Sertraline and Carvedilol: 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 recordCarvedilol
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.
You're taking sertraline (an antidepressant) along with carvedilol (a beta blocker for your heart or blood pressure). Sertraline can slow down one of the liver enzymes (called CYP2D6) that normally breaks down carvedilol. When that happens, more carvedilol can build up in your body.
In plain terms, the carvedilol may act stronger than expected. You might notice things like a slower heartbeat, dizziness, or feeling lightheaded, especially when you stand up. The good news is this is very manageable. Your care team can adjust your dose and keep an eye on your blood pressure and pulse, so please don't stop either medicine on your own. Just check in with your pharmacist or doctor.
Mechanism: Sertraline inhibits CYP2D6, the primary enzyme metabolizing carvedilol (an active drug, not a prodrug). Inhibition reduces clearance and increases carvedilol exposure (AUC/Cmax).
Direction: Increased beta-blocker effect, with potential for bradycardia, hypotension, and dizziness.
- Evidence: Theoretical; based on established CYP2D6 pharmacology rather than dedicated interaction studies.
- Severity/onset: Rated major; onset unspecified.
- Management: Monitor HR and BP. Carvedilol dose may need to be reduced and individualized during coadministration; consider upward titration if sertraline is discontinued.
What happens
Increased CYP2D6 substrate exposure
Interaction Deep Dive
When sertraline, which inhibits CYP2D6, is taken together with a CYP2D6 substrate, the substrate's exposure may rise. Should the two be given at the same time, lower the CYP2D6 substrate's dose as appropriate; on the other hand, stopping sertraline may call for raising the dose of a CYP2D6 substrate1.
Why it happens (mechanism)
Inhibition of CYP2D6 substrate metabolism by sertraline
How to manage this interaction
Both medicines can be used together safely when your care team keeps track of how you're doing. Here's what that usually looks like:
- Keep taking both as prescribed unless your doctor or pharmacist tells you otherwise.
- Your carvedilol dose may need to be adjusted and individualized by your care team while you're also on sertraline.
- Your team may monitor your heart rate and blood pressure more closely.
- If sertraline is ever stopped, your carvedilol dose may need to be raised again.
Tell your pharmacist or prescriber if you feel unusually dizzy, lightheaded, faint, or notice a very slow heartbeat.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
1 report — tap to read
a) During drug interaction investigations, PARoxetine produced the following effects on medications metabolized by CYP2D6. PARoxetine 20 mg once daily at steady-state raised the Cmax, AUC, and t(1/2) of a single 100 mg dose of desipramine by roughly 2-, 5-, and 3-fold, respectively. Among patients maintained on risperiDONE 4 to 8 mg/day, daily PARoxetine 20 mg raised mean risperiDONE plasma concentrations by 4-fold, lowered 9-hydroxyrisperiDONE concentrations by 10%, and increased concentrations of the active moiety by 1.4-fold. In healthy volunteers who were extensive CYP2D6 metabolizers, steady-state atomoxetine AUC values were 6- to 8-fold higher and Cmax values were 3- to 4-fold higher when PARoxetine was given concurrently compared with atomoxetine alone. Mean digoxin steady-state AUC fell by 15% in the presence of PARoxetine. In a study using propranolol 80 mg twice daily for 18 days, the steady-state plasma concentrations of propranolol remained unchanged during coadministration with PARoxetine 30 mg once daily over the final 10 days 2.
Common questions
Can I take Sertraline and Carvedilol together?
Sertraline can raise carvedilol levels and strengthen its effects, so watch for dizziness or a slow heartbeat and let your care team adjust the dose and monitor you. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Sertraline and Carvedilol 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 Sertraline and Carvedilol interaction managed?
Both medicines can be used together safely when your care team keeps track of how you're doing. Here's what that usually looks like: Keep taking both as prescribed unless your doctor or pharmacist tells you otherwise. Your carvedilol dose may need to be adjusted and individualized by your care team while you're also on sertraline. Your team may monitor your heart rate and blood pressure more close… 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:
- Switching Between Generic Sertraline Brands: What to Know
- Is Ashwagandha Safe With Bupropion, Sertraline And Azelastine?
- Converting Doses Of Lexapro (Escitalopram) To Zoloft (Sertraline)
- Does Lemon Verbena Interact With Coreg (Carvedilol)?
- Is Amoxicillin Safe With Losartan, Carvedilol And Prasugrel?
Questions for your pharmacist
- Does my dose of Sertraline or Carvedilol 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: PEXEVA(R) oral tablets, paroxetine mesylate oral tablets. Sebela Pharmaceuticals Inc (per FDA), Roswell, GA, 2023.
Keep reading about Sertraline
Keep reading about Carvedilol
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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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