Other types of interactions are also possible.
While some interactions can be managed, others should be avoided entirely.
What Drugs Interact With Zoloft?
Getty Images / Bloomberg / Contributor.
The chart below is an overview of Zoloft interactions.
However, it is not a comprehensive list of all drug interactions that can occur.
It is most likely to occur when taking more than one drug that increases serotonin.
Symptoms can include:
2.
Other Antidepressants
Many people are prescribed more than one antidepressant.
Taking more than one drug in this class can raise serotonin levels and increase the risk of serotonin syndrome.
However, you’ll still need to watch for signs of serotonin syndrome.
Examples of interacting drugs include:
3.
Certain Antipsychotics
Certain antipsychotic drugs are contraindicated with Zoloft, meaning they should never be used together.
Examples of other interacting drugs include:
4.
Zoloft is also associated with a bleeding risk.
When taken together, the risk of bleeding may be significantly increased.
Examples of blood thinners include:
5.
Dextromethorphan
Dextromethorphanis acough suppressant.
Dextromethorphan can increase serotonin levels, so taking it with Zoloft can increase the risk of serotonin syndrome.
Dextromethorphan can be found in many cough and cold products, both OTC and prescription.
It’s important to be aware of any medications you are taking that also contain dextromethorphan.
Examples of interacting drugs include:
If you are taking Zoloft, venture to avoid taking dextromethorphan-containing products.
If you need a cough remedy, talk to your healthcare provider or pharmacist about safe alternatives for you.
It is known as a narrow therapeutic index (NTI) drug.
This means that there is a small window between the drug being effective and potential toxicity.
While certain antipsychotics can cause this risk, other drugs can also have this same effect.
Opioids
Combining opioid pain medications with Zoloft can increase the risk of serotonin syndrome.
Lithium
Lithiumis a mood stabilizer used to treatbipolar disorder.
Taking lithium with Zoloft may increase the risk of serotonin syndrome.
It can also increase the risk of long QT syndrome, although the risk is considered low.
MAOIs
Monoamine oxidase inhibitorsare an older class of drugs used to treat depression.
They are not as commonly prescribed due to their side effects and drug and food interactions.
Zoloft is contraindicated with MAOI drugs, meaning they should never be used together.
If you take either Zoloft or an MAOI, your healthcare provider will not prescribe the other drug.
Examples of MAOIs include:
11.
NSAIDs
Nonsteroidal anti-inflammatory drugsare commonly used to help relieve pain, inflammation, and fever.
Zoloft can increase the risk of bleeding, as can NSAIDs.
Taken together, then, the risk of bleeding, including gastrointestinal bleeding, could increase.
Check with your healthcare provider before taking an NSAID if you take Zoloft.
Check with a healthcare provider before combining Saint-John’s-wort and Zoloft.
Triptans
Triptansare a class of drugs used to treat migraine.
Both triptans and Zoloft increase serotonin.
If your healthcare provider prescribes a triptan with Zoloft, you will be carefully monitored for serotonin syndrome.
Examples of triptans are:
14.
Alcohol
According to the prescribing information, people who take Zoloft should avoid drinking alcohol.
Summary
Zoloft is a medication commonly prescribed to treat depression and other mental health conditions.
There are various drug interactions to be aware of when taking Zoloft.
Some medications must be completely avoided, while others may be used cautiously with close monitoring.
Your healthcare provider can give you medical advice on potential interactions and how they may affect you.
Merck Manual.Drugs that can cause serotonin syndrome.
UpToDate.Serotonin syndrome (serotonin toxicity).
Apseloff G, Wilner KD, Gerber N, et al.Effect of sertraline on protein binding of warfarin.Clin Pharmacokinet.
2012;14(6):PCC.12l01388.
doi:10.4088/PCC.12l01388
Food and Drug Administration.FY2015 Regulatory Science Research Report: Narrow therapeutic index drugs.
Haselberger MB, Freedman LS, Tolbert S.Elevated serum phenytoin concentrations associated with coadministration of sertraline.J Clin Psychopharmacol.
2006;26(9):1307-1313. doi:10.1592/phco.26.9.1307
National Center for Complementary and Integrative Health.St.
2002;54(4):349-356. doi:10.1046/j.1365-2125.2002.01683.x
