Zoloft

Generic name: sertraline
Drug class: Selective serotonin reuptake inhibitors

Medically reviewed by A Ras MD.

What is Zoloft?

Zoloft is a prescription medicine used to treat Major Depressive Disorder (MDD). Panic Disorder, Social Anxiety Disorder, Obsessive Compulsive Disorder (OCD), Post traumatic Stress Disorder (PTSD), Premenstrual Dysphoric Disorder (PMDD)

It is important to talk with your healthcare provider about the risks of treating depression and also the risks of not treating it. You should discuss all treatment choices with your healthcare provider.

Zoloft is safe and effective in treating children with OCD age 6 to 17 years.

It is not known if Zoloft is safe and effective for use in children under 6 years of age with OCD or children with other behavior health conditions.

Talk to your healthcare provider if you do not think that your condition is getting better with Zoloft treatment.

Description

ZOLOFT contains sertraline hydrochloride, an SSRI. Sertraline hydrochloride has a molecular weight of 342.7 and has the following chemical name: (1S-cis)-4-(3,4-dichlorophenyl)-1,2,3,4-tetrahydro-N-methyl-1-naphthalenamine hydrochloride. The empirical formula C17H17NCl2∙HCl is represented by the following structural formula:

Sertraline hydrochloride is a white crystalline powder that is slightly soluble in water and isopropyl alcohol, and sparingly soluble in ethanol.

ZOLOFT tablets for oral administration contain 28.0 mg, 56.0 mg and 111.9 mg sertraline hydrochloride equivalent to 25, 50 and 100 mg of sertraline and the following inactive ingredients: dibasic calcium phosphate dihydrate, D & C Yellow #10 aluminum lake (in 25 mg tablet), FD & C Blue #1 aluminum lake (in 25 mg tablet), FD & C Red #40 aluminum lake (in 25 mg tablet), FD & C Blue #2 aluminum lake (in 50 mg tablet), hydroxypropyl cellulose, hypromellose, magnesium stearate, microcrystalline cellulose, polyethylene glycol, polysorbate 80, sodium starch glycolate, synthetic yellow iron oxide (in 100 mg tablet), and titanium dioxide.

ZOLOFT oral solution is available in a multidose 60 mL bottle. Each mL of solution contains 22.4 mg sertraline hydrochloride equivalent to 20 mg of sertraline. The solution contains the following inactive ingredients: glycerin, alcohol (12%), menthol, butylated hydroxytoluene (BHT). The oral solution must be diluted prior to administration . The dispenser contains dry natural rubber.

Mechanism of Action

Sertraline potentiates serotonergic activity in the central nervous system through inhibition of neuronal reuptake of serotonin (5-HT).

What is the most important information I should know about Zoloft?

Zoloft and other antidepressant medicines may cause serious side effects. Call your healthcare provider right away if you have any of the following symptoms, or call 911 if there is an emergency.

1. Suicidal thoughts or actions

Zoloft and other antidepressant medicines may increase suicidal thoughts or actions in some people 24 years of age and younger, especially within the first few months of treatment or when the dose is changed.
Depression or other serious mental illnesses are the most important causes of suicidal thoughts or actions.
Watch for these changes and call your healthcare provider right away if you notice new or sudden changes in mood, behavior, actions, thoughts, or feelings, especially if severe.
- Pay particular attention to such changes when Zoloft is started or when the dose is changed.
- Keep all follow-up visits with your healthcare provider and call between visits if you are worried about symptoms.

Call your healthcare provider right away if you have any of the following symptoms, or call 911 if an emergency, especially if they are new, worse, or worry you:

attempts to commit suicide
acting aggressive or violent
new or worse depression
feeling agitated, restless, angry or irritable
an increase in activity or talking more than what is normal for you
acting on dangerous impulses
thoughts about suicide or dying
new or worse anxiety or panic attacks
trouble sleeping
other unusual changes in behavior or mood

2. Serotonin syndrome

This condition can be life-threatening and symptoms may include:

agitation, hallucinations, coma, or other changes in mental status
racing heartbeat, high or low blood pressure
coordination problems or muscle twitching (overactive reflexes)
nausea, vomiting, or diarrhea
sweating or fever
muscle rigidity

3. Increased chance of bleeding

Zoloft and other antidepressant medicines may increase your risk of bleeding or bruising, especially if you take the blood thinner warfarin (Coumadin, Jantoven), a non- steroidal anti-inflammatory drug (NSAIDs, like ibuprofen or naproxen), or aspirin.

4. Manic episodes

Symptoms may include:

greatly increased energy
racing thoughts
unusually grand ideas
severe trouble sleeping
reckless behavior
excessive happiness or irritability
talking more or faster than usual

5. Seizures or convulsions

6. Glaucoma (angle-closure glaucoma)

Many antidepressant medicines including Zoloft may cause a certain type of eye problem called angle-closure glaucoma. Call your healthcare provider if you have eye pain, changes in your vision, or swelling or redness in or around the eye. Only some people are at risk for these problems. You may want to undergo an eye examination to see if you are at risk and receive preventative treatment if you are.

7. Changes in appetite or weight

Children and adolescents should have height and weight monitored during treatment.

8. Low salt (sodium) levels in the blood

Elderly people may be at greater risk for this. Symptoms may include:

headache
weakness or feeling unsteady
confusion, problems concentrating or thinking, memory problems.

9. Sexual problems (dysfunction). Taking serotonin reuptake inhibitors (SSRIs), including ZOLOFT, may cause sexual problems.

Symptoms in males may include:

Delayed ejaculation or inability to have an ejaculation
Decreased sex drive
Problems getting or keeping an erection

Symptoms in females may include:

Decreased sex drive
Delayed orgasm or inability to have an orgasm

Talk to your healthcare provider if you develop any changes in your sexual function or if you have any questions or concerns about sexual problems during treatment with ZOLOFT. There may be treatments your healthcare provider can suggest.

Do not stop Zoloft without first talking to your healthcare provider. Stopping Zoloft too quickly may cause serious symptoms including:

anxiety, irritability, high or low mood, feeling restless or changes in sleep habits
headache, sweating, nausea, dizziness
electric shock-like sensations, shaking, confusion

Who should not take Zoloft?

Do not take Zoloft if you:

take a monoamine oxidase inhibitor (MAOI). Ask your healthcare provider or pharmacist if you are not sure if you take an MAOI, including the antibiotic linezolid.
have taken an MAOI within 2 weeks of stopping Zoloft unless directed to do so by your healthcare provider.
have stopped taking an MAOI in the last 2 weeks unless directed to do so by your healthcare provider.
take any other medicines that contain sertraline (such as sertraline HCl or sertraline hydrochloride).
take the antipsychotic medicine pimozide (Orap) because this can cause serious heart problems.
are allergic to sertraline or any of the ingredients in Zoloft. See the end of this Medication Guide for a complete list of ingredients in Zoloft.
take Antabuse (disulfiram) (if you are taking the liquid form of Zoloft) due to the alcohol content.

People who take Zoloft close in time to an MAOI may have serious or even life-threatening side effects. Get medical help right away if you have any of these symptoms:

high fever
rapid changes in heart rate or blood pressure
uncontrolled muscle spasms
confusion
stiff muscles
loss of consciousness (pass out)

What should I tell my healthcare provider before taking Zoloft?

Before starting Zoloft, tell your healthcare provider if you have:

liver problems
heart problems
bipolar disorder or mania
kidney problems
or have had seizures or convulsions
low sodium levels in your blood
a history of a stroke
high blood pressure
or have had bleeding problems
are pregnant or plan to become pregnant. Your baby may have withdrawal symptoms after birth or may be at increased risk for a serious lung problem at birth. Talk to your healthcare provider about the benefits and risks of taking Zoloft during pregnancy.
are breastfeeding or plan to breastfeed. A small amount of Zoloft may pass into your breast milk. Talk to your healthcare provider about the best way to feed your baby while taking Zoloft.

Tell your healthcare provider about all the medicines that you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

Zoloft and some medicines may interact with each other, may not work as well, or may cause serious side effects.

Your healthcare provider or pharmacist can tell you if it is safe to take Zoloft with your other medicines. Do not start or stop any medicine while taking Zoloft without talking to your healthcare provider first.

How should I take Zoloft?

Take Zoloft exactly as prescribed. Your healthcare provider may need to change the dose of Zoloft until it is the right dose for you.
Zoloft tablets may be taken with or without food.
Zoloft oral solution may look cloudy or hazy after mixing, this is normal.
Zoloft oral solution must be diluted before use:
- Do not mix Zoloft until you are ready to take it.
- When diluting Zoloft oral solution, use only water, ginger ale, lemon/lime soda, lemonade, or orange juice.
- The oral dropper contains latex. If you are sensitive or allergic to latex, ask your healthcare provider or pharmacist about the best way to measure your medicine.
If you miss a dose of Zoloft, take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and take your next dose at the regular time. Do not take two doses of Zoloft at the same time.

If you take too much Zoloft, call your healthcare provider or poison control center right away, or go to the nearest hospital emergency room right away.

What should I avoid while taking Zoloft?

Zoloft can cause sleepiness or may affect your ability to make decisions, think clearly, or react quickly. You should not drive, operate heavy machinery, or do other dangerous activities until you know how Zoloft affects you. Do not drink alcohol while you take Zoloft.

What are the possible side effects of Zoloft?

Zoloft may cause serious side effects, including:

See “What is the most important information I should know about Zoloft?”

The most common side effects in adults who take Zoloft include:

nausea, loss of appetite, diarrhea, or indigestion
increased sweating
tremor or shaking
agitation
change in sleep habits including increased sleepiness or insomnia
sexual problems including decreased libido and ejaculation failure
feeling tired or fatigued
anxiety

The most common side effects in children and adolescents who take Zoloft include abnormal increase in muscle movement or agitation, nose bleeds, urinary incontinence, aggressive reaction, possible slowed growth rate, and weight change. Your child’s height and weight should be monitored during treatment with Zoloft.

Tell your healthcare provider if you have any side effect that bothers you or that does not go away. These are not all the possible side effects of Zoloft. For more information, ask your healthcare provider or pharmacist.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Drug Interactions

A total of 636 medications are known to interact with Zoloft. Use the Interactions Checker Tool.

Common Interactions Checks

clonazepam
gabapentin
Klonopin
levothyroxine
lisinopril
metformin
omeprazole
Seroquel
Synthroid
trazodone
Vitamin D3
Xanax

General information about the safe and effective use of Zoloft

Medicines are sometimes prescribed for purposes other than those listed in a Medication Guide. Do not use Zoloft for a condition for which it was not prescribed. Do not give Zoloft to other people, even if they have the same condition. It may harm them.

This Medication Guide summarizes the most important information about Zoloft. If you would like more information, talk with your healthcare provider. You may ask your healthcare provider or pharmacist for information about Zoloft that is written for healthcare professionals.

For more information about Zoloft call 1-800-438-1985 or go to www.pfizer.com.

How should I store Zoloft?

Store Zoloft at room temperature, 68°F to 77°F (20°C to 25°C).
Keep Zoloft bottle closed tightly.

Keep Zoloft and all medicines out of the reach of children.

What are the ingredients in Zoloft?

Active ingredient: sertraline hydrochloride

Inactive ingredients:

Tablets: dibasic calcium phosphate dihydrate, D&C Yellow #10 aluminum lake (in 25 mg tablet), FD&C Blue #1 aluminum lake (in 25 mg tablet), FD&C Red #40 aluminum lake (in 25 mg tablet), FD&C Blue #2 aluminum lake (in 50 mg tablet), hydroxypropyl cellulose, hypromellose, magnesium stearate, microcrystalline cellulose, polyethylene glycol, polysorbate 80, sodium starch glycolate, synthetic yellow iron oxide (in 100 mg tablet), and titanium dioxide.