Drug interactions
Dofetilide + Sertraline
Severity: Major
Dofetilide and Sertraline: major interaction.
Last updated Sources: UK SmPC
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Dofetilide has a high risk of dose-related QT prolongation and torsades de pointes. Sertraline may add a smaller QT effect, so the combination lowers the safety margin of an already high-risk antiarrhythmic.
What this interaction means in plain words
Dofetilide and Sertraline can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Dofetilide belongs to Cardiovascular; Sertraline belongs to Central Nervous System.
Why it happens
Additive QT prolongation.
What to do
Dofetilide is started in a monitored setting with continuous ECG. Avoid the combination where possible, and if it is needed, check QTc often and keep potassium and magnesium normal.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
- Lustral 100mg film coated tablets - SmPC sections 4.3/4.5 (class statement: drugs which prolong the QTc interval; "The risk of QTc prolongation and/or ventricular arrhythmias (e.g. TdP) may be increased with concomitant use of other drugs which prolong the QTc interval (e.g.") — electronic medicines compendium (UK SmPC)
Other interactions of Sertraline
- Isocarboxazid + Sertraline Contraindicated
- Methylene blue + Sertraline Contraindicated
- Phenelzine + Sertraline Contraindicated
- Pimozide + Sertraline Contraindicated
- Selegiline transdermal + Sertraline Contraindicated
- Selegiline + Sertraline Contraindicated
Other interactions of Dofetilide
- Amiodarone + Dofetilide Contraindicated
- Amisulpride + Dofetilide Contraindicated
- Amlodipine-hydrochlorothiazide-valsartan + Dofetilide Contraindicated
- Amlodipine-olmesartan-hydrochlorothiazide + Dofetilide Contraindicated
- Candesartan-hydrochlorothiazide + Dofetilide Contraindicated
- Captopril-hydrochlorothiazide + Dofetilide Contraindicated
Frequently asked questions
Can I take Dofetilide with Sertraline?
MediHelp rates the interaction as major. Dofetilide and Sertraline can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Dofetilide has a high risk of dose-related QT prolongation and torsades de pointes. Sertraline may add a smaller QT effect, so the combination lowers the safety margin of an already high-risk antiarrhythmic.
How serious is the interaction between Dofetilide and Sertraline?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Dofetilide is started in a monitored setting with continuous ECG. Avoid the combination where possible, and if it is needed, check QTc often and keep potassium and magnesium normal.
What other medicines interact with Sertraline?
MediHelp also lists interactions of Sertraline with, for example, Isocarboxazid, Methylene blue, Phenelzine. The full list is on the Sertraline page.
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