Do not use sertraline if you are using pimozide (Orap), or an MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), rasagiline (Azilect), or selegiline (Eldepryl, Emsam). Serious and sometimes fatal reactions can occur when these medicines are taken with sertraline. You must wait at least 14 days after stopping an MAO inhibitor before you can take sertraline. After you stop taking sertraline, you must wait at least 14 days before you start taking an MAOI.
Before taking sertraline, tell your doctor if you have:
- liver or kidney disease;
- seizures or epilepsy;
- bipolar disorder (manic depression); or
- a history of drug abuse or suicidal thoughts.
If you have any of these conditions, you may need a dose adjustment or special tests to safely take sertraline.
You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Tell your doctor if you have worsening symptoms of depression or suicidal thoughts during the first several weeks of treatment, or whenever your dose is changed.
Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.
FDA pregnancy category C. SSRI antidepressants may cause serious or life-threatening lung problems in newborn babies whose mothers take the medication during pregnancy. However, you may have a relapse of depression if you stop taking your antidepressant during pregnancy. If you are planning a pregnancy, or if you become pregnant while taking sertraline, do not stop taking the medication without first talking to your doctor.
It is not known whether sertraline passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.
Do not give sertraline to anyone younger than 18 years old without the advice of a doctor. Sertraline is FDA-approved for children with obsessive-compulsive disorder (OCD). It is not approved for treating depression in children.
Avoid drinking alcohol, which can increase some of the side effects of sertraline.
Do not take the liquid form of sertraline if you are taking disulfiram (Antabuse). Liquid sertraline may contain alcohol and you could have a severe reaction to the disulfiram.
Sertraline can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.
Tell your doctor if you regularly use other medicines that make you sleepy (such as cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures or anxiety). They can add to sleepiness caused by sertraline.
Seek emergency medical attention if you think you have taken too much of this medication. Overdose symptoms may include dizziness, drowsiness, nausea, vomiting, rapid heartbeat, agitation, tremor, confusion, seizures, and coma.
Take the missed dose as soon as you remember. However, if it is almost time for the next regularly scheduled dose, skip the missed dose and take the next one as directed. Do not take extra medicine to make up the missed dose.
Get emergency medical help if you have any of these signs of an allergic reaction: skin rash or hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.
Call your doctor at once if you have any of these serious side effects:
- very stiff (rigid) muscles, high fever, sweating, fast or uneven heartbeats, tremors, overactive reflexes;
- nausea, vomiting, diarrhea, loss of appetite, feeling unsteady, loss of coordination; or
- headache, trouble concentrating, memory problems, weakness, confusion, hallucinations, fainting, seizure, shallow breathing or breathing that stops.
Less serious side effects may include:
- drowsiness, dizziness, tired feeling;
- mild nausea, stomach pain, upset stomach, constipation;
- dry mouth;
- changes in appetite or weight;
- sleep problems (insomnia); or
- decreased sex drive, impotence, or difficulty having an orgasm.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. You may report side effects to FDA at 1-800-FDA-1088.
Talk to your doctor before taking any medicine for pain, arthritis, fever, or swelling. This includes aspirin and NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), diclofenac (Voltaren), indomethacin, piroxicam (Feldene), nabumetone (Relafen), etodolac (Lodine), and others. Taking any of these drugs with sertraline may cause you to bruise or bleed easily.
Before taking sertraline, tell your doctor if you are using any of the following medicines:
- tramadol (Ultram, Ultram ER, Ultracet);
- digitoxin (Crystodigin);
- phenytoin (Dilantin), valproate (Depacon, Depakene);
- lithium (Lithobid, Eskalith);
- a blood thinner such as warfarin (Coumadin);
- any other antidepressant such as amitriptyline (Elavil), citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), imipramine (Tofranil), nortriptyline (Pamelor), or paroxetine (Paxil);
- almotriptan (Axert), frovatriptan (Frova), sumatriptan (Imitrex), naratriptan (Amerge), rizatriptan (Maxalt), or zolmitriptan (Zomig); or
- heart rhythm medication such as flecainide (Tambocor), propafenone (Rhythmol), and others.
This list is not complete and there may be other drugs that can interact with sertraline. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.
Zoloft and sertraline
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Copyright 1996-2004 Cerner Multum, Inc. Version 2.05. Revision date 8/23/04