Ozanimod 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
Ozanimod
No brand names on recordSertraline
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.
These two medicines are not meant to be taken together. Sertraline is an antidepressant that raises serotonin, a chemical messenger in your brain. Ozanimod (used for conditions like MS or ulcerative colitis) has a property that acts a bit like an older type of antidepressant called an MAOI, which can also push serotonin and related chemicals higher.
When you stack them, serotonin can climb too high and cause a dangerous reaction called serotonin syndrome (agitation, sweating, fast heartbeat, shaking). Ozanimod can also slow your heart rate. The good news: this is very manageable. Your care team can space these drugs apart in time or choose a different option. Never stop or change either one on your own, just talk with your doctor or pharmacist.
Status: Contraindicated. An active metabolite of ozanimod inhibits MAO-B in vitro, giving it MAOI-like properties. Combined with sertraline (an SSRI), the additive serotonergic and noradrenergic effects raise the risk of serotonin syndrome and hypertensive reactions.
- Direction: additive PD effect, increased serotonergic/adrenergic activity (neither drug is a prodrug in a way that reverses this).
- Cardiac: ozanimod causes transient bradycardia and AV conduction delay; caution with QT-prolonging/arrhythmogenic agents.
- Evidence: theoretical (in vitro MAO-B inhibition).
- Management: avoid coadministration. Allow >=14-day washout between sertraline and ozanimod in either direction. Seek cardiology input if concurrent use is unavoidable.
What happens
An increased risk of serotonin syndrome and an increased risk of serious adverse reactions
Interaction Deep Dive
Combining sertraline with ozanimod (an MAOI) is contraindicated. A minimum of 14 days must pass after stopping an MAOI prescribed for psychiatric conditions before sertraline can be started. Likewise, at least 14 days should elapse following sertraline discontinuation before beginning an MAOI used to treat psychiatric disorders1. Because an active metabolite of ozanimod inhibits MAO-B in vitro, coadministration of ozanimod with agents that raise norepinephrine or serotonin (for example, SSRIs) carries the potential for serious adverse reactions. Ozanimod may also cause a transient reduction in heart rate as well as atrioventricular conduction delays. Its use in patients receiving QT-prolonging medications has not been evaluated. Given the possibility of additive heart rate effects, ozanimod therapy should generally not be started in patients already receiving QT-prolonging drugs that have known arrhythmogenic properties. When concurrent use is unavoidable, consultation with a cardiologist is advised2.
Why it happens (mechanism)
Additive serotonergic effects; MAO-B inhibition and additive effects on heart rate
How to manage this interaction
The safest step is to keep these two apart. Because this combination is contraindicated, your care team will usually avoid using them at the same time.
- Wait at least 14 days after stopping sertraline before starting ozanimod, and at least 14 days after stopping ozanimod before starting sertraline.
- Keep taking your medications exactly as prescribed. Do not start, stop, or switch either one on your own.
- Tell your pharmacist or prescriber about every medication you take so they can plan the right timing or choose an alternative.
- If both must be used, your team may involve a cardiologist because ozanimod can slow the heart.
Get urgent help for agitation, high fever, sweating, muscle twitching, or a racing heart.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Ozanimod and Sertraline together?
Sertraline and ozanimod should not be used together because of the risk of serotonin syndrome and heart-rate effects; your care team will separate them by at least 14 days or pick another option. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Ozanimod and Sertraline interaction?
It is rated contraindicated. These should generally not be used together.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How is the Ozanimod and Sertraline interaction managed?
The safest step is to keep these two apart. Because this combination is contraindicated, your care team will usually avoid using them at the same time. Wait at least 14 days after stopping sertraline before starting ozanimod, and at least 14 days after stopping ozanimod before starting sertraline. Keep taking your medications exactly as prescribed. Do not start, stop, or switch either one on your… 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 Ozanimod 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 (2)
- Product Information: ZOLOFT oral tablets, oral solution, sertraline hydrochloride oral tablets, oral solution. Viatris Specialty LLC (per FDA), Morgantown, WV, 2023. DailyMed
- Product Information: ZEPOSIA(R) oral capsules, ozanimod oral capsules. Bristol-Myers Squibb Company (per FDA), Princeton, NJ, 2024. DailyMed
Keep reading about Ozanimod
Keep reading about Sertraline
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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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