Generic Name and Formulations:
Sertraline (as HCl) 20mg/mL; soln; contains alcohol 12%. Dilute just before administering in 4oz water, ginger ale, lemon/lime soda, lemonade, or orange juice.
Company:
Pfizer Inc.
Panic disorder. Posttraumatic stress disorder (PTSD). Obsessive-compulsive disorder (OCD). Social anxiety disorder.
Give once daily (AM or PM). Panic or social anxiety disorder, PTSD: initially 25mg/day, increase after 1 week to 50mg/day; titrate at intervals of at least 1 week. OCD: Initially 50mg/day; may increase at 1-week intervals. For all: max 200mg/day.
<6yrs: not recommended. Give once daily (AM or PM). OCD: 6–12yrs: initially 25mg/day. 13–17yrs: initially 50mg/day. May increase at 1-week intervals; max 200mg/day.
SSRI.
Concomitant MAOIs during or within 14 days of discontinuing sertraline. Within 14 days of discontinuing an MAOI. Concomitant linezolid or IV methylene blue. Concomitant pimozide. Oral soln: concomitant disulfiram.
Increased risk of suicidal thinking and behavior in children, adolescents, and young adults; monitor for clinical worsening or changes. Monitor for signs/symptoms of serotonin syndrome; discontinue if occurs. Monitor for mania/hypomania. Seizure disorders. Hepatic dysfunction (reduce dose or prolong dosing interval). Cardiac disease. Conditions that affect metabolism or hemodynamic response. History of glaucoma. Volume depleted. Monitor weight. Avoid abrupt cessation. Reevaluate periodically in long-term use. Write ℞ for smallest practical amount. Elderly. Labor & delivery. Pregnancy (Cat.C). Nursing mothers.
See Contraindications. Do not start with concomitant linezolid or IV methylene blue; if treatment is necessary, discontinue sertraline before starting; monitor for serotonin syndrome for 2 weeks or until 24 hours after last dose of linezolid or methylene blue, whichever comes first. Risk of serotonin syndrome with concomitant serotonergic drugs (eg, triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, tryptophan, buspirone, St. John's Wort) and with drugs that impair serotonin metabolism (eg, MAOIs, linezolid, IV methylene blue). Avoid alcohol. May potentiate or be potentiated by cimetidine, protein bound drugs (eg, warfarin, digitoxin). Caution with other CNS drugs and drugs metabolized by CYP2D6 (eg, tricyclics, flecainide, propafenone). Potentiates diazepam, tolbutamide. Monitor lithium, warfarin, tricyclics. Monitor patients on sumatriptan for serotonin syndrome (eg, weakness, incoordination, hyperreflexia). Increased risk of bleeding with NSAIDs, aspirin, warfarin, and others that affect coagulation.
Diarrhea, nausea, insomnia, sexual dysfunction, somnolence, decreased libido, anorexia, weight loss, agitation, tremor, dry mouth, sweating, hyponatremia/SIADH (esp in elderly), weak uricosuric effect. Children: also, hyperkinesia, fever, urinary incontinence, aggressiveness, sinusitis, epistaxis, purpura.
Tabs 25mg—30, 50; 50mg, 100mg—30, 100, 500, 5000; Conc—60mL (w. dropper)
Depression. Premenstrual dysphoric disorder (PMDD).
Give once daily (AM or PM). Depression: initially 50mg/day, may increase at 1-week intervals; max 200mg/day. PMDD: give either for entire menstrual cycle or only during luteal phase. Luteal phase dosing: initially 50mg/day; if no response, may increase to 100mg/day, starting each cycle at 50mg/day for 3 days. Entire cycle dosing: initially 50mg/day, if no response, may increase by 50mg/cycle to max 150mg/day.
Not recommended.
SSRI.
Concomitant MAOIs during or within 14 days of discontinuing sertraline. Within 14 days of discontinuing an MAOI. Concomitant linezolid or IV methylene blue. Concomitant pimozide. Oral soln: concomitant disulfiram.
Increased risk of suicidal thinking and behavior in children, adolescents, and young adults; monitor for clinical worsening or changes. Monitor for signs/symptoms of serotonin syndrome; discontinue if occurs. Monitor for mania/hypomania. Seizure disorders. Hepatic dysfunction (reduce dose or prolong dosing interval). Cardiac disease. Conditions that affect metabolism or hemodynamic response. History of glaucoma. Volume depleted. Monitor weight. Avoid abrupt cessation. Reevaluate periodically in long-term use. Write ℞ for smallest practical amount. Elderly. Labor & delivery. Pregnancy (Cat.C). Nursing mothers.
See Contraindications. Do not start with concomitant linezolid or IV methylene blue; if treatment is necessary, discontinue sertraline before starting; monitor for serotonin syndrome for 2 weeks or until 24 hours after last dose of linezolid or methylene blue, whichever comes first. Risk of serotonin syndrome with concomitant serotonergic drugs (eg, triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, tryptophan, buspirone, St. John's Wort) and with drugs that impair serotonin metabolism (eg, MAOIs, linezolid, IV methylene blue). Avoid alcohol. May potentiate or be potentiated by cimetidine, protein bound drugs (eg, warfarin, digitoxin). Caution with other CNS drugs and drugs metabolized by CYP2D6 (eg, tricyclics, flecainide, propafenone). Potentiates diazepam, tolbutamide. Monitor lithium, warfarin, tricyclics. Monitor patients on sumatriptan for serotonin syndrome (eg, weakness, incoordination, hyperreflexia). Increased risk of bleeding with NSAIDs, aspirin, warfarin, and others that affect coagulation.
Diarrhea, nausea, insomnia, somnolence, sexual dysfunction, tremor, dry mouth, sweating, anorexia, weight loss, anxiety, decreased libido, hyponatremia, weak uricosuric effect.
Tabs 25mg—30, 50; 50mg, 100mg—30, 100, 500, 5000; Conc—60mL (w. dropper)