Drug & supplement interaction

Hirudotherapy + Sertraline

Sertraline brand name: Zoloft.

No Known Interaction
The bottom line No known interaction

We found no known interaction between Hirudotherapy and Sertraline in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Hirudotherapy and Sertraline

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Sertraline and Hirudotherapy in our sources. This does not guarantee that the combination is completely free of risk — research on Hirudotherapy alongside specific medications may be limited.

Worth understanding: our licensed dataset holds no drug-interaction record for Hirudotherapy at all — not against Sertraline, and not against any other medication we track. This verdict therefore rests on the absence of any recorded data, not on research that looked at this combination and found nothing. We cannot rule an interaction out.

Hirudotherapy is a treatment rather than something you take. Tell whoever provides it which medicines you use, and ask your prescriber whether it is appropriate for your health and treatment. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Hirudotherapy safety at a glance

Hirudotherapy overall Use caution Should only be performed by trained practitioners using medical-grade leeches due to infection and bleeding risks.
Pregnancy Avoid Not enough safety data; the bleeding and infection risks make it best avoided in pregnancy.
Breastfeeding Avoid Safety during breastfeeding is unknown, so it is best avoided unless a doctor advises otherwise.

Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Sertraline and Hirudotherapy? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
What to actually watch for

No Interaction Found — But Data Suggests Hirudotherapy and Sertraline May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so having Hirudotherapy while taking the medicine can make those effects more likely to turn up, and harder to pin on one or the other if they do. One of them is worth acting on rather than waiting out — marked below.

  • Bleeding or bruising Worth acting on Additional detail

    Hirudotherapy

    “Topically, hirudotherapy can cause prolonged bleeding and anemia. In a case report, a young adult male presented with neck bleeding after self-applying leeches for acne. Bleeding was controlled by suturing. A case series in critically ill pediatric patients describes bleeding that led to hirudotherapy discontinuation in 5 of 7 cases, and 4 of the patients expired secondary to multiorgan failure.”

    Hirudotherapy · Natural Medicines adverse-effect record, reported in acne.

    4 sources cited
    1. 99399. Zengin S, Yarbil P, Kilic H, Al B. Prolonged bleeding due to a medicinal leech bite: another treatment method, primary suture. BMJ Case Rep. 2012;2012. pii: bcr0220125759. PubMed
    2. 106752. Sepaskhah M, Yazdanpanah N, Sari Aslani F, Akbarzadeh Jahromi M. Cutaneous pseudolymphoma as a rare adverse effect of medicinal leech therapy: a case report and review of the literature. Cureus. 2020 Apr 2;12(4):e7517. PubMed
    3. 106753. Temiz SA, Özer I, Ataseven A, Dursun R, Findik S. Cutaneous pseudolymphoma due to hirudotherapy. Turkiye Parazitol Derg. 2019;43(1):50-2. PubMed
    4. 112900. Resch JC, Hedstrom R, Steiner ME, Said SM, Somani A. Hirudotherapy for limb ischemia in the pediatric intensive care unit: A retrospective observational cohort. Front Pediatr 2023;10:1011171. PubMed

    Sertraline

    Listed in the ADVERSE REACTIONS section of the FDA label for Sertraline. Read the label on DailyMed ›

  • Fever / Headache reported in 5.1% of FDA reports for Sertraline Additional detail

    Hirudotherapy

    “Topically, hirudotherapy can cause itching, pain, vesicle formation, and skin redness at the application site. Less often, it can cause necrotic ulcers, keloid formation, allergic or irritant contact dermatitis, and skin infections. Use of leeches can sometimes cause infections with Aeromonas hydrophila, which is found in the leech gut, and also with parasites.”

    Hirudotherapy · Natural Medicines adverse-effect record, reported in cluster headache.

    6 sources cited
    1. 99392. Bibbo C, Fritsche T, Stemper M, Hall M. Flap infection associated with medicinal leeches in reconstructive surgery: two new drug-resistant organisms. J Reconstr Microsurg. 2013;29(7):457-60. PubMed
    2. 99394. Michalsen A, Lüdtke R, Cesur O, et al. Effectiveness of leech therapy in women with symptomatic arthrosis of the first carpometacarpal joint: a randomized controlled trial. Pain. 2008;137(2):452-9. PubMed
    3. 99395. Pietrzak A, Kanitakis J, Tomasiewicz K, et al. Cutaneous complications of improper leech application. Ann Agric Environ Med. 2012;19(4):790-2.
    4. 99397. van Alphen NA, Gonzalez A, McKenna MC, McKenna TK, Carlsen BT, Moran SL. Ciprofloxacin-resistant Aeromonas infection following leech therapy for digit replantation: report of 2 cases. J Hand Surg Am. 2014;39(3):499-502. PubMed
    5. 99398. Wang H, Zhang J, Chen L. The efficacy and safety of medical leech therapy for osteoarthritis of the knee: A meta-analysis of randomized controlled trials. Int J Surg. 2018;54(Pt A):53-61. PubMed
    6. 106752. Sepaskhah M, Yazdanpanah N, Sari Aslani F, Akbarzadeh Jahromi M. Cutaneous pseudolymphoma as a rare adverse effect of medicinal leech therapy: a case report and review of the literature. Cureus. 2020 Apr 2;12(4):e7517. PubMed

    Sertraline

    Listed in the ADVERSE REACTIONS section of the FDA label for Sertraline, and in voluntary FDA adverse-event reports. Read the label on DailyMed ›

Reported for Hirudotherapy but not commonly for Sertraline: bleeding in the gut, low blood pressure, a skin rash and a higher chance of infection.

Effects for Sertraline come from the ADVERSE REACTIONS section of its FDA label; effects for Hirudotherapy come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 214,799 voluntary FDA FAERS reports for Sertraline that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

From our Q&A

Questions About Hirudotherapy or Sertraline

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Hirudotherapy or Sertraline, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Sertraline

This page covers Hirudotherapy only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Sertraline page lists 188 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), Arsenic (major), Cesium (major) and Ephedra (major).

By severity: 9 major · 139 moderate · 40 minor.

From our pharmacist’s overview on the Sertraline page

“If you take sertraline (Zoloft) for depression, anxiety, or panic, treat this page with real care. Nine of the 188 supplements here carry a major rating, and the biggest issue is how your body clears the drug.”

Reviewed by 2 · Jul 18, 2026

Open the Sertraline interaction page

How much people look this up

Where Hirudotherapy and Sertraline Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Hirudotherapy
Steady interest

#1,223 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Sertraline
Top 10

#5 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Hirudotherapy reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Hirudotherapy and Sertraline records this page draws on were last updated July 10, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Treatment approach

About Hirudotherapy

What is Hirudotherapy?

  • Reconstructive and plastic surgery (relieving blood congestion in reattached tissue)
  • Osteoarthritis and joint pain
  • Circulation problems
  • Varicose veins
  • Traditional treatment for various inflammatory conditions

Hirudotherapy is the medical use of living leeches placed on the skin to draw blood and release saliva compounds that thin blood and ease congestion. It has a real, accepted role in some surgical settings (such as saving reattached fingers or skin flaps), but evidence for most other uses is limited. It should only be done by trained professionals because of risks of infection and bleeding.

Hirudo medicinalis · Hirudinidae · Whole living medicinal leech (and its saliva) · Live medicinal leeches applied to the skin by a trained practitioner

An interaction check asks whether these two react with each other — it does not ask whether Hirudotherapy is a good idea for someone in your situation. Here is what our Hirudotherapy record says about it on its own.

Hirudotherapy: dosing

There is no standardized "dose" for hirudotherapy. The number of leeches, where they are placed, and how long treatment continues are decided by the treating clinician based on the medical situation, such as how much blood is congested in a tissue flap.This is a medical procedure, not a supplement you take at home.

From our Hirudotherapy monograph — the full record covers uses, side effects and every documented interaction.

Read the full Hirudotherapy monograph & all interactions
Medication

About Sertraline

What Is Sertraline Used For?

Brand name: Zoloft

Sertraline treats a range of mental health conditions. All formulations are approved for major depressive disorder (MDD) in adults and obsessive-compulsive disorder (OCD). The oral solution (including Zoloft oral solution) and several tablet formulations are also approved for panic disorder, post-traumatic stress disorder (PTSD), social anxiety disorder, and premenstrual dysphoric disorder (PMDD).

For OCD specifically, the capsule formulations and some tablet products are approved for use in adults and children aged 6 and older. Sertraline hydrochloride tablets (plain, not film-coated) are approved for OCD in pediatric patients as well. However, sertraline is not approved for major depressive disorder in children — only in adults.

Most-Reported Side Effects for Sertraline

From FAERS, the FDA’s public side-effect reporting system (218,320 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Nausea 13,865 reports
Fatigue 12,822 reports
Headache 11,106 reports
Anxiety 10,369 reports
Diarrhea 10,339 reports
See full Sertraline drug information
Keep checking

Other Drugs & Hirudotherapy

Browse every other medication we’ve checked against Hirudotherapy — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
0Moderate
0Minor
2,829No known interaction
No interaction 2,829 drugs checked — show the list
Evidence & sources

Hirudotherapy References

The 15 references that drive our Hirudotherapy monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Altamura D, Calonje E, Liau Jl, Rogers M, Verdolini R. Diffuse cutaneous pseudolymphoma due to therapy with medicinal leeches. JAMA Dermatol. 2014;150(7):783-4. PubMed
  2. Bibbo C, Fritsche T, Stemper M, Hall M. Flap infection associated with medicinal leeches in reconstructive surgery: two new drug-resistant organisms. J Reconstr Microsurg. 2013;29(7):457-60. PubMed
  3. Khelifa E, Kaya G, Laffitte E. Cutaneous pseudolymphomas after leech therapy. J Dermatol. 2013;40(8):674-5. doi: PubMed
  4. Michalsen A, Lüdtke R, Cesur O, et al. Effectiveness of leech therapy in women with symptomatic arthrosis of the first carpometacarpal joint: a randomized controlled trial. Pain. 2008;137(2):452-9. PubMed
  5. Pietrzak A, Kanitakis J, Tomasiewicz K, et al. Cutaneous complications of improper leech application. Ann Agric Environ Med. 2012;19(4):790-2.
  6. van Alphen NA, Gonzalez A, McKenna MC, McKenna TK, Carlsen BT, Moran SL. Ciprofloxacin-resistant Aeromonas infection following leech therapy for digit replantation: report of 2 cases. J Hand Surg Am. 2014;39(3):499-502. PubMed
  7. Wang H, Zhang J, Chen L. The efficacy and safety of medical leech therapy for osteoarthritis of the knee: A meta-analysis of randomized controlled trials. Int J Surg. 2018;54(Pt A):53-61. PubMed
  8. Zengin S, Yarbil P, Kilic H, Al B. Prolonged bleeding due to a medicinal leech bite: another treatment method, primary suture. BMJ Case Rep. 2012;2012. pii: bcr0220125759. PubMed
  9. Sepaskhah M, Yazdanpanah N, Sari Aslani F, Akbarzadeh Jahromi M. Cutaneous pseudolymphoma as a rare adverse effect of medicinal leech therapy: a case report and review of the literature. Cureus. 2020 Apr 2;12(4):e7517. PubMed
  10. Temiz SA, Özer I, Ataseven A, Dursun R, Findik S. Cutaneous pseudolymphoma due to hirudotherapy. Turkiye Parazitol Derg. 2019;43(1):50-2. PubMed
  11. Daye M, Isik B, Kilinç F. Lichen planus due to hirudotherapy. Turkiye Parazitol Derg. 2021;45(2):149-52. PubMed
  12. Mentes BB, Leventoglu S, Osmanov I, Kösehan D, Erol T. Anal abscess due to leech therapy of hemorrhoids: mumbo jumbo is still in vogue. J Surg Case Rep. 2019 Jul 31;2019(7):rjz218. PubMed
  13. Kiliç M, Ak R. Orbital cellulitis due to leech therapy. Bull Emerg Trauma. 2019 Jul;7(3):335-6. PubMed
  14. Dolek UC, Ozdemir S, Babayeva K, Gol M. Leech Application-related Upper Gastrointestinal Bleeding: A Case Report. Bull Emerg Trauma 2023;11(1):47-50.
  15. Resch JC, Hedstrom R, Steiner ME, Said SM, Somani A. Hirudotherapy for limb ischemia in the pediatric intensive care unit: A retrospective observational cohort. Front Pediatr 2023;10:1011171. PubMed

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Having Hirudotherapy While Taking Sertraline: Common Questions

Is it safe to have Hirudotherapy while taking Sertraline?
We do not list a known interaction between Hirudotherapy and Sertraline. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Hirudotherapy and Sertraline have any of the same side effects?
Yes — our sources link each of them separately to 3 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
Does Sertraline interact with any supplements?
Yes. Sertraline has documented interactions with 188 supplements in our database — Hirudotherapy is not one of them. The Sertraline interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Sertraline and Hirudotherapy?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.