Sertraline and Ivosidenib: 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
Ivosidenib
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 your medicines can affect your heart's electrical timing, something doctors call the QT interval. Ivosidenib (Tibsovo) is known to stretch this timing out a bit, and sertraline can nudge it in the same direction. When two medicines do the same thing, the effect can add up, which in rare cases can lead to an irregular heartbeat.
The good news is that this concern is based on how the drugs work rather than lots of real-world reports, and it is very manageable. Your care team can keep an eye on your heart rhythm and adjust things if needed. Please don't stop either medicine on your own. Just check in with your pharmacist or doctor so they can watch out for you.
Effect: Additive QTc prolongation from concurrent ivosidenib and sertraline.
- Mechanism: Pharmacodynamic additive effect on cardiac repolarization; both agents independently prolong the QT interval. Not a pharmacokinetic/prodrug interaction.
- Direction: Increased QTc prolongation risk (increased effect on repolarization).
- Evidence: Theoretical; severity rated major.
- Onset: Unspecified.
- Management: Avoid coadministration where feasible or substitute an alternative. If combined, obtain baseline and periodic ECGs, monitor electrolytes (K+, Mg2+), and review other QT-prolonging agents. Individualize based on risk factors.
What happens
An increased risk of QT interval prolongation
Interaction Deep Dive
Prolongation of the QTc interval is a known effect of ivosidenib. Concurrent use with other medications recognized for prolonging the QTc interval should be avoided, or alternative treatments should be substituted. When coadministration is unavoidable, patients require monitoring due to the heightened risk of QTc interval prolongation1.
Why it happens (mechanism)
Additive QT interval prolongation
How to manage this interaction
Your care team has clear ways to handle this combination safely:
- They may avoid using both together if a suitable alternative exists, or choose a different medicine for one of them.
- If both are needed, they may monitor you more closely, often with ECGs to check your heart rhythm and blood tests for electrolytes like potassium and magnesium.
What you can do: keep taking both as prescribed unless told otherwise, and let your pharmacist or doctor know about any dizziness, fainting, or heart palpitations. Also share a full list of your other medicines so they can review anything else that affects heart rhythm.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Sertraline and Ivosidenib together?
Both ivosidenib and sertraline can prolong the QT interval, and together the effect may add up, so your care team may avoid the combination or monitor your heart rhythm more closely. Keep taking both as prescribed and report any palpitations, dizziness, or fainting. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Sertraline and Ivosidenib 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 Ivosidenib interaction managed?
Your care team has clear ways to handle this combination safely: They may avoid using both together if a suitable alternative exists, or choose a different medicine for one of them. If both are needed, they may monitor you more closely, often with ECGs to check your heart rhythm and blood tests for electrolytes like potassium and magnesium. What you can do: keep taking both as prescribed unless to… 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 Sertraline or Ivosidenib 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: TIBSOVO(R) oral tablets, ivosidenib oral tablets. Agios Pharmaceuticals Inc (per FDA), Cambridge, MA, 2018. DailyMed
Keep reading about Ivosidenib
Keep reading about Sertraline
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