Moderate
omeprazole × sertraline
Proton pump inhibitors×Selective serotonin reuptake inhibitors (SSRIs)
Mechanism
Omeprazole inhibits CYP2C19 – sertraline concentration rises by roughly 40 %. Clinically, side effects may intensify: nausea, diarrhea, insomnia, agitation, QT prolongation.
Management
With concurrent use in CYP2C19 poor metabolizers, start sertraline at the lowest dose (25 mg) and titrate more slowly. Obtain an ECG when QT-prolongation risk factors are present.
Sources
- Lexicomp: Lexicomp Drug Interactions (2024)— Wolters Kluwer Clinical Drug Information, Inc. Lexi-Interact Online, 2024
- Pharmaceutical Press: Stockley's Drug Interactions, 12th edition (2024)— Preston CL (ed.). Stockley's Drug Interactions. 12th ed. London: Pharmaceutical Press; 2024