Can I take Sertraline and Fluoxetine together?

Perché succede

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.

Disturbi depressivi e d'ansia

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.

Sindrome serotoninergica

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.

Disturbi emorragici

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.

Alcol

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.

Succo di pompelmo

You should avoid drinking large amounts of grapefruit juice while taking sertraline. Grapefruit can increase the level of sertraline in your blood, which may increase the risk of side effects.

Caffeina (Caffè, tè, bevande energetiche)

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

Taking multiple medicines? Our Controllo Interazioni Farmaci 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.

Avvertenza

Queste informazioni sono solo a scopo educativo generale e non devono essere considerate un sostituto del consiglio medico professionale. Consultate sempre il vostro medico di base, farmacista o un altro professionista sanitario qualificato prima di prendere decisioni sui vostri farmaci. Le circostanze individuali possono variare, e solo un professionista sanitario che conosce la vostra storia medica può fornire una guida personalizzata.