Does sertraline (selective serotonin reuptake inhibitor) interact with itraconazole (antifungal medication)?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Article Review Status
Submitted
Under Review
Approved

Last updated: June 12, 2025 • View editorial policy

From the Research

Yes, sertraline and itraconazole can interact with each other, and caution should be exercised when using these medications together. Itraconazole is a strong inhibitor of the CYP3A4 enzyme and can also affect CYP2D6, which are enzymes involved in metabolizing sertraline 1. When taken together, itraconazole may increase sertraline blood levels by slowing its breakdown in the liver, potentially leading to increased side effects such as nausea, dizziness, drowsiness, or serotonin syndrome in severe cases. Some studies have shown that certain medications can interact with sertraline, either by increasing or decreasing its plasma concentration, which can lead to adverse effects or reduced efficacy 2, 1. However, the specific interaction between sertraline and itraconazole is not well-studied in the provided evidence. Given the potential for interaction, if you need to take both medications, your doctor might consider reducing the sertraline dose or monitoring you more closely for side effects. Never adjust medication doses yourself without medical supervision. The interaction is generally considered moderate rather than severe, but it's essential to inform all your healthcare providers about all medications you're taking, including over-the-counter drugs and supplements, to avoid potential drug interactions. If you experience unusual symptoms while taking these medications together, contact your healthcare provider promptly. It's also important to note that sertraline is generally well-tolerated and effective for treating depression and anxiety disorders, but it can have adverse effects, such as increased risk of suicidality in children and young adults 3. Ultimately, the decision to use sertraline and itraconazole together should be made on a case-by-case basis, taking into account the individual patient's medical history, current medications, and potential risks and benefits.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.