitor.erythromycin stearateSerious - Use Alternative (1)sertraline and erythromycin stearate both increase QTc interval. Avoid or Use Alternate Drug.escitalopramSerious - Use Alternative (2)escitalopram and sertraline both increase serotonin levels. Avoid or Use Alternate Drug. escitalopram increases toxicity of sertraline by QTc interval. Avoid or Use Alternate Drug.eslicarbazepine acetateMonitor Closely (1)eslicarbazepine acetate will increase the level or effect of sertraline by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.esmololMinor (1)sertraline increases levels of esmolol by decreasing metabolism. Minor/Significance Unknown.estradiol vaginalMinor (1)sertraline will increase the level or effect of estradiol vaginal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.ethacrynic acidMinor (1)ethacrynic acid, sertraline. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Possible additive hyponatremia.etodolacMonitor Closely (1)sertraline, etodolac. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.fedratinibMonitor Closely (2)fedratinib will increase the level or effect of sertraline by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. Adjust dose of drugs that are CYP2C19 substrates as necessary. fedratinib will increase the level or effect of sertraline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Adjust dose of drugs that are CYP2D6 substrates as necessary.Serious - Use Alternative (1)sertraline will increase the level or effect of fedratinib by Other (see comment). Avoid or Use Alternate Drug. Avoid coadministration of fedratinib (a CYP3A4 and CYP2C19 substrate) with dual CYP3A4 and CYP2C19 inhibitor. Effect of coadministration of a dual CYP3A4 and CYP2C19 inhibitor with fedratinib has not been studied.fenbufenMonitor Closely (1)sertraline, fenbufen. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.fenfluramineMonitor Closely (2)fenfluramine, sertraline. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration with drugs that increase serotoninergic effects may increase the risk of serotonin syndrome. sertraline and fenfluramine both increase serotonin levels. Modify Therapy/Monitor Closely.fenoprofenMonitor Closely (1)sertraline, fenoprofen. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.fentanylSerious - Use Alternative