Sertraline

For depression and obsessive-compulsive disorder, the recommended doses range from 50 mg to 200 mg once daily, taken with food.

For panic disorder, the recommended doses range from 25 mg to 200 mg once daily.

Your doctor may start you on a lower dose and gradually increase your dose to one that's appropriate for you.

Sertraline should be taken with food, preferably in the evening. But if you prefer to take it in the morning, take it with breakfast. Swallow the capsule whole. Do not crush, chew, or divide the capsules.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take Sertraline exactly as prescribed by your doctor.

If you miss a dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store Sertraline at room temperature, protect it from moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

In addition to its desired action, this medication may cause some adverse effects, notably: it may cause dryness of the mouth; it may cause diarrhea; it may cause dizziness - use caution when getting up from a lying or sitting position and use caution if driving; it may cause either drowsiness or excitability - use caution until you know how you will react; it may cause nausea or, rarely, vomiting; it may make your skin more sensitive to UV rays (e.g., sunlight, tanning lamps) - avoid exposure to UV rays as much as possible and protect yourself when out in the sun. Each person may react differently to a treatment. If you think this medication may be causing adverse effects (including those described here, or others), talk to your health care professional. He or she can help you to determine whether or not the medication is the source of the problem.

25 mg
Each yellow, size 4 capsule, imprinted "APO 25", contains sertraline HCl equivalent to 25 mg of sertraline. Nonmedicinal ingredients: colloidal silicon dioxide, cornstarch, croscarmellose sodium, stearic acid, and talc; capsule shell: D&C Yellow No. 10, FD&C Yellow No. 6, gelatin, silicon dioxide, sodium lauryl sulfate, and titanium dioxide; edible black ink: synthetic black iron oxide, pharmaceutical glaze, FD&C Blue No. 1 Aluminum Lake, FD&C Blue No. 2 Aluminum Lake, D&C Yellow No. 10 Aluminum Lake, FD&C Red No. 40 Aluminum Lake, may contain n-butyl alcohol, propylene glycol, and SDA-3A alcohol.

50 mg
Each white and yellow, size 3 capsule, imprinted "APO 50", contains sertraline HCl equivalent to 50 mg of sertraline. Nonmedicinal ingredients: colloidal silicon dioxide, cornstarch, croscarmellose sodium, stearic acid, and talc; capsule shell: D&C Yellow No. 10, FD&C Yellow No. 6, gelatin, silicon dioxide, sodium lauryl sulfate, and titanium dioxide; edible black ink: synthetic black iron oxide, pharmaceutical glaze, FD&C Blue No. 1 Aluminum Lake, FD&C Blue No. 2 Aluminum Lake, D&C Yellow No. 10 Aluminum Lake, FD&C Red No. 40 Aluminum Lake, may contain n-butyl alcohol, propylene glycol, and SDA-3A alcohol.

100 mg
Each orange, size 2 capsule, imprinted "APO 100", contains sertraline HCl equivalent to 100 mg of sertraline. Nonmedicinal ingredients: colloidal silicon dioxide, cornstarch, croscarmellose sodium, stearic acid, and talc; capsule shell: D&C Yellow No. 10, FD&C Red No. 40, gelatin, silicon dioxide, sodium lauryl sulfate, and titanium dioxide; edible black ink: synthetic black iron oxide, pharmaceutical glaze, FD&C Blue No. 1 Aluminum Lake, FD&C Blue No. 2 Aluminum Lake, D&C Yellow No. 10 Aluminum Lake, FD&C Red No. 40 Aluminum Lake, may contain n-butyl alcohol, propylene glycol, and SDA-3A alcohol.

Do not take sertraline if you:

• are allergic to sertraline or any ingredients of the medication
• are taking a MAO inhibitor (e.g., Phenelzine, Tranylcypromine, Moclobemide) or have taken a MAO inhibitor within the last 14 days
• are taking Pimozide

There may be an interaction between sertraline and any of the following:

• acetylsalicylic acid (ASA)
• alcohol
• Amiodarone
• amphetamines (e.g., Dextroamphetamine, Lisdexamfetamine)
• antihistamines (e.g., cetirizine, doxylamine, Diphenhydramine, Hydroxyzine, Loratadine)
• antipsychotic medications (e.g., Chlorpromazine, Clozapine, Haloperidol, Olanzapine, pimozide, Quetiapine, Risperidone)
• Apalutamide
• Apixaban
• barbiturates (e.g., butalbital, pentobarbital, Phenobarbital)
• benzodiazepines (e.g., Alprazolam, Diazepam, Lorazepam)
• beta-blockers (e.g. Pindolol, Propranolol, Sotalol)
• Bromocriptine
• Bupropion
• Buspirone
• Celecoxib
• chloral hydrate
• chloroquine
• Clopidogrel
• dabigatran
• Degarelix
• Desmopressin
• dexmethylphenidate
• Dextromethorphan
• diabetes medications (e.g., chlorpropamide, Glyburide, insulin, Metformin, Rosiglitazone)
• Dipyridamole
• Disopyramide
• disulfiram
• dofetilide
• Domperidone
• Dronedarone
• Edoxaban
• efavirenz
• Enzalutamide
• ergot alkaloids (e.g., ergotamine, Dihydroergotamine)
• Flecainide
• glucosamine
• grapefruit juice
• Heparin
• Linezolid
• lithium
• low molecular weight heparins (e.g., Dalteparin, Enoxaparin, Tinzaparin)
• macrolide antibiotics (e.g., clarithromycin, erythromycin)
• Methadone
• methylene blue
• methamphetamine
• Metoclopramide
• mifepristone
• Mirtazapine
• monoamine oxidase inhibitors (M.O.S. e.g., moclobemide, Rasagiline, Selegiline, tranylcypromine)
• multivitamins
• muscle relaxants (e.g., Baclofen, Cyclobenzaprine, methocarbamol, orphenadrine)
• narcotic pain relievers (e.g., Codeine, Fentanyl, Morphine, Oxycodone)
• non-steroidal anti-inflammatory medications (NSAIDs; e.g., Diclofenac, ibuprofen, naproxen)
• Obinutuzumab
• Octreotide
• omega-3 fatty acids
• Pentoxifylline
• Prasugrel
• procainamide
• quinidine
• quinine
• quinolone antibiotics (e.g., ciprofloxacin, Ofloxacin, sparfloxacin)
• rifabutin
• rifampin
• Rivaroxaban
• St. John's wort
• scopolamine
• seizure medications (e.g., Carbamazepine, Clobazam, Levetiracetam, phenobarbital, Phenytoin, primidone, Topiramate, Valproic acid, zonisamide)
• serotonin antagonists (anti-emetic medications; e.g., Granisetron, Ondansetron)
• serotonin/norepinephrine reuptake inhibitors (SNRIs; e.g., Desvenlafaxine, Duloxetine, Venlafaxine)
• other selective serotonin reuptake inhibitors (SSRIs; e.g., Citalopram, Fluoxetine, Paroxetine, sertraline)
• sotalol
• Tapentadol
• Tetrabenazine
• thiazide diuretics (water pills; e.g., Hydrochlorothiazide, Indapamide, Metolazone)
• Thyroid replacements (e.g., desiccated thyroid, Levothyroxine)
• Ticagrelor
• Ticlopidine
• Tizanidine
• tramadol
• Trazodone
• tricyclic antidepressants (e.g., Amitriptyline, Imipramine, Nortriptyline)
• "triptan" migraine medications (e.g., Eletriptan, sumatriptan)
• Tryptophan
• tyrosine kinase inhibitors (e.g., Dasatinib, Lapatinib, Nilotinib, Pazopanib, Sunitinib)
• vitamin E
• warfarin
• Zolpidem
• Zopiclone

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Sertraline. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Sertraline.

Bleeding: Sertraline may increase the risk of bleeding, especially if you are also taking medications such as acetylsalicylic acid (Asa), nonsteroidal anti-inflammatory drugs (NSAIDs; e.g., Ibuprofen, Naproxen, Ketoprofen), or Warfarin. If you experience easy bruising, pinpoint-sized red spots on the skin, or unusual bleeding while taking Sertraline, contact your doctor immediately.

Bones: Sertraline may increase the risk of bone fracture, especially if you are a senior or have Osteoporosis or other major risk factors for breaking a bone. Take extra care to avoid falls, especially if you get dizzy or have Low Blood Pressure. Your doctor may monitor your bones while you are taking Sertraline.

Diabetes: Sertraline may cause a loss of blood sugar control (increased or decreased blood sugar) for some people who have diabetes and glucose tolerance may change. If you have diabetes, monitor your blood sugar closely and report any changes to your doctor.

If you have diabetes or are at risk for developing diabetes, discuss with your doctor how Sertraline may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Sertraline, and whether any special monitoring is needed.

Drowsiness/reduced alertness: Sertraline may impair judgment, thinking, or motor skills. People using sertraline should avoid driving a car or operating hazardous machinery until they determine whether or not the medication affects them in this way.

Glaucoma: Sertraline may cause an increase in pressure in the eyes. It can cause symptoms of glaucoma to become worse. If you have glaucoma, discuss with your doctor how Sertraline may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Sertraline, and whether any special monitoring is needed.

Heart rhythm: Sertraline can cause changes to the normal rhythm of the heart, including an irregular heartbeat called QT prolongation. QT prolongation is a serious life-threatening condition that can cause fainting, seizures, and sudden death. If you are at risk for heart rhythm problems (e.g., people with heart failure, Angina, low potassium or magnesium levels, family history of QT prolongation), discuss with your doctor how Sertraline may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Sertraline, and whether any special monitoring is needed.

Liver function: Liver disease or reduced liver function may cause Sertraline to build up in the body, causing side effects. If you have liver problems, discuss with your doctor how Sertraline may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Sertraline, and whether any special monitoring is needed. Your doctor may want to test your liver function regularly with blood tests while you are taking Sertraline.

If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.

Mania: Sertraline may cause activation of mania. This means that people who are prone to mania may be more likely to have their mania start up again. If you have a history of mania or bipolar disorder, your doctor should closely monitor your condition while you are taking Sertraline.

Seizures: If you have a history of seizures, your doctor should closely monitor your condition while you are taking sertraline. If you develop seizures, stop taking the medication and contact your doctor.

Serotonin syndrome: Sertraline may cause a rare but potentially life-threatening condition called serotonin syndrome, especially when used with other medications that increase serotonin levels (e.g., Sumatriptan, Rizatriptan, Tramadol, St. John's wort). If you experience symptoms such as agitation, confusion, hallucinations, fast heart rate, fever, lack of coordination, increased body temperature, overactive reflexes, nausea, vomiting, and diarrhea, get immediate medical attention.

Sodium levels: Sertraline can occasionally cause low levels of sodium in the blood (hyponatremia). This is more likely to happen to seniors or people who are also taking diuretics (water pills). If you experience confusion, weakness, headache, and memory problems, talk to your doctor as soon as possible. If too much sodium is lost from the body, it can cause hallucinations, confusion, seizures, coma, breathing, and even death.

Stopping the medication: Stopping Sertraline suddenly may lead to side effects. If you are thinking of stopping the medication, check with your doctor or pharmacist first. See also "What side effects are possible with Sertraline?"

Suicidal or agitated behaviour: People taking Sertraline may feel agitated (restless, anxious, aggressive, emotional, and feeling not like themselves), or they may want to hurt themselves or others. These symptoms may occur within several weeks after people start taking Sertraline. Your doctor will monitor you closely for emotional and behavioural changes. If you feel suicidal or agitated or notice any other changes in behaviour, talk to your doctor. Family members or caregivers of people who are taking Sertraline should contact the person's doctor immediately if they notice unusual behaviour changes.

Pregnancy: Sertraline should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Sertraline, contact your doctor immediately. There have been some reports that women taking SSRIs such as sertraline during the second half of pregnancy may be associated with lung disorders in newborns. Talk to your doctor if you have any concerns.

Breast-feeding: It is not known if sertraline passes into breast milk. If you are a breast-feeding mother and are taking Sertraline, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children and adolescents: The safety and effectiveness of using Sertraline have not been established for people under the age of 18 years. The use of Sertraline by children below the age of 18 may cause behavioural and emotional changes, such as suicidal thoughts and behaviour.

Seniors: Seniors who take sertraline appear to be more likely to experience low sodium in their blood, which can cause problems with coordination, achy muscles, or confusion. If you experience anything unusual while taking sertraline, contact your doctor.

Sertraline belongs to a class of medications known as selective serotonin reuptake inhibitors (SSRIs). It is used to treat Depression, panic disorder, and obsessive-compulsive disorder (OCD). Sertraline works by affecting the balance of chemicals in the brain. Specifically, it increases the level of a neurotransmitter called serotonin in the brain. Increased serotonin levels can help improve mood, reduce panic attacks, and treat OCD.

Although improvements may occur earlier, the full response to the medication may not appear until after 4 weeks of treatment or longer.

Sertraline may be available under multiple brand names and/or in several different forms. Any specific brand name of Sertraline may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of Sertraline may not be used for all of the conditions discussed here.

Your doctor may have suggested Sertraline for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking Sertraline, speak to your doctor. Do not stop taking Sertraline without consulting your doctor.

Do not give Sertraline to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take Sertraline if their doctor has not prescribed it.