Top 300 Pharmacy Drug Cards

SERTRALINE: Zoloft, Various

Class: SSRI Antidepressant

Dosage Forms. Tablet: 25 mg, 50 mg, 100 mg; Solution, Syrup: 20 mg/mL

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Common FDA Label Indication, Dosing, and Titration.

1. Depression: 50 mg po daily, may titrate to 200 mg/d

2. OCD: Children 6-12 y, 25 mg po daily, may titrate to 200 mg/d; Children 13-17 y and Adults, 50 mg po daily, may titrate to 200 mg/d

3. Panic disorder, post-traumatic stress disorder, social phobia disorder: 25 mg po daily for 1 wk, then increase to 50 mg po daily, may titrate to 200 mg/d

4. Premenstrual dysphoric disorder: 50 mg po daily continuously or only during luteal phase; may titrate to 100 mg/d

Off-Label Uses. None

MOA. Sertraline is an SSRI which indirectly results in a downregulation of β-adrenergic receptors. It has no clinically important effect on noradrenergic or histamine receptors and no effect on MAO. It lacks stimulant, cardiovascular, anticholinergic, and convulsant effects.

Drug Characteristics: Sertraline

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Medication Safety Issues: Sertraline

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Drug Interactions: Sertraline

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Adverse Reactions: Sertraline

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Efficacy Monitoring Parameters. Improvement in symptoms of depression, panic disorder, OCD.

Toxicity Monitoring Parameters Worsening of depression, suicidality, or unusual changes in behavior, especially at the initiation of therapy or with dosage increases or decreases; signs/symptoms of abnormal bleeding. Monitor CBC.

Key Patient Counseling Points. Avoid activities requiring mental alertness or coordination until drug effects are realized. Symptomatic improvement may not be seen for several weeks. Report worsening depression, suicidal ideation, unusual changes in behavior, or unusual bleeding. Avoid abrupt discontinuation, may precipitate withdrawal symptoms. Do not drink alcohol or use NSAIDs or aspirin while taking this drug.

Clinical Pearls. If intolerable withdrawal symptoms occur following a decrease in dose or therapy discontinuation, may need to resume the previous dose and taper at a more gradual rate. Oral concentrate must be diluted before administration. Medication guide required at dispensing.