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Brand Name

Apo-Sertraline

Common Name

sertraline (for depression, panic disorder, obsessive compulsive disorders)

How does this medication work? What will it do for me?

Sertraline is a selective serotonin reuptake inhibitor (SSRI). It is used for the treatment of depression, panic disorder, and obsessive-compulsive disorder (OCD). It helps to elevate mood by treating depression and reduces panic attacks and the unpleasant thoughts associated with OCD.

Your doctor may have suggested this medication for conditions other than the ones listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

How should I use this medication?

Recommended doses range from 50 mg to 200 mg once daily, taken with food at the evening meal. If morning dose times are preferable, sertraline should be taken with breakfast. Swallow the capsule whole.

Although improvements may occur earlier, the full response to the medication may not appear until four weeks of treatment or longer.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

For this medication to be effective, it is very important that you take it exactly as prescribed by your doctor. If you miss a dose of sertraline, take it as soon as possible. If you do not remember your missed dose until the next day, skip the missed dose and go back to your regular dosing schedule. Do not take a double dose to make up for a missed one.

What form(s) does this medication come in?

25 mg
Each yellow, size 4 capsule, imprinted "APO 25", contains sertraline HCl equivalent to 25 mg of sertraline. Nonmedicinal ingredients: colloidal silicon dioxide, cornstarch, croscarmellose sodium, stearic acid and talc; capsule shell (D&C Yellow No. 10, FD&C Yellow No. 6, gelatin, silicon dioxide, sodium lauryl sulfate and titanium dioxide); edible black ink (synthetic black iron oxide, pharmaceutical glaze, FD&C Blue No. 1 aluminum lake, FD&C Blue No. 2 aluminum lake, D&C Yellow No. 10 aluminum lake, FD&C Red No. 40 aluminum lake, may contain: n-butyl alcohol, propylene glycol, SDA-3A alcohol).

50 mg
Each white and yellow, size 3 capsule, imprinted "APO 50", contains sertraline HCl equivalent to 50 mg of sertraline. Nonmedicinal ingredients: colloidal silicon dioxide, cornstarch, croscarmellose sodium, stearic acid and talc; capsule shell (D&C Yellow No. 10, FD&C Yellow No. 6, gelatin, silicon dioxide, sodium lauryl sulfate and titanium dioxide); edible black (synthetic black iron oxide, pharmaceutical glaze, FD&C Blue No. 1 aluminum lake, FD&C Blue No. 2 aluminum lake, D&C Yellow No. 10 aluminum lake, FD&C Red No. 40 aluminum lake, may contain: n-butyl alcohol, propylene glycol, SDA-3A alcohol).

100 mg
Each orange, size 2 capsule, imprinted "APO 100", contains sertraline HCl equivalent to 100 mg of sertraline. Nonmedicinal ingredients: colloidal silicon dioxide, cornstarch, croscarmellose sodium, stearic acid and talc; capsule shell (D&C Yellow No. 10, FD&C Red No. 40, gelatin, silicon dioxide, sodium lauryl sulfate and titanium dioxide); edible black ink (synthetic black iron oxide, pharmaceutical glaze, FD&C Blue No. 1 aluminum lake, FD&C Blue No. 2 aluminum lake, D&C Yellow No. 10 aluminum lake, FD&C Red No. 40 aluminum lake, may contain: n-butyl alcohol, propylene glycol, SDA-3A alcohol).

Some medications may have other generic brands available. Always ask your doctor or pharmacist about the safety of switching between brands of the same medication.

Who should NOT take this medication?

This medication should not be used by anyone who:

• is allergic to sertraline or any of the ingredients of this product
• is taking a MAO inhibitor (e.g., phenelzine, tranylcypromine, moclobemide) or has taken a MAO inhibitor within the last 14 days
• is taking pimozide

What side effects are possible with this medication?

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your health professional. They may be able to help you to deal with some of the effects.

The following side effects may go away as your body becomes used to the medication; check with your doctor if they continue or become bothersome.

More common
• diarrhea or loose stools
• dizziness
• drowsiness
• dry mouth
• headache
• insomnia
• nausea
• tiredness or weakness
• trembling or shaking
• trouble sleeping

Less common
agitation, anxiety, or nervousness back pain changes in taste sensations changes in vision, including blurred vision constipation decreased appetite or weight loss difficulty concentrating flushing or redness of skin, with feeling of warmth or heat heartburn	increased appetite and weight gain increased sweating increased urination joint pain menstrual disorder stomach or abdominal cramps, gas, or pain vomiting yawning

Contact your doctor as soon as possible if any of the following side effects occur:

More common
• decreased sexual desire or ability

Less common or rare

abnormal burning or prickling sensation (usually found in hands, arms, legs, or feet, but may occur anywhere in the body) abnormal increase in muscle tension breast tenderness or enlargement decreased touch sensitivity fast or irregular heartbeat fast talking and excited feelings or actions that are out of control feeling of detachment from self fever inability to sit still low blood sodium (confusion, convulsions [seizures], drowsiness, dryness of mouth, increased thirst, lack of energy) muscle pain

nose bleeds paranoia (suspicions of people, organizations, or situations, with no basis in reality) red or purple spots on skin restlessness ringing in ears serotonin syndrome (diarrhea, fever, increased sweating, mood or behaviour changes, overactive reflexes, racing heartbeat, restlessness, shivering, or shaking) skin rash, hives, or itching twitching unusual or sudden body or facial movements or postures unusual secretion of milk (in women)

After you stop taking sertraline, your body may need time to adjust. The length of time this takes depends on the amount of medication you were using and how long you used it. During this period of time, check with your doctor if you notice any of the following side effects:

• abnormal dreams
• agitation
• anxiety
• dizziness
• headache
• increased sweating
• nausea
• trembling or shaking
• sensations similar to electric shocks

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Be sure to inform your doctor of all your medical conditions before you begin taking a medication. Some conditions can affect how you should take this medication.

Drowsiness/reduced alertness: This medication may impair judgment, thinking, or motor skills. People using sertraline should avoid driving a car or operating hazardous machinery until they determine whether or not the medication affects them in this way.

Kidney function: Sertraline should be used with caution by people with reduced kidney function.

Liver function: People with reduced liver function should take sertraline with caution and they should be closely monitored by their doctor. A lower than usual dose of sertraline may be required.

Seizures: People with a history of seizures should use caution when taking sertraline. Anyone who develops seizures should stop taking the medication.

Stopping the medication: Stopping this medication suddenly may lead to side effects. If you are thinking of stopping the medication, check with your doctor or pharmacist first.

Suicidal or agitated behaviour: Adults and children taking this medication may feel agitated (restless, anxious, aggressive, emotional, and feeling not like themselves), or they may want to hurt themselves or others. These symptoms may occur within several weeks after people start taking this medication. Your doctor will monitor you closely for emotional and behavioural changes. If you feel suicidal or agitated, talk to your doctor.

Pregnancy: The safety of using sertraline during pregnancy has not been established. It has been reported that babies born to pregnant women who have taken medications of this kind during the last trimester of pregnancy may be adversely affected. Physicians and pregnant women should carefully consider the benefits and the risks of all treatment options.

Breast-feeding: The safety of using sertraline while breast-feeding has not been established. It should not be used by nursing women, unless, in the opinion of the doctor, the potential benefits outweigh the possible risks.

Children and adolescents: The safety and effectiveness of using this medication have not been established for people under the age of 18 years. The use of this medication by children below the age of 18 may cause behavioural and emotional changes, such as suicidal thoughts and behaviour.

What other drugs could interact with this medication?

The following agents may affect the way that sertraline works or increase the risk of side effects:

• alcohol
• certain antiarrhythmic medications (e.g., flecainide, propafenone)
• cimetidine
• lithium
• MAO inhibitors (e.g., phenelzine, tranylcypromine, moclobemide)
• other SSRIs (e.g., paroxetine, fluoxetine, citalopram, fluvoxamine)
• sibutramine
• St. John's wort
• tricyclic antidepressants (e.g., amitriptyline, imipramine, nortriptyline)
• tryptophan

The following medications may be affected by sertraline or increase the risk of side effects:

• pimozide
• warfarin

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. In many cases, interactions are intended or are managed by close monitoring. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Disclaimer

The information within this website is for Canadian audiences only. This content is for informational purposes only. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects. It should not be construed to indicate that the use of a particular drug is safe, appropriate or effective for you. It should not be relied upon or interpreted as a recommendation for any specific treatment plan, product or course of action. The information on the site is not intended as a substitute of any kind for professional medical advice, diagnosis or treatment. Speak to your healthcare professional before taking any product, changing your lifestyle, or beginning or discontinuing any course of treatment. If you suspect that you are ill or may have a medical emergency, contact a physician, a health professional or call 911 immediately.