Drug interactions
Perhexiline + Sertraline
Severity: Major
Perhexiline 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
Perhexiline is cleared mainly by CYP2D6 and has a narrow therapeutic index. Sertraline can inhibit CYP2D6, particularly at higher doses, which may raise perhexiline levels and the risk of hepatotoxicity and neuropathy.
What this interaction means in plain words
Perhexiline 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.
Why it happens
Inhibition of CYP2D6-mediated perhexiline metabolism by sertraline.
What to do
Monitor plasma perhexiline concentrations and liver function when sertraline is started or its dose is changed. Reduce the perhexiline dose as guided by levels.
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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Other interactions of Sertraline
- Isocarboxazid + Sertraline Contraindicated
- Methylene blue + Sertraline Contraindicated
- Phenelzine + Sertraline Contraindicated
- Pimozide + Sertraline Contraindicated
- Selegiline transdermal + Sertraline Contraindicated
- Selegiline + Sertraline Contraindicated
Frequently asked questions
Can I take Perhexiline with Sertraline?
MediHelp rates the interaction as major. Perhexiline 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. Perhexiline is cleared mainly by CYP2D6 and has a narrow therapeutic index. Sertraline can inhibit CYP2D6, particularly at higher doses, which may raise perhexiline levels and the risk of hepatotoxicity and neuropathy.
How serious is the interaction between Perhexiline 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: Monitor plasma perhexiline concentrations and liver function when sertraline is started or its dose is changed. Reduce the perhexiline dose as guided by levels.
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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