Sertraline Tablets

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

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
• Frequently drink alcohol
• Glaucoma
• Heart disease
• High blood pressure
• History of irregular heartbeat
• History of low levels of calcium, magnesium, or potassium in the blood
• Liver disease
• Receiving electroconvulsive therapy
• Seizures
• Suicidal thoughts, plans, or attempt; a previous suicide attempt by you or a family member
• Take medications that prevent or treat 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 with a glass of water. Follow the directions on the prescription label. You can take it 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 other mental health conditions
• 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 care team if your symptoms do not get better or if they get worse. Visit your care team 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 care team.

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 care team.

This medication may affect your coordination, reaction time, or judgment. Do not drive or operate machinery until you know how this medication affects you. Sit or stand up slowly to reduce the risk of dizzy or fainting spells. Drinking alcohol with this medication can increase the risk of these side effects.

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

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.

What is sertraline (Zoloft®) used for?

Sertraline (Zoloft) has approval from the U.S. Food and Drug Administration (FDA) to help manage the following conditions:

• Major depressive disorder (clinical depression). Healthcare providers consider sertraline to be a first-line treatment for this condition.
• Obsessive-compulsive disorder (OCD).
• Panic disorder.
• Post-traumatic stress disorder (PTSD).
• Premenstrual dysphoric disorder (PMDD).
• Social anxiety disorder.

Providers sometimes prescribe sertraline for other conditions. This is considered an off-label, or non-FDA-approved, use of the medication. Off-label uses of sertraline include:

• Binge eating disorder.
• Body dysmorphic disorder.
• Bulimia nervosa.
• Generalized anxiety disorder.
• Premature ejaculation.

Does sertraline (Zoloft) cause weight gain?

Sertraline may cause weight gain, although most people don’t experience this. But it’s important to remember that several factors can contribute to weight gain. For example:

• Untreated depression can lead to loss of appetite and unexpected weight loss. Taking an antidepressant (like Trintellix) can improve your mood and restore your appetite. A restored appetite might result in eventual weight gain.
• Adults tend to gain weight as they age in general.

If you’re concerned about this possible side effect, talk to your healthcare provider. Know that the benefits of taking an antidepressant may outweigh possible weight gain. There are also steps you can take to manage your weight, such as exercise or adjusting your eating patterns.

Does sertraline (Zoloft) make you tired?

One of the potential side effects of sertraline is fatigue (tiredness). But side effects of SSRIs (selective serotonin reuptake inhibitors) — including sertraline — are generally mild.

If fatigue is affecting your day-to-day life, talk to your healthcare provider. While sertraline may be the cause, it’s more likely to be something else.

How long does sertraline (Zoloft) stay in your system?

Your body slowly absorbs sertraline. It has peak concentrations in your body about four to 10 hours after you take it. Sertraline has a half-life of 24 to 32 hours in children, adolescents and adults.

This means that it takes 24 to 32 hours for the active ingredient in the medication to reduce by half in your body. In other words, if you were to take a single dose of sertraline, the medication would likely be completely out of your system 48 to 64 hours after you take it.

Can you take sertraline (Zoloft) while pregnant?

There are certain risks and benefits associated with taking antidepressants while pregnant. Because of this, you should have a conversation with your healthcare provider. They make recommendations on a case-by-case basis because each person and situation is unique. Never suddenly stop taking sertraline. This can lead to antidepressant discontinuation syndrome.

The main risk for a fetus from antidepressant exposure is the possibility of birth defects (congenital conditions). This risk is generally very low. There are reports of more than 20,000 pregnancies exposed to sertraline. Some studies suggest an increased chance of congenital heart disease or other birth defects. But most studies haven’t found an increased risk for birth defects when you take sertraline during pregnancy.

It’s important to remember that the benefits of taking sertraline during pregnancy to manage an underlying mental health condition may outweigh the potential risks. Untreated major depression during pregnancy can lead to an increased risk of:

• Decreased fetal growth.
• Premature birth.
• Low birth weight (less than 5.5 pounds).

Untreated depression during pregnancy can also increase your risk of postpartum depression.

A note from Cleveland Clinic

Sertraline (Zoloft) is a very common prescription medication that can help treat depression and other mental health conditions. Talk to your healthcare provider about any concerns or questions you have about the medication. They’re available to help.