IV. Background

  1. Cost: $75 per month

V. Preparations

  1. Tablets (Scored): 25, 50, 100 mg
  2. Oral concentrate: 20 mg/ml (60 ml bottle)

VI. Dosing

  1. Start
    1. Children (ages 6-12 years of age): 25 mg PO qAM
    2. Adults (and children over age 12): 50 mg PO qAM
    3. Elderly: 25 mg PO qAM
  2. Titrate
    1. Adults: Increase by 50 mg every 2 weeks
  3. Maximum: 200 mg per day

VII. Drug Interactions

  1. Significantly raises Pimozide levels
    1. Concurrent use with Pimozide is contraindicated
  2. Inhibits Cytochrome P450-2C and P450-3A4
    1. Clinically Significant interactions are uncommon
  3. Highly protein bound
    1. Interacts with other protein bound medications
  4. Absorption affected by food intake
  5. Raises Tricyclic Antidepressant levels
  6. Allow two week wash-out prior to starting MAO inhibitor

VIII. Pharmacokinetics

  1. Half Life: 1 to 4 days
  2. Therapeutic Blood level 9.5 to 56 ng/ml

IX. Adverse Effects

  1. Neutral on the Sedation to excitation continuum
    1. Less sedating than Paxil or Luvox
  2. Anxiety, Insomnia or other sleep disturbance
    1. Less stimulating than Prozac
    2. Consider Trazodone (Desyrel) at bedtime
  3. Diarrhea or gastrointestinal upset
    1. Diarrhea more common than with Fluoxetine
    2. Usually resolves within 2 weeks
  4. Sexual Dysfunction may be more common
    1. Includes decreased libido
    2. See Antidepressant Induced Sexual Dysfunction
  5. Antidepressant Withdrawal symptoms on stopping
    1. Taper 50 mg per every 5-7 days
    2. Taper to 25-50 mg daily before stopping

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Cost: Medications

sertraline (on 8/17/2016 at Medicaid.Gov Survey of pharmacy drug pricing)
SERTRALINE 20 MG/ML ORAL CONC Generic $0.78 per ml
SERTRALINE HCL 100 MG TABLET Generic $0.05 each
SERTRALINE HCL 25 MG TABLET Generic $0.06 each
SERTRALINE HCL 50 MG TABLET Generic $0.05 each
zoloft (on 6/1/2016 at Medicaid.Gov Survey of pharmacy drug pricing)
ZOLOFT 100 MG TABLET Generic $0.05 each
ZOLOFT 25 MG TABLET Generic $0.06 each
ZOLOFT 50 MG TABLET Generic $0.05 each

Ontology: Sertraline (C0074393)

Definition (NCI_NCI-GLOSS) A drug used to treat depression. It is a type of selective serotonin reuptake inhibitor (SSRI).
Definition (CSP) selective serotonin uptake inhibitor; used as an antidepressant.
Definition (MSH) A selective serotonin uptake inhibitor that is used in the treatment of depression.
Definition (PDQ) The salt form of a synthetic derivative of naphthalenamine with anti-serotoninergic and anti-depressant properties. Sertraline appears to selectively inhibit the neuronal uptake of serotonin, raising serotonin levels in the CNS. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=322832&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=322832&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C29451" NCI Thesaurus)
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D020280
SnomedCT 96211006, 321958004, 372594008
LNC LP17242-6, MTHU004268
English Sertraline, 1-Naphthalenamine,1,2,3,4-tetrahydro-4-(3,4-dichlorophenyl)-N-methyl-, (1S-cis)-, Sertraline [Chemical/Ingredient], SERTRALINE, sertraline, Sertraline (product), Sertraline (substance)
Swedish Sertralin
Czech sertralin
Finnish Sertraliini
Russian SERTRALIN, СЕРТРАЛИН
Japanese セルトラリン
Polish Sertralina
Croatian SERTRALIN
Spanish sertralina (producto), sertralina (sustancia), sertralina, Sertralina
French Sertraline
German Sertralin
Italian Sertralina
Portuguese Sertralina

Ontology: Zoloft (C0284660)

Concepts Organic Chemical (T109) , Pharmacologic Substance (T121)
MSH D020280
German Altruline, Lustral, Zoloft
English lustral, Zoloft, Lustral, Altruline, Parke Davis Brand of Sertraline Hydrochloride, Pfizer Brand of Sertraline Hydrochloride, Roerig Brand of Sertraline Hydrochloride