MajorFirst-generation antipsychotics. Butyrophenone derivatives×Selective serotonin reuptake inhibitors (SSRIs)
Updated · Methodology
Mechanism
Sertraline at high doses prolongs QT, additively with haloperidol. Sertraline also weakly blocks CYP2D6, so haloperidol levels may rise.
Symptoms
QT prolongation on ECG. Dizziness, syncope, palpitations. Severe cases: polymorphic ventricular tachycardia (torsades de pointes). Risk is higher with hypokalaemia and hypomagnesaemia.
Management
Avoid the combination with sertraline above 100 mg and parenteral haloperidol. Alternative antipsychotics with minimal QT effect: olanzapine or aripiprazole. Alternative antidepressants: mirtazapine or agomelatine.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.
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Sources
- FDA: Haloperidol tablet (Ajanta Pharma USA Inc.) – Prescribing Information (2020)– ; DailyMed setid 31e33656-2f53-49e6-9816-261ea2e6961a
- AEMPS: Ficha técnica: Haloperidol Esteve 2 mg/ml solución oral (nº registro 58355), secciones 4.4 y 4.5 (2020)– AEMPS, CIMA, nº registro 58355, revisión 07/2020, secciones 4.4 y 4.5