Lustral

How can this medicine affect other medicines?

It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to ensure that the combination is safe.

Sertraline should not be taken at the same time as monoamine oxidase inhibitor medicines (MAOIs). These include monoamine oxidase inhibitor antidepressants such as phenelzine, tranylcypromine and moclobemide, the antibiotic linezolid and the anti-Parkinson's medicine selegiline. Sertraline should not be started until at least at least a day after stopping moclobemide or linezolid, and at least two weeks after stopping other monoamine oxidase inhibitors. Similarly, treatment with any MAOIs should not be started until at least two weeks after stopping treatment with sertraline.

Sertraline must not be taken with the antipsychotic medicine pimozide.

Sertraline should not be taken in combination with benzodiazepines or other tranquilisers by people who need to drive or operate machinary.

There may be an increased risk of side effects if sertraline is taken with the following medicines, which also enhance the activity of serotonin in the brain:

- lithium
- triptans for migraine, eg sumatriptan
- tramadol
- tryptophan.

The herbal remedy St John's wort should not be taken with sertraline for the same reason.

Sertraline may increase the blood levels of the following medicines:

- clozapine
- some tricyclic antidepressants (imipramine, desipramine, nortriptyline and possibly amitriptyline).

Sertraline may increase the effect of anti-blood-clotting medicines (anticoagulants) such as warfarin, and this may increase the risk of bleeding. If you are taking an anticoagulant with this medicine, your blood clotting time should be regularly monitored.

As SSRIs have been associated with bleeding abnormalities, the following medicines, which are known to affect the ability of the blood to clot, should be used with caution with sertraline:

- tricyclic antidepressants
- some antipsychotic medicines
- some antisickness medicines, eg prochlorperazine
- aspirin and non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen
- ticlopidine
- dipyridamole.

Treatment with this medicine may alter control of blood sugar in people with diabetes, who may need an adjustment in their dose of insulin or antidiabetic tablets. People with diabetes should discuss this with their doctor.

Sertraline blood levels may be increased by cimetidine and this may increase the risk of sertraline side effects.

Other medicines containing the same active ingredient

Sertraline tablets are available without a brand name, ie as the generic medicine.

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