Precautions and warnings

If you have liver or kidney problems, seizures, heart conditions, or allergies, you should use this medicine with caution. This drug can make you feel dizzy or sleepy, so be careful when driving or operating machines. Older adults should be especially careful, as they may react more strongly to this medicine. Also, do not take this medication if you have used a monoamine oxidase inhibitor (MAOI) in the past five weeks.

Drug Interactions

**This medication can cause certain risks when used with other drugs:**

- Using it with antimuscarinics may raise the chance of delirium.
- Taking it with aripiprazole increases the risk of movement problems and a serious reaction called neuroleptic malignant syndrome.
- Carbamazepine may lower the levels of this drug in your blood.
- When taken with dihydroergotamine or linezolid, it can cause a dangerous condition called serotonin syndrome.
- It can increase the amount and toxicity risk of lamotrigine in the blood.
- It may also raise the blood levels of olanzapine, pimozide, risperidone, methadone, clozapine, and amiodarone.
- Cimetidine and ritonavir can raise its level in the blood.
- It may increase the blood-thinning effects of warfarin and acenocoumarol.

**Warning:** Taking this drug with MAOIs at the same time can cause life-threatening serotonin syndrome.

Contraindications

Sertraline should not be used by people who are allergic to Sertraline or any of the other ingredients in the medicine.

Mode of actions

Sertraline works by strongly and specifically blocking the reuptake of serotonin (5-HT) in the brain’s nerve cells. This causes more serotonin to be available at the connections between nerve cells, which helps improve symptoms of depression by increasing activity at the receptor sites. Sertraline’s effect is also helped by a decrease in the breakdown of serotonin in the brain. Because it stays in the body for a long time, sertraline can be taken just once a day.

Dosage & Administration

Depressive illness :Initially 50 mg daily, increased if necessary by increments of 50 mg over several weeks to maximum 200 mg daily. Usual maintenance dose is 50 mg daily.

Child and adolescent less than 18 years are not recommended.

Obsessive-compulsive disorder :Adult and adolescent over 13 years- Initially 50 mg daily, increased if necessary in steps of 50 mg over several weeks. Usual dose range is 50-200 mg daily.

Child (6-12 years) - 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 (maximum 200 mg daily).

Post-traumatic stress disorder: Initially 25 mg daily, increased after 1 week to 50 mg daily; if response is partial and if drug is tolerated, dose can be increased in steps of 50 mg over several weeks to maximum 200 mg daily.

Child and adolescent less than 18 years are not recommended.

Pregnancy & Lactation

Although animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in pregnant women, but during pregnancy, this medicine can be used just when definitely required despite potential risks.

Mothers with a newborn baby who have used this drug during the last 3 months of pregnancy may seldom create symptoms including drowsiness, muscle stiffness or shakiness, feeding or breathing troubles, constant crying. If you notice any of these symptoms of your baby's particularly during their first month, tell the doctor immediately.

This medicine passes into breast milk. Talk to your doctor before breastfeeding.

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