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Can I take Sertraline and Fluoxetine together?

Guia de interação medicamentosa

Taking sertraline and fluoxetine together significantly increases the risk of a rare but serious condition called serotonin syndrome. This happens because both medicines work by increasing the level of a chemical called serotonin in your brain. If levels get too high, it can cause symptoms like shivering, diarrhoea, confusion, severe muscle tightness, fever, and even seizures. Additionally, fluoxetine can slow down how your body breaks down sertraline, leading to a build-up of the drug in your system and increasing the risk of side effects.

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Por que isso acontece

Both drugs are Selective Serotonin Reuptake Inhibitors (SSRIs) that have an additive effect on serotonin levels (pharmacodynamic interaction). Furthermore, fluoxetine interferes with the liver enzymes (specifically CYP2D6 and potentially others) responsible for clearing sertraline from your body, making sertraline levels rise higher than intended (pharmacokinetic interaction).

You should not take these two medicines together unless specifically instructed and closely monitored by a specialist. If you are currently taking both, do not stop taking them abruptly, but contact your doctor immediately to discuss a safe plan. Seek urgent medical help if you experience agitation, hallucinations, a very fast heartbeat, or muscle twitching.

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Transtornos de depressão e ansiedade

These medicines can increase thoughts of self-harm or suicide, particularly in the first few weeks of treatment or when the dose is changed. Patients under 25 are at higher risk. Seek medical help immediately if your mood worsens or you have distressing thoughts.

Síndrome da Serotonina

Taking these medicines with other drugs that affect serotonin (such as St John’s Wort, tramadol, or triptans for migraine) can cause a life-threatening condition called serotonin syndrome. Symptoms include high fever, agitation, confusion, trembling, and sweating.

Distúrbios de sangramento

These medicines can increase your risk of bleeding, especially in the stomach. This risk is much higher if you also take aspirin, ibuprofen (NSAIDs), or blood-thinning medicines like warfarin. Seek medical advice for unusual bruising or black, tarry stools.

Low blood sodium (Hyponatraemia)

These medicines can cause the level of sodium in your blood to fall too low, which can be serious. This is more common in elderly patients. Symptoms include extreme tiredness, confusion, muscle twitching, or fits.

Álcool

It is best to avoid or strictly limit alcohol while taking these medicines. Combining alcohol with antidepressants can increase drowsiness, dizziness, and coordination problems, and may make your depression or anxiety worse. There is also an increased risk of liver damage when mixing alcohol with certain medications.

Suco de toranja

Você deve evitar consumir grandes quantidades de suco de toranja enquanto estiver tomando sertralina. A toranja pode aumentar o nível de sertralina no seu sangue, o que pode aumentar o risco de efeitos colaterais.

Cafeína (Café, chá, bebidas energéticas)

Limit your intake of caffeine. These medicines can sometimes cause jitteriness, anxiety, or difficulty sleeping. Caffeine can make these side effects worse.

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Taking multiple medicines? Our Verificador de Interações de Medicamentos helps you check whether your prescriptions, over-the-counter medicines, and supplements are safe to take together. Simply search for your medicines to see potential interactions and what to do about them.

Aviso Legal

Esta informação é apenas para fins educacionais gerais e não deve ser considerada como um substituto para aconselhamento médico profissional. Sempre consulte seu médico, farmacêutico ou outro profissional de saúde qualificado antes de tomar decisões sobre seus medicamentos. As circunstâncias individuais podem variar, e somente um profissional de saúde que conheça seu histórico médico pode fornecer orientações personalizadas.

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Histórico do artigo

As informações nesta página são escritas e revisadas por clínicos qualificados.

  • 24 Jan 2026 | Publicado originalmente
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