Sertraline Solution

What is this medication?

SERTRALINE (SER tra leen) treats depression, anxiety, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and premenstrual dysphoric disorder (PMDD). It increases the amount of serotonin in the brain, a hormone that helps regulate mood. It belongs to a group of medications called SSRIs.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

COMMON BRAND NAME(S): Zoloft, Zoloft Concentrate, Zoloft Solution

What should I tell my care team before I take this medication?

They need to know if you have any of these conditions:

• Bleeding disorders
• Bipolar disorder or a family history of bipolar disorder
• Glaucoma
• Heart disease
• High blood pressure
• History of irregular heartbeat
• History of low levels of calcium, magnesium, or potassium in the blood
• If you often drink alcohol
• Liver disease
• Receiving electroconvulsive therapy
• Seizures
• Suicidal thoughts, plans, or attempt; a previous suicide attempt by you or a family member
• Take medications that treat or prevent blood clots
• Thyroid disease
• An unusual or allergic reaction to sertraline, other medications, foods, dyes, or preservatives
• Pregnant or trying to get pregnant
• Breast-feeding

How should I use this medication?

Take this medication by mouth. Follow the directions on the prescription label.

Before taking your dose, you need to dilute the solution in a beverage. Measure your medication dose using the dropper in the bottle. Next, place the measured dose in at least 4 ounces (one-half cup) of water, ginger-ale, lemon-lime soda, lemonade or orange juice and mix. Do not mix in grapefruit juice or in any other liquids other than those listed.

Drink all of mixed liquid immediately. Do not mix the dose and store it for later. It must be taken right away. You may take this medication with or without food. Take your medication at regular intervals. Do not take your medication more often than directed. Do not stop taking this medication suddenly except upon the advice of your care team. Stopping this medication too quickly may cause serious side effects or your condition may worsen.

A special MedGuide will be given to you by the pharmacist with each prescription and refill. Be sure to read this information carefully each time.

Talk to your care team about the use of this medication in children. While this medication may be prescribed for children as young as 7 years for selected conditions, precautions do apply.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

What may interact with this medication?

Do not take this medication with any of the following:

• Cisapride
• Dronedarone
• Linezolid
• MAOIs like Carbex, Eldepryl, Marplan, Nardil, and Parnate
• Methylene blue (injected into a vein)
• Pimozide
• Thioridazine

This medication may also interact with the following:

• Alcohol
• Amphetamines
• Aspirin and aspirin-like medications
• Certain medications for depression, anxiety, or psychotic disturbances
• Certain medications for fungal infections like ketoconazole, fluconazole, posaconazole, and itraconazole
• Certain medications for irregular heart beat like flecainide, quinidine, propafenone
• Certain medications for migraine headaches like almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, zolmitriptan
• Certain medications for sleep
• Certain medications for seizures like carbamazepine, valproic acid, phenytoin
• Certain medications that treat or prevent blood clots like warfarin, enoxaparin, dalteparin
• Cimetidine
• Digoxin
• Diuretics
• Fentanyl
• Isoniazid
• Lithium
• NSAIDs, medications for pain and inflammation, like ibuprofen or naproxen
• Other medications that prolong the QT interval (cause an abnormal heart rhythm) like dofetilide
• Rasagiline
• Safinamide
• Supplements like St. John's wort, kava kava, valerian
• Tolbutamide
• Tramadol
• Tryptophan

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medication?

Tell your health care provider if your symptoms do not get better or if they get worse. Visit your health care provider for regular checks on your progress. Because it may take several weeks to see the full effects of this medication, it is important to continue your treatment as prescribed by your health care provider.

Patients and their families should watch out for new or worsening thoughts of suicide or depression. Also watch out for sudden changes in feelings such as feeling anxious, agitated, panicky, irritable, hostile, aggressive, impulsive, severely restless, overly excited and hyperactive, or not being able to sleep. If this happens, especially at the beginning of treatment or after a change in dose, call your health care provider.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medication affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Alcohol may interfere with the effect of this medication.

Your mouth may get dry. Chewing sugarless gum or sucking hard candy, and drinking plenty of water may help. Contact your health care provider if the problem does not go away or is severe.

Some products may contain alcohol. Ask your pharmacist or healthcare provider if this medication contains alcohol. Be sure to tell all healthcare providers you are taking this medication. Certain medications, like metronidazole and disulfiram, can cause an unpleasant reaction when taken with alcohol. The reaction includes flushing, headache, nausea, vomiting, sweating, and increased thirst. The reaction can last from 30 minutes to several hours.

What side effects may I notice from receiving this medication?

Side effects that you should report to your care team as soon as possible:

• Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
• Bleeding—bloody or black, tar-like stools, red or dark brown urine, vomiting blood or brown material that looks like coffee grounds, small red or purple spots on skin, unusual bleeding or bruising
• Heart rhythm changes—fast or irregular heartbeat, dizziness, feeling faint or lightheaded, chest pain, trouble breathing
• Low sodium level—muscle weakness, fatigue, dizziness, headache, confusion
• Serotonin syndrome—irritability, confusion, fast or irregular heartbeat, muscle stiffness, twitching muscles, sweating, high fever, seizure, chills, vomiting, diarrhea
• Sudden eye pain or change in vision such as blurred vision, seeing halos around lights, vision loss
• Thoughts of suicide or self-harm, worsening mood

Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):

• Change in sex drive or performance
• Diarrhea
• Excessive sweating
• Nausea
• Tremors or shaking
• Upset stomach

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medication?

Keep out of the reach of children and pets.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Get rid of any unused medication after the expiration date.

To get rid of medications that are no longer needed or expired:

• Take the medication to a medication take-back program. Check with your pharmacy or law enforcement to find a location.
• If you cannot return the medication, check the label or package insert to see if the medication should be thrown out in the garbage or flushed down the toilet. If you are not sure, ask your care team. If it is safe to put in the trash, empty the medication out of the container. Mix the medication with cat litter, dirt, coffee grounds, or other unwanted substance. Seal the mixture in a bag or container. Put it in the trash.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.