Composition
Tab 50 mg/100 mg: Sertraline (as HCI) 50 mg/100 mg.
Indications & Dosage
Depressive illness: 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; max. 200 mg per day. Obsessive-compulsive disorder: 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; max. 200 mg per day. Children 6-12 yrs: Initially 25 mg daily increased to 50 mg daily after 1 week, further increased if necessary in steps of 50 mg at intervals of at least 1 week, max 200 mg daily; 12-18yrs: initially 50 mg daily increased if necessary in steps of 50 mg over several wk, max 200 mg daily. Panic disorder, Post-traumatic stress disorder, Social anxiety disorder: 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; max. 200 mg per day. Premenstrual Dysphoric Disorder: Adult: Initially 50 mg once daily continuous or limit to luteal cycle phase, increase by 50 mg/cycle up to 150 mg/ day for continuous or 100 mg/day for luteal phase dosing for 3 days at beginning of each luteal phase dosing period.
Contraindications
Severe hepatic impairment, unstable epilepsy. Within 2 weeks of stopping MAOls or 7 days of stopping moclobemide.
Precautions
Mild to moderate hepatic impairment, ECT, epilepsy, diabetes, schizophrenia, history of mania/hypomania (discontinue if enter a manic phase), monitor for suicidal ideation, possible risk of cutaneous bleeding abnormalities, such as ecchymosis and purpura in patients taking anti-platelet drugs or those with a history of bleeding disorders. Withdraw gradually,
Interactions
MAOls including selegiline and moclobemide, pimozide, lithium, tryptophan, fenfluramine, tramadol, TCADs, diazepam, tolbutamide, cimetidine, warfarin, centrally acting drugs, St. Johns Wort, NSAIDs, and other drugs affecting platelet function, other SSRIs, SNRIs, 5HT1 agonists/triptans, other serotonergic drugs.
Pregnancy
Avoid unless potential benefit outweighs risk
Lactation
Caution advised or avoid
Side Effects
Aggression, anorexia, amnesia, agitation, bruxism, bronchospasm, hepatitis, hypercholesterolaemia, hyperprolactinaemia, hypertension, hypoglycaemia, hypothyroidism, jaundice, leucopenia, liver failure, menstrual irregularities, palpitation, pancreatitis, paraesthesia, postural hypotension, stomatitis, tachycardia, tinnitus, urinary incontinence, GI disturbance, sexual dysfunction, tremor, increases sweating, akathisia, pharyngitis, nightmares, dysgeusia, tinnitus, chest pain, paraesthesia, hypertonia, disturbed attention, hot flushes, dizziness, insomnia, somnolence, malaise, arthralgia, myalgia, rash, anaphylactoid reactions, angioedema, visual disturbances, headache, panic reactions, drowsiness, nervousness, urinary retention, seizures, psychosis. Rare: Erythema, multiforme, hyponatraemia, activation of mania/hypomania, altered platelet function, withdrawal symptoms.