Drug interactions
Sertraline + Trimipramine
Severity: Major
Sertraline and Trimipramine: 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
Both drugs increase serotonergic activity and can cause serotonin syndrome, and each has some potential to prolong the QT interval. Sertraline can also modestly raise tricyclic levels through CYP2D6 inhibition.
What this interaction means in plain words
Sertraline and Trimipramine 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.
Sertraline belongs to Central Nervous System; Trimipramine belongs to Central Nervous System.
Why it happens
Additive serotonergic and QT-prolonging effects, with sertraline weakly inhibiting CYP2D6 metabolism of trimipramine.
What to do
Avoid if possible; if combined, start with low trimipramine doses, monitor for serotonin toxicity and obtain an ECG in patients with cardiac risk factors. Consider trimipramine plasma level monitoring.
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 Trimipramine
- Disopyramide + Trimipramine Contraindicated
- Dofetilide + Trimipramine Contraindicated
- Ibutilide + Trimipramine Contraindicated
- Isocarboxazid + Trimipramine Contraindicated
- Pentamidine + Trimipramine Contraindicated
- Phenelzine + Trimipramine Contraindicated
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 Sertraline with Trimipramine?
MediHelp rates the interaction as major. Sertraline and Trimipramine 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. Both drugs increase serotonergic activity and can cause serotonin syndrome, and each has some potential to prolong the QT interval. Sertraline can also modestly raise tricyclic levels through CYP2D6 inhibition.
How serious is the interaction between Sertraline and Trimipramine?
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 if possible; if combined, start with low trimipramine doses, monitor for serotonin toxicity and obtain an ECG in patients with cardiac risk factors. Consider trimipramine plasma level monitoring.
What other medicines interact with Trimipramine?
MediHelp also lists interactions of Trimipramine with, for example, Disopyramide, Dofetilide, Ibutilide. The full list is on the Trimipramine page.
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