Drug interactions
Mifepristone + Sertraline
Severity: Major
Mifepristone and Sertraline: major interaction.
Last updated
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
Mifepristone, particularly at the higher doses used for Cushing's syndrome, prolongs the QT interval, and sertraline may add a small effect. Mifepristone also inhibits CYP3A4 and CYP2D6 and could raise sertraline levels.
What this interaction means in plain words
Mifepristone 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.
Mifepristone belongs to Endocrine; Sertraline belongs to Central Nervous System.
Why it happens
Additive QT prolongation, with mifepristone inhibition of CYP enzymes increasing sertraline exposure.
What to do
Prefer an alternative where possible when mifepristone is used at high doses; otherwise obtain a baseline ECG and monitor electrolytes and QTc. Watch for sertraline adverse effects and consider dose reduction.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Mifepristone and Sertraline, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
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 Mifepristone
- Apixaban + Mifepristone Contraindicated
- Argatroban + Mifepristone Contraindicated
- Cisapride + Mifepristone Contraindicated
- Cortisone + Mifepristone Contraindicated
- Cyclosporin + Mifepristone Contraindicated
- Dabigatran etexilate + Mifepristone Contraindicated
Frequently asked questions
Can I take Mifepristone with Sertraline?
MediHelp rates the interaction as major. Mifepristone 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. Mifepristone, particularly at the higher doses used for Cushing's syndrome, prolongs the QT interval, and sertraline may add a small effect. Mifepristone also inhibits CYP3A4 and CYP2D6 and could raise sertraline levels.
How serious is the interaction between Mifepristone 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: Prefer an alternative where possible when mifepristone is used at high doses; otherwise obtain a baseline ECG and monitor electrolytes and QTc. Watch for sertraline adverse effects and consider dose reduction.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
