Sertraline and Cimetidine: 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
Cimetidine
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.
Cimetidine (Tagamet) can slow down how your body breaks down sertraline, your antidepressant. When that happens, more sertraline can build up in your blood than usual. That may make sertraline's normal side effects show up more strongly, like nausea, diarrhea, tremor, or feeling dizzy.
The good news is this is very manageable. Your care team may simply keep a closer eye on how you feel and, if needed, adjust your sertraline dose. Please don't stop or change either medicine on your own. Just let your pharmacist or doctor know you take both, and mention any new side effects you notice.
Interaction: Cimetidine inhibits CYP450-mediated metabolism of sertraline, reducing clearance and raising sertraline serum concentrations (neither drug is relevant as a prodrug here; sertraline is the active moiety, so exposure and effect both increase).
- Direction: increased sertraline exposure, greater risk of serotonergic/SSRI adverse effects
- Onset: rapid
- Evidence: probable; clinical magnitude not well defined
- Monitoring: watch for sertraline toxicity (nausea, diarrhea, tremor, dizziness)
- Management: sertraline dose may need reduction; reassess when cimetidine is started or stopped
What happens
Elevated sertraline serum concentrations and increased risk of adverse side effects
Interaction Deep Dive
When cimetidine is given together with sertraline, the metabolism of sertraline may be suppressed, which can raise its serum levels2. At present, the clinical relevance of this outcome has not been established. Sertraline dosing may need to be modified whenever cimetidine is introduced into or removed from the treatment regimen.
Why it happens (mechanism)
Inhibited cytochrome P450 metabolism of sertraline
How to manage this interaction
This interaction is manageable and does not usually mean you have to avoid either drug.
- Keep taking both as prescribed unless your prescriber tells you otherwise.
- Your care team may monitor you more closely for signs of too much sertraline: nausea, diarrhea, tremor, or dizziness.
- Your sertraline dose may need to be adjusted and individualized while you are on cimetidine, and reviewed again if cimetidine is later stopped.
- Tell your pharmacist or doctor that you take both, and report any new or worsening side effects.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
1 report — tap to read
a) When sertraline 100 mg was administered on the second day of an 8-day course of cimetidine 800 mg daily, the mean area under the concentration-time curve (AUC) of sertraline rose by 50%, the maximum concentration (Cmax) rose by 24%, and the half-life increased by 26% relative to the placebo group 1. The clinical significance of this interaction is unknown.
Common questions
Can I take Sertraline and Cimetidine together?
Cimetidine can raise sertraline levels and make its side effects (nausea, diarrhea, tremor, dizziness) more likely, so keep taking both as prescribed and let your care team monitor you and adjust the sertraline dose if needed. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Sertraline and Cimetidine interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "rapid". Effects can appear quickly, often within about 24 hours of combining the drugs.
How is the Sertraline and Cimetidine interaction managed?
This interaction is manageable and does not usually mean you have to avoid either drug. Keep taking both as prescribed unless your prescriber tells you otherwise. Your care team may monitor you more closely for signs of too much sertraline: nausea, diarrhea, tremor, or dizziness. Your sertraline dose may need to be adjusted and individualized while you are on cimetidine, and reviewed again if cime… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Sertraline or Cimetidine 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 anything you'd monitor while I'm on both?
References (2)
Keep reading about Cimetidine
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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