Does domperidone interact with sertraline? (3+ side effects)

In this article, we will discuss the potential interactions between domperidone, a medication to manage nausea, and sertraline – an antidepressant. We will discuss some relevant research studies and talk about the potential risks of this combination.

Does domperidone interact with sertraline?

Domperidone does not necessarily interact with sertraline, a selective serotonin reuptake inhibitor (SSRI). However, sertraline might affect the bioavailability of domperidone in some cases by decreasing its absorption in the body. 

Sertraline is primarily used as an antidepressant, which may cause nausea, lightheadedness, etc, as early side effects (1). It’s not uncommon for people to turn to medications like domperidone to manage these side effects or to take them for nausea unrelated to sertraline.

Pharmacokinetically, these medications do not affect each other’s metabolism or how they work in your body, and the diminishing effects of sertraline on domperidone might not be clinically significant. However, people are different and can respond differently to medications. 

It is also important to note that individuals can have different underlying factors affecting their health that may influence how these medications work in their bodies. 

So, it’s best to discuss the use of domperidone with your provider. In general, the two can be taken together, and cases of toxicity associated with these medications have not been frequently reported.

What does research suggest?

There is limited research on the potential interaction between domperidone and sertraline, and the two are considered safe to use together. Research studies do not indicate any effects of domperidone specifically on serotonin receptors, and the drug does not alter serotonergic activity in the brain or enter the CNS (2).

Sertraline, being an SSRI, primarily works on serotonin. It inhibits the reuptake of this monoamine excitatory neurotransmitter by blocking serotonin transporters (SERT) (1,3). This action increases serotonergic activity in the brain to manage the symptoms associated with depression, anxiety, and several other mental health conditions. 

Therefore, domperidone does not affect how sertraline works, unlike some antiemetics that can influence serotonin receptors, such as ondansetron.

What are the potential benefits of taking domperidone with sertraline?

Taking domperidone with sertraline can help manage sertraline-induced nausea and vomiting during the early course of treatment (4). Gastrointestinal side effects with antidepressants are quite common, and it takes time for your body to adjust to these medications. 

Sertraline also takes time to kick in and tends to cause side effects much earlier than producing the beneficial effects. So, while the drug makes you nauseous, it’s okay to take domperidone occasionally to manage it. 

However, these early side effects of sertraline start to get better with time and fade away once your body adapts to the drug.

What are the potential risks of taking domperidone with sertraline?

The combined use of domperidone and sertraline can cause some additive side effects – side effects that are common with both medications. These include: (1,5)

  • Dizziness
  • Lightheadedness
  • Palpitations
  • Muscle pain
  • Decreased libido in men (less common with domperidone)

It is important to note that some people could be allergic to domperidone or sertraline, which can trigger life-threatening reactions that may require immediate medical attention. If you’re taking these medications for the first time and start to experience unusual signs, please seek immediate attention right away. 

How to ensure the safe use of domperidone with sertraline?

The following points are important to ensure the safe and effective use of domperidone with sertraline:

  • Take the medications exactly as your doctor prescribed. Don’t try to adjust the doses on your own or take extra doses, thinking it will help more. Always follow your doctor’s instructions.
  • Pay attention to how you feel. If you notice anything strange or different, like an upset stomach or drowsiness, let your doctor know.
  • Mixing these meds with alcohol can make things worse, especially if you’re feeling nauseous. It’s best to skip the drinks.
  • Tell your doctor about all the meds you’re taking, including over-the-counter ones. Some combinations might not be safe.

Are all antiemetics considered safe to take with sertraline?

No, not all antiemetics are considered safe to take with sertraline. Some antiemetics or antidiarrheal medications can interact with this antidepressant and cause side effects. These include: 

MedicationType Potential Interaction with Sertraline
OndansetronAntiemeticRisk of serotonin syndrome when used with sertraline.
MetoclopramideAntiemeticRisk of serotonin syndrome when used with sertraline.
LoperamideAntidiarrhealPotential for cardiac rhythm disturbances when used excessively with sertraline.
Bismuth SubsalicylateAntidiarrhealPotential for blood thinning when used with sertraline.

As a pharmacist, I always advise keeping an eye on side effects to ensure whether the medications you are currently taking are causing you any harm. It is a known fact that not everyone responds to medications in the same way. 

Some people can have different factors affecting their health, and they might not do well even on common combinations that are generally well-tolerated. What works for one may not work for another, and we are all unique. 

So, it’s best to monitor your side effects and attend follow-up appointments with your doctor to make sure that you’re receiving the best possible treatment and that your body is responding well to it.

References 

  1. Singh HK, Saadabadi A. Sertraline. 2023 Feb 13. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 31613469. Available from: https://www.ncbi.nlm.nih.gov/books/NBK547689 
  1. Brogden RN, Carmine AA, Heel RC, Speight TM, Avery GS. Domperidone. A review of its pharmacological activity, pharmacokinetics and therapeutic efficacy in the symptomatic treatment of chronic dyspepsia and as an antiemetic. Drugs. 1982 Nov;24(5):360-400. doi: 10.2165/00003495-198224050-00002. PMID: 6756878. https://pubmed.ncbi.nlm.nih.gov/6756878/
  1. The Food and Drug Administration (FDA). HIGHLIGHTS OF PRESCRIBING INFORMATION. ZOLOFT (sertraline hydrochloride) tablets, for oral use. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/019839s74s86s87_20990s35s44s45lbl.pdf
  1. National Library of Medicine. Sertraline: MedlinePlus Drug Information [Internet]. Bethesda (MD): U.S. National Library of Medicine. Available from: https://medlineplus.gov/druginfo/meds/a697048.html
  1. Junqueira DR, Bennett D, Huh SY, Fahrbach K, Neupane B, Betts M. Risk of Adverse Events Associated with Domperidone and Metoclopramide in Gastroparesis: Systematic Review and Meta-analysis. Drugs R D. 2023 Mar;23(1):1-20. doi: 10.1007/s40268-023-00413-x. Epub 2023 Feb 7. PMID: 36749528; PMCID: PMC9985532. https://pubmed.ncbi.nlm.nih.gov/36749528/ 

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