Drug interactions
Dosulepin + Sertraline
Severity: Major
Dosulepin and Sertraline: major interaction.
Last updated Sources: US FDA label
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
Dosulepin is a tricyclic antidepressant with serotonergic activity, and combining it with an SSRI increases the risk of serotonin syndrome. Sertraline may also raise tricyclic levels, and tricyclics are cardiotoxic in overdose and can prolong QRS and QT.
What this interaction means in plain words
Dosulepin 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.
Dosulepin belongs to Central Nervous System; Sertraline belongs to Central Nervous System.
Why it happens
Additive serotonergic effects, plus weak CYP2D6 inhibition by sertraline that can raise tricyclic concentrations.
What to do
Avoid the combination where possible. If used, start with a low dosulepin dose, monitor for serotonin toxicity and anticholinergic or cardiac effects, and consider an ECG.
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
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 Dosulepin
- Dosulepin + Isocarboxazid Contraindicated
- Dosulepin + Phenelzine Contraindicated
- Dosulepin + Thioridazine Contraindicated
- Dosulepin + Tranylcypromine Contraindicated
- Amitriptyline + Dosulepin Major
- Buprenorphine + Dosulepin Major
Frequently asked questions
Can I take Dosulepin with Sertraline?
MediHelp rates the interaction as major. Dosulepin 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. Dosulepin is a tricyclic antidepressant with serotonergic activity, and combining it with an SSRI increases the risk of serotonin syndrome. Sertraline may also raise tricyclic levels, and tricyclics are cardiotoxic in overdose and can prolong QRS and QT.
How serious is the interaction between Dosulepin 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: Avoid the combination where possible. If used, start with a low dosulepin dose, monitor for serotonin toxicity and anticholinergic or cardiac effects, and consider an ECG.
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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