Moderate
Probable
Description
Fluconazole inhibits CYP2C19 and CYP3A4, increasing sertraline plasma concentrations, which may enhance both therapeutic and adverse effects including QT prolongation.
Mechanism
Fluconazole reduces sertraline clearance via CYP2C19 and CYP3A4 inhibition; higher sertraline levels increase serotonergic tone and may modestly prolong QTc.
Clinical Significance
Sertraline AUC is significantly increased with fluconazole co-administration; clinical monitoring for adverse effects is warranted.
Management
Monitor for sertraline side effects; consider sertraline dose reduction during fluconazole courses; obtain ECG if prolonged co-administration.