SERTRALINE HCL

Indications & Dose:

Depressive illness

•   BY MOUTH

Adult: Initially 50 mg daily, then increased in steps of 50 mg at intervals of at least 1 week if required; maintenance 50 mg daily; maximum 200 mg per day

Obsessive-compulsive disorder

•  BY MOUTH

Adult: Initially 50 mg daily, then increased in steps of 50 mg at intervals of at least 1 week if required; maximum 200 mg per day

Panic disorder | Post-traumatic stress disorder Social anxiety disorder

•  BY MOUTH

Adult: Initially 25 mg daily for 1 week, then increased to 50 mg daily, then increased in steps of 50 mg at intervals of at least 1 week if required, increase only if response is partial and if drug is tolerated; maximum 200 mg per day

Contraindications:

Side Effects:

Cautions:

Precautions:

Weight loss, hepatic or renal disease, epilepsy. 

Interaction:

Drugs

Carbamazepine: Inhibition of hepatic metabolism of carbamazepine, but the formation of carbamazepine epoxide is not inhibited, contributing to increased toxicity

Cyproheptadine: Serotonin antagonist may partially reverse antidepressant and other effects

Dexfenfluramine: Duplicate effects on inhibition of serotonin reuptake; inhibition of dexfenfluramine metabolism (CYP2D6) exaggerates effect; both mechanisms increase risk of serotonin syndrome

Fenfluramine: Duplicate effects on inhibition of serotonin reuptake; inhibition of dexfenfluramine metabolism (CYP2D6) exaggerates effect; both mechanisms increase risk of serotonin syndrome Lithium: Neurotoxicity (tremor, confusion, ataxia, dizziness, dysarthria,and absence seizures) reported in patients receiving fluoxetinelithium combination; mechanism unknown

MAOI’s (isocarboxazid. phenelzine, tranyleypromine): Increased CNS serotonergic effects has been associated with severe or fatal reactions with this combination

Selegiline: Sporadic cases of mania and hypertension

Tricyclic antidepressants (clomipramine, desipramine, doxepin, imipramine. nortripqline, trazadone): Marked increases in tricyclic antidepressant levels due to inhibition of metabolism (CYP2D6)

Tryptaphan: Additive serotonergic effects

Warfarin: Increased hypoprothrombinemic response to warfarin 

Warnings:

Adverse Effects:

Lactations:

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

CNS: Agitation, ataxia, confusion, dizziness, fatigue, headache, insomnia, paresthesia, somnolence, tremor, twitching

CV: Chest pain, hypotension, palpitations

EENT: Vision abnormalities

GU: Male sexual dysfunction, micturition disorder

GI: Anorexia, constipation, diarrhea, dry mouth, dyspepsia, flatulence. nausea, vomiting 

Patient And Carer Advice: