Medicine Information

Charm

Name: Charm
Brand: Charm
Rating: 4.5 (117 reviews)

Tablet25 mgAntidepressant, Selective Serotonin Reuptake Inhibitor (SSRI)ATC: N06AB06

Generic Name

Sertraline

Manufacturer

Medicon Pharma Ltd.

Country

Bangladesh

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Price Details

Current market pricing information

Variant	Unit Price	Strip Price
charm 25 mg tablet	৳ 20.00	৳ 80.00

Description

Overview of the medicine

Charm 25 mg Tablet contains Sertraline, an antidepressant medication used to treat depression, obsessive-compulsive disorder (OCD), panic disorder, post-traumatic stress disorder (PTSD), social anxiety disorder, and premenstrual dysphoric disorder (PMDD). It works by increasing the levels of serotonin in the brain, which helps to improve mood and reduce symptoms of anxiety.

Uses & Indications

Major depressive disorder

Obsessive-compulsive disorder (OCD)

Panic disorder

Post-traumatic stress disorder (PTSD)

Social anxiety disorder

Premenstrual dysphoric disorder (PMDD)

Dosage

Adults

Typical starting dose for most indications is 25 mg or 50 mg once daily. May be increased gradually to a maximum of 200 mg daily.

Elderly

Similar to adult dosage, but starting with a lower dose (e.g., 25 mg) and slower titration may be advisable due to potential for increased sensitivity.

Renal_impairment

No dosage adjustment is generally required in patients with mild to moderate renal impairment. Use with caution in severe renal impairment.

How to Take

Take orally, once daily, with or without food. It is generally recommended to take it at the same time each day.

Mechanism of Action

Sertraline selectively inhibits the reuptake of serotonin (5-HT) by presynaptic neurons in the central nervous system, thereby enhancing serotonergic transmission. It has only weak effects on norepinephrine and dopamine neuronal reuptake. Sertraline does not have significant affinity for muscarinic, histaminergic, alpha-adrenergic, or benzodiazepine receptors.

Pharmacokinetics

Onset

Therapeutic effects may take 2-4 weeks to become apparent, with maximum benefit often seen after 6-8 weeks.

Excretion

Excreted in both urine and feces, with about 40-45% in urine and 40-45% in feces as metabolites. Less than 0.2% is excreted unchanged in urine.

Half life

Approximately 26 hours for sertraline; 62-104 hours for its active metabolite, desmethylsertraline.

Absorption

Well absorbed from the gastrointestinal tract, peak plasma concentrations occur 4.5-8.4 hours after once-daily dosing.

Metabolism

Extensively metabolized in the liver, primarily by CYP2C19, CYP2B6, CYP2D6, CYP3A4, CYP2C9, and CYP2C8, to an active metabolite (desmethylsertraline) and other inactive metabolites.

Side Effects

Contraindications

Hypersensitivity to sertraline or any component of the formulation.
Concurrent use with monoamine oxidase inhibitors (MAOIs) or within 14 days of discontinuing an MAOI.
Concurrent use with pimozide.

Drug Interactions

MAOIs

Concurrent use is contraindicated due to risk of serotonin syndrome.

Diazepam

May reduce diazepam clearance.

Pimozide

Concurrent use is contraindicated due to risk of QT prolongation and ventricular arrhythmias.

Warfarin

May enhance anticoagulant effect, increasing risk of bleeding.

Cimetidine

May increase sertraline exposure.

Other serotonergic drugs (e.g., SSRIs, SNRIs, Triptans, Fentanyl, Tramadol, Lithium, St. John's Wort)

Increased risk of serotonin syndrome.

Storage

Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.

Overdose

Symptoms of overdose include somnolence, vomiting, tachycardia, nausea, dizziness, agitation, and tremor. Rarely, coma has been reported. Management is supportive and symptomatic; maintain a clear airway, monitor cardiac and vital signs. Activated charcoal may be considered.

Pregnancy & Lactation

Pregnancy Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Neonates exposed to SSRIs late in the third trimester have developed complications requiring prolonged hospitalization, respiratory support, and tube feeding. Sertraline is excreted in breast milk; caution should be exercised when administered to a nursing mother.

Frequently Asked Questions

Common questions about this medicine

Pack Sizes

10 tablets per box30 tablets per box

Shelf Life

24 months from manufacturing date.

Availability

Available in all pharmacies and hospitals

Approval Status

Approved by DGDA

Patent Status

Generic available

WHO Essential Medicine

Yes

Clinical Trials

Numerous clinical trials have established the efficacy and safety of sertraline across its approved indications. Ongoing post-marketing surveillance continues to monitor long-term effects and rare adverse events.

Lab Monitoring

Monitor serum sodium levels, especially in elderly patients or those on diuretics.
Liver function tests may be considered in patients with hepatic impairment.

Doctor Notes

Initiate sertraline at a low dose and titrate gradually to minimize side effects.
Educate patients about the delayed onset of therapeutic effects and the importance of adherence.
Monitor for suicidality, especially during early treatment and dose changes.

Patient Guidelines

Take medicine exactly as prescribed by your doctor.
Do not stop taking this medicine suddenly, as it can cause withdrawal symptoms. Consult your doctor for gradual tapering.
Report any worsening of depression, suicidal thoughts, or unusual changes in behavior immediately to your doctor.

Missed Dose Advice

If a dose is missed, take it as soon as you remember, unless it is almost time for your next dose. In that case, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.

Driving Precautions

May cause dizziness, drowsiness, or visual disturbances. Patients should be cautioned about operating hazardous machinery, including automobiles, until they are reasonably certain that sertraline therapy does not adversely affect their ability to engage in such activities.

Lifestyle Advice

Avoid alcohol consumption while taking this medication as it may worsen side effects.
Maintain a healthy lifestyle, including regular exercise and a balanced diet, to support mental well-being.
Engage in stress-reducing activities like meditation or yoga.