Adagrasib and Sertraline: Interaction Details
AI-assisted, pharmacist-reviewed · AI content regenerated Jul 11, 2026 · Source data updated Jul 2, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Adagrasib
Sertraline
No brand names on record
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
Both of these medicines can affect the timing of your heartbeat. Adagrasib (a cancer medicine) and sertraline (an antidepressant) can each stretch out a part of the heart's electrical cycle called the QT interval. When taken together, that effect can add up and, in rare cases, lead to a dangerous irregular heartbeat.
The good news is this is very manageable. Your care team can check your heart rhythm with an EKG and watch your blood minerals like potassium and magnesium. Please keep taking both medicines as prescribed, and let your doctor or pharmacist know if you feel faint, dizzy, or notice a fluttering or racing heartbeat.
Additive QTc prolongation. Adagrasib is a known QTc-prolonging agent; sertraline carries a lower but recognized QT risk. Combined use may produce greater QTc prolongation and increased risk of torsade de pointes, polymorphic VT, and other serious arrhythmias. Neither drug's effect here depends on activation, so this is a pharmacodynamic (not PK) interaction. Evidence is theoretical; severity rated major.
- Avoid concomitant use where possible.
- If unavoidable: obtain baseline and periodic ECG plus electrolytes (K+, Mg2+); correct abnormalities.
- Higher risk with CHF, bradyarrhythmias, electrolyte disturbance.
- Withhold adagrasib if QTc >500 msec or change >60 msec; resume at next lower dose. Discontinue permanently if TdP/serious arrhythmia occurs.
What happens
An increased risk of QT interval prolongation, torsade de pointes, polymorphic ventricular tachycardia, other serious arrhythmias
Interaction Deep Dive
Do not use adagrasib together with other agents recognized as capable of prolonging the QTc interval, because adagrasib itself induces QTc interval prolongation. When adagrasib is combined with other QTc-prolonging products, the QTc interval may increase to a greater degree, along with adverse reactions linked to QTc interval prolongation, such as torsade de pointes, additional serious arrhythmias, and sudden death. Electrocardiogram and electrolytes should be monitored before adagrasib is initiated, throughout concomitant use, and as clinically warranted in patients with congestive heart failure, bradyarrhythmias, or electrolyte abnormalities, as well as in those who cannot avoid concurrent medications known to prolong the QT interval. Withhold adagrasib when the QTc interval exceeds 500 msec or when the change from baseline exceeds 60 msec, continuing to withhold until the QTc interval falls below 481 msec or returns to baseline. Restart adagrasib at the next lower dose level. In the event of torsade de pointes, polymorphic ventricular tachycardia, or any signs or symptoms of a serious or life-threatening arrhythmia, adagrasib must be permanently discontinued1.
Why it happens (mechanism)
Additive QT interval prolongation
How to manage this interaction
Your care team will decide whether these two can be used together safely, and often prefers to avoid the combination when an alternative exists. If both are needed, here is what they typically do:
- Check an EKG before starting and periodically during treatment.
- Monitor and correct electrolytes, especially potassium and magnesium.
- Watch more closely if you have heart failure, a slow heart rhythm, or electrolyte problems.
- The adagrasib dose may be adjusted or paused by your team based on your EKG results.
Keep taking both as prescribed and ask your pharmacist or doctor before making any changes. Report fainting, palpitations, or dizziness right away.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Adagrasib and Sertraline together?
Combining adagrasib and sertraline can add together their effect on heart rhythm (QT prolongation), so your care team may avoid the pair or monitor your EKG and electrolytes closely. Keep taking both as prescribed and report any fainting or palpitations. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Adagrasib and Sertraline interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How is the Adagrasib and Sertraline interaction managed?
Your care team will decide whether these two can be used together safely, and often prefers to avoid the combination when an alternative exists. If both are needed, here is what they typically do: Check an EKG before starting and periodically during treatment. Monitor and correct electrolytes, especially potassium and magnesium. Watch more closely if you have heart failure, a slow heart rhythm, or… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Adagrasib or Sertraline need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (1)
- Product Information: KRAZATI(TM) oral tablets, adagrasib oral tablets. Mirati Therapeutics Inc (per FDA), San Diego, CA, 2024. DailyMed
Keep reading about Adagrasib
Keep reading about Sertraline
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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