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How should this medicine be used?

Sertraline comes as a tablet and a concentrate (liquid) to take by mouth. It is usually taken once daily in the morning or evening. To treat premenstrual dysphoric disorder, sertraline is taken once a day, either every day of the month or on certain days of the month. Take sertraline at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take sertraline exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Sertraline concentrate must be diluted before use. Immediately before taking it, use the provided dropper to remove the amount of concentrate your doctor has told you to take. Mix the concentrate with 4 ounces (1/2 cup [120 milliliters]) of water, ginger ale, lemon or lime soda, lemonade, or orange juice. Do not mix the concentrate with any liquids other than the ones listed. Drink immediately.

Your doctor may start you on a low dose of sertraline and gradually increase your dose, not more than once a week.

It may take a few weeks or longer before you feel the full benefit of sertraline. Continue to take sertraline even if you feel well. Do not stop taking sertraline without talking to your doctor.

Other uses for this medicine

Sertraline is also used sometimes to treat headaches and sexual problems. Talk to your doctor about the possible risks of using this medication for your condition.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

What special precautions should I follow?

Before taking sertraline,

• tell your doctor and pharmacist if you are allergic to sertraline or any other medications. Before taking sertraline liquid concentrate, tell your doctor if you are allergic to latex.
• tell your doctor if you are taking monoamine oxidase (MAO) inhibitors, including isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate), or have stopped taking them within the past 2 weeks, or if you are taking pimozide (Orap). Your doctor will probably tell you not to take sertraline. If you stop taking sertraline, you should wait at least 2 weeks before you start to take an MAO inhibitor.
• do not take disulfiram (Antabuse) while taking sertraline concentrate.
• tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: anticoagulants ('blood thinners') such as warfarin (Coumadin); antidepressants ('mood elevators') such as amitriptyline (Elavil), amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Adapin, Sinequan), imipramine (Tofranil), nortriptyline (Aventyl, Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil); aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn); cimetidine (Tagamet); diazepam (Valium); digoxin (Lanoxin); linezolid ; lithium (Eskalith, Lithobid); medications for anxiety, mental illness, Parkinson's disease, and seizures; medications for irregular heartbeat such as flecainide (Tambocor) and propafenone (Rythmol); methylene blue; oral medications for diabetes such as tolbutamide (Orinase); medications for migraine headaches such as almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt), sumatriptan (Imitrex), and zolmitriptan (Zomig); sedatives; sibutramine (Meridia); sleeping pills; and tranquilizers. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• tell your doctor if you have recently had a heart attack and if you have or have ever had seizures or liver or heart disease.
• tell your doctor if you are pregnant, especially if you are in the last few months of your pregnancy, or if you plan to become pregnant or are breast-feeding. If you become pregnant while taking sertraline, call your doctor. Sertraline may cause problems in newborns following delivery if it is taken during the last months of pregnancy.
• you should know that sertraline may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you.
• ask your doctor about the safe use of alcoholic beverages while you are taking sertraline.

What special dietary instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet.

What should I do if I forget a dose?

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

What side effects can this medication cause?

Sertraline may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• nausea
• diarrhea
• constipation
• vomiting
• dry mouth
• gas or bloating
• loss of appetite
• weight changes
• drowsiness
• dizziness
• excessive tiredness
• headache
• pain, burning, or tingling in the hands or feet
• nervousness
• uncontrollable shaking of a part of the body
• sore throat
• changes in sex drive or ability
• excessive sweating

Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately:

• blurred vision
• seizures
• fever, sweating, confusion, fast or irregular heartbeat, and severe muscle stiffness
• abnormal bleeding or bruising
• hallucinating (seeing things or hearing voices that do not exist)

Sertraline may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/Safety/MedWatch] or by phone [1-800-332-1088].

What storage conditions are needed for this medicine?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

In case of emergency/overdose

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

• hair loss
• changes in sex drive or ability
• drowsiness
• excessive tiredness
• difficulty falling asleep or staying asleep
• diarrhea
• vomiting
• rapid, pounding, or irregular heartbeat
• nausea
• dizziness
• excitement
• uncontrollable shaking of a part of the body
• seizures
• hallucinating (hearing voices or seeing things that do not exist)
• unconsciousness
• fainting

What other information should I know?

Keep all appointments with your doctor.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

Brand Names

• Zoloft®