Can you take Flecainide with Sertraline? (1+ interactions)
By
Ivan Kahwa
Author bio
Mr Ivan Kahwa is a chemist and phytopharmaceutical scientist with expertise in chemistry, pharmacology, phytochemistry, and Nanobiotechnology. He writes and reviews content on these topics.
Mr Ivan Kahwa’s Highlights:
Guest Researcher at the University of Leipzig, Senior Research Fellow/Scientist, and Lecturer at the Department of Pharmacy, Faculty of Medicine, Mbarara University of Science and Technology.
Professional Experience:
Mr Ivan joined PHARMBIOTRAC as a research fellow/scientist during his master of science tenure. He contributed to the development of most of the phytopharmaceutical products in the project. Furthermore, he participated in carrying out the pharmacological activities of the developed products in laboratory animals such as mice and rats in order to develop proper doses hence leading to pre-clinical studies.
With the above relevant research experience, Ivan started to work with the University of Leipzig on collaborative projects with Mbarara University to develop the chemistry of Ugandan Medicinal plants and their pharmacological activities. This was coupled with several consultative positions by different German NGOs. Mr. Kahwa is also a supporting in the teaching and learning at the Departments of Pharmacy and Pharmaceutical Sciences, Faculty of Medicine, Mbarara University of Science and Technology.
With the increase in antimicrobial resistance globally, Ivan retooled his thinking towards developing new naturally derived antibiotic regimens from Ugandan propolis with the assistance of nanotechnology to improve their delivery to microbial cells. Kahwa has also published over 28 articles in peer-reviewed journals and he is currently reviewing for many journals.
Education:
2023-2027: PhD in Pharmaceutical Sciences (ongoing) with a focus on Pharmaceutical Microbiology and Nanobiology at Mbarara University of Science and Technology.
2022: 2Msc. in Pharmacognosy and Natural Medicine Science at Mbarara University of Science and Technology.
2018: Bachelor of Science (Chemistry) at Mbarara University of Science and Technology.
Publications:
▪ Iqbal, S., Jabeen, F., Kahwa, I., & Omara, T. 2023. Suberosin Alleviates Thiazolidinedione-Induced Cardiomyopathy in Diabetic Rats by Inhibiting Ferroptosis via Modulation of ACSL4-LPCAT3 and PI3K-AKT Signaling Pathways. Cardiovascular Toxicology. https://doi.org/10.1007/s12012-023-09804-7
▪ Gupta, A. K., Yadav, R., Sharma, S., Sawale, J., & Kahwa, I. 2023. Anti-ageing Activity and Antioxidant Activity of Methanol Extracts of Leaves and Flowers of Salvia officinalis and Rosmarinus officinalis. Journal of Young Pharmacists, 15(3), 448–455. https://doi.org/10.5530/jyp.2023.15.60
▪ Tolo, C.U., Kahwa, I., Nuwagira, U., Weisheit, A. and Ikiriza, H., 2023. Medicinal plants used in treatment of various diseases in the Rwenzori Region, Western Uganda. Ethnobotany Research and Applications, 25, pp.1-16.
https://ethnobotanyjournal.org/index.php/era/article/view/4683
▪ Kahwa, I., Ajayi, C.O., Yadav, R., Chauhan, N.S., Shah, K., Abdelgadir, A.A., Shegena, E.A., Daniel, S., Omara, T., Asiimwe, J.B. and Ikiriza, H., 2023. Pharmacognostic and phytochemical studies as an invaluable approach for correct identification of medicinal plants: The case of Artemisia vulgaris L. substituted for Artemisia annua L. in Western Uganda. TMR Integr Med, 7, p.e23004.
https://doi.org/10.53388/TMRIM202307004
▪ Nalimu, F., Oloro, J., Kahwa, I. and Ogwang, P.E., 2021. Review on the phytochemistry and toxicological profiles of Aloe vera and Aloe ferox. Future Journal of Pharmaceutical Sciences, 7, pp.1-21.
https://doi.org/10.1186/s43094-021-00296-2
▪ Elamin, O.H.S., Ali, M.A., Elgezuli, I.A.A., Bashir, M.A. and Kahwa, I., 2021. Diagnosis of pre-and post-treatment of echinococcus granulosus with counter current immune electrophoresis and bacterial co-agglutination. Journal of Microbiology and Infectious Diseases, 11(02), pp.88-94.
https://doi.org/10.5799/jmid.951600
Published book Chapter
▪ Kahwa, I., Ayesiga, I., Nakalema, S., Alinaiswe, R., Mbabazi, R. and Iqbal, S., 2023. Natural products in the management of onchocerciasis. In Natural Products in Vector-Borne Disease Management (pp. 63-80). Academic Press. Book Chapter.
https://doi.org/10.1016/B978-0-323-91942-5.00012-4
Submitted manuscripts Under Review:
▪ Comparison of the Wound Healing Activity of the Leaf and Leaf Ash Extracts of Vernonia amygdalina in Rats. Journal name: Clinical Phytoscience
▪ Ethnobotanical Survey of Medicinal plants used in the management of cancer in Uganda. Journal name: Journal of Herbal Medicine
▪ Ethnobotanical survey and phytochemical screening of medicinal plants used in treatment of epilepsy by PROMETRA-Uganda Traditional Health Practitioners in Mpigi District, Uganda. Journal name: Journal of Ethnopharmacology
Submitted book chapters under review
1.Book title: Algae as a Natural Solution for Water-Food-Energy Nexus, Section 4: Microalgae and cyanobacteria for food applications, Chapter 4.6: Safety, toxicological and allergenic aspects of using algae for food. Authors: Christine Kyarimpa, Tom Omute, Caroline K. Nakiguli, Alice V. Khanakwa4, Christopher Angiro, Ivan Kahwa, Fortunate Ahumuza, Timothy Omara*. Publisher: Springer Nature Singapore Pte Ltd. 152 Beach Road, #21-01/04 Gateway East, Singapore 189721, Singapore.
2.Book title: Nutraceuticals Inspiring the Contemporary Therapy for Lifestyle Diseases. Chapter: Nutraceutical applications of Seaweeds and their Phytocompounds in Nutrition and Treatment of Diseases. Authors: Ivan Kahwa, Timothy Omara , Innocent Ayesiga , Gael Noel Neh Neba Ambe , Zehbanaz Javidbhai Panwala , Rachel Mbabazi , Shabnoor Iqbal , Christine Kyarimpa , Christine Betty Nagawa , Kamal Shah ,Nagendra Singh Chauhan* Publisher: CRC Press
You can view my works on the following professional sites:
Research Gate: https://www.researchgate.net/profile/Ivan-Kahwa
Google Scholar: https://scholar.google.com/citations?user=tOwrvqoAAAAJ&hl=en
ORCID: https://orcid.org/0000-0002-6440-3437
Linkedin: https://de.linkedin.com/in/ivan-kahwa-865450159
In this article, we will explore the possible interaction between Sertraline and Flecainide. We will also discuss what side effects one may experience by combining these two medications and how to manage the side effects associated with this interaction.
Can you take Flecainide with Sertraline?
Yes, you can take Flecainide with Sertraline. Flecainide and Sertraline are two commonly prescribed medications for different medical conditions. Nevertheless, Flecainide does interact with Sertraline in terms of side effects.
Flecainide is an antiarrhythmic medication primarily used in the management of atrial fibrillation (1). Sertraline (Zoloft), on the other hand, is a widely prescribed antidepressant for the management of depressive disorders (2).
While both Flecainide and Sertraline are effective in their respective areas, they have different mechanisms of action that amplify their interactions when taken together.
Additionally, it is important to understand that while these medications may interact and cause life-threatening side effects, you can take them together, but only under the guidance of your doctor. These medications are available only by prescription, and you should only use them as directed by your healthcare provider.
What is the mechanism of Sertraline-Flecainide interaction?
Several research studies have attributed the interaction between Flecainide and Sertraline to their metabolism by the Cytochrome P450 enzymes (CYP450) and their effects on the neurotransmitters in the brain. This interaction is caused by their inhibitory and additive effects when used together.
SSRI medications such as Sertraline and Fluoxetine increase levels of Flecainide in the body through inhibition of CYP450 enzymes. Flecainide is primarily metabolized by Cytochrome P450 isoenzyme 2D6 (CYP2D6).
Sertraline inhibits this enzyme increasing levels of Flecainide and potentially causing several side effects (3,4).
Conversely, Flecainide can also increase Sertraline levels in the brain and peripheral system via inhibition of the CYP2D6 enzyme potentiating its side effects profile.
What are the factors influencing Sertraline-Flecainide interactions?
Several factors can influence the interaction between these drugs including:
- Dosage – The dosage of both medications influences the likelihood of interactions between these medications.
- Duration of use – Long-term use of either drug may increase the likelihood of interactions as they accumulate in the body.
- Genetic factors – Genetic variations in CYP450 metabolizing enzymes influence how these medications are metabolised and their side effects.
- Underlying health conditions – Certain health conditions like liver disorders can influence how drugs are metabolized and their potential interaction.
What are the potential side effects of Sertraline-Flecainide interactions?
Sertraline-flecainide interactions can vary among individuals and are dependent on individual patient factors such as genetics and their prescribed dosage.
Increased risk of QT prolongation and cardiac arrhythmias:
Both drugs carry the potential for QT interval prolongation, a condition that can trigger life-threatening irregular heart rhythms, known as cardiac arrhythmias. Combining these two medications amplifies the likelihood of developing or worsening pre-existing cardiac arrhythmias.
Serotonin syndrome:
Individually, both these medications can elevate serotonin levels. While rare, concurrent use of these two medications may increase the likelihood of Serotonin syndrome, a potentially life-threatening condition that occurs when there are excess serotonin levels in the brain.
Serotonin syndrome can manifest with some of the side effects associated with Sertraline, including tremors, muscle rigidity, seizures and sweating. However, it can also present as agitation, confusion, rapid heart rate, fever, and, in severe cases, even coma.
How to manage the Sertraline-Flecainide interaction side effects?
While taking these two medications it is important to be cautious and take precautions against them including:
- Symptom awareness: You should stay vigilant of any unusual symptoms while taking these medications and report them immediately.
- Regular monitoring and assessment of symptoms: While using these medications, it is important to have frequent consultations with your primary healthcare provider. They need to closely monitor you for potential side effects and negative interactions.
- Dose adjustments and scheduling: Your primary healthcare provider may modify the dosages of one or both medications to minimise interaction and adverse events. Additionally, your healthcare provider will determine the optimal drug schedule for dual therapy with these medications.
- Consideration of alternative medications: In the event of a severe interaction, such as serotonin syndrome, your doctor may adjust your treatment plan by discontinuing one or both medications or switching you to alternative medications with fewer side effects.
Conclusion
While it is possible to take Flecainide and Sertraline together with proper precautions and monitoring, the potential risks associated with this combination necessitate open communication and close supervision by your doctor to maintain safe and effective treatment.
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References
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Singh HK, Saadabadi A. Sertraline [Internet]. PubMed. Treasure Island (FL): StatPearls Publishing; 2021 [cited 2023 Oct 5]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK547689/#article-28926.s5
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