Iobenguane I 123 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
Sertraline
No brand names on recordIobenguane I 123
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.
Iobenguane I 123 is a special imaging agent, not a regular medicine. It works by slipping into certain nerve endings using the same doorway that your body uses for a natural chemical called norepinephrine. The scan then shows how those tissues light up.
Sertraline (an SSRI) can partly block that doorway. If it does, the imaging agent may not get into the tissue well, so the scan could look normal even when something is actually there (a false negative). Turning up the dose of the imaging agent will not fix this. The good news: your care team plans these scans carefully and can manage the timing of your medicines so you get an accurate result. Always talk with them before any changes.
Effect: Sertraline may reduce iobenguane I 123 uptake, risking false negative imaging.
Mechanism: Iobenguane is a norepinephrine analog taken up via the norepinephrine transporter (NET) into adrenergic nerve terminals. SSRIs such as sertraline can inhibit NET function, reducing tracer accumulation in target tissue. Neither agent is metabolically activated here; this is a pharmacodynamic imaging interference, not a PK effect.
- Direction: Reduced diagnostic efficacy of the tracer.
- Evidence: Theoretical; severity rated major.
- Management: Increasing tracer dose does NOT overcome NET inhibition. When clinically feasible, discontinue sertraline for at least 5 biological half-lives before imaging. Coordinate with the prescriber and nuclear medicine team.
What happens
Potential for false negative imaging results
Interaction Deep Dive
Structurally, iobenguane resembles the neurotransmitter norepinephrine, and the norepinephrine transporter within adrenergic nerve terminals takes it up. Once inside, it is held in the presynaptic storage vesicles. Because iobenguane concentrates in tissues that receive adrenergic innervation, tagging it with the iodine 123 isotope allows imaging of particular organs and tissues. The clinical effectiveness of iobenguane I 123 may be compromised by antidepressants that block norepinephrine transporter activity, including SSRIs, tricyclic antidepressants, and MAOIs. Raising the iobenguane I 123 dose does not counteract the norepinephrine uptake inhibition these agents may cause. When iobenguane I 123 imaging must be performed, stop this drug for a minimum of 5 biological half-lives if doing so is clinically feasible1.
Why it happens (mechanism)
Inhibition of norepinephrine transporter function by antidepressants
How to manage this interaction
Keep taking your sertraline as prescribed and do not stop it on your own. This concern applies only around the time of an iobenguane I 123 scan.
- Tell the nuclear medicine team and your prescriber that you take sertraline before the scan is scheduled.
- When it is safe to do so, your care team may pause sertraline for at least 5 of its biological half-lives before imaging to keep the results accurate.
- Do not expect a higher tracer dose to fix this; it will not, so timing is what matters.
- Any stopping and restarting should be planned and individualized by your care team.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Iobenguane I 123 and Sertraline together?
Sertraline can block the transporter iobenguane I 123 uses, which may cause a false negative scan; if you need this imaging, your care team may have you pause sertraline beforehand, but never stop it on your own. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Iobenguane I 123 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 Iobenguane I 123 and Sertraline interaction managed?
Keep taking your sertraline as prescribed and do not stop it on your own. This concern applies only around the time of an iobenguane I 123 scan. Tell the nuclear medicine team and your prescriber that you take sertraline before the scan is scheduled. When it is safe to do so, your care team may pause sertraline for at least 5 of its biological half-lives before imaging to keep the results accurate… 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 Iobenguane I 123 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: AdreView(TM) intravenous injection, iobenguane I 123 intravenous injection. GE Healthcare (per FDA), Arlington Heights, IL, 2013. DailyMed
Keep reading about Sertraline
Keep reading about Iobenguane I 123
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