Salost
Generic Name
Sertraline Hydrochloride
Manufacturer
MediCare Pharma Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| salost 150 mg tablet | ৳ 200.00 | ৳ 200.00 |
Description
Overview of the medicine
Salost 150 mg Tablet contains Sertraline Hydrochloride, a selective serotonin reuptake inhibitor (SSRI) used to treat various mood and anxiety disorders. It helps restore the balance of a certain natural substance (serotonin) in the brain.
Uses & Indications
Dosage
Adults
Initial dose 50 mg once daily, may be increased weekly by 50 mg increments to a maximum of 200 mg/day. 150 mg is a common therapeutic dose.
Elderly
Lower initial doses (e.g., 25 mg/day) may be considered, with cautious titration based on response and tolerability.
Renal_impairment
No dosage adjustment needed for 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 recommended to take it at the same time each day.
Mechanism of Action
Sertraline selectively inhibits the reuptake of serotonin (5-HT) by the presynaptic neuron in the central nervous system, leading to an potentiation of serotonergic activity in the brain. It has very weak effects on norepinephrine and dopamine neuronal uptake.
Pharmacokinetics
Onset
Clinical effects usually seen within 1-2 weeks, full antidepressant effect may take 4-6 weeks.
Excretion
Mainly excreted in urine (40-45%) and feces (40-45%) as metabolites.
Half life
Approximately 26 hours (range 22-36 hours) for sertraline, and 62-104 hours for the active metabolite, N-desmethylsertraline.
Absorption
Well absorbed orally, peak plasma concentrations reached within 4.5 to 8.4 hours after once-daily dosing.
Metabolism
Extensive first-pass metabolism in the liver via multiple CYP enzymes (primarily CYP2C19, CYP2B6, CYP2C9, CYP3A4, CYP2D6) to the main active metabolite N-desmethylsertraline.
Side Effects
Contraindications
- Concomitant use with MAOIs (Monoamine Oxidase Inhibitors) or within 14 days of discontinuing an MAOI
- Concomitant use with pimozide
- Known hypersensitivity to sertraline or any component of the formulation
- Concomitant use with disulfiram (due to alcohol content in oral concentrate)
Drug Interactions
MAOIs
Serious, sometimes fatal, reactions including hyperthermia, rigidity, myoclonus, autonomic instability, and mental status changes, including extreme agitation progressing to delirium and coma.
Pimozide
Increased pimozide levels and cardiotoxicity; contraindicated.
Warfarin
Increased prothrombin time/INR and bleeding risk.
CYP2D6 Substrates (e.g., Tricyclic Antidepressants, some antipsychotics)
Sertraline is a moderate CYP2D6 inhibitor, potentially increasing levels of co-administered drugs.
Other Serotonergic Drugs (e.g., Triptans, Fentanyl, Lithium, Tramadol, 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 include somnolence, vomiting, tachycardia, nausea, dizziness, agitation, tremor, and coma. Management involves supportive care, ensuring adequate airway, oxygenation, and ventilation. Gastric lavage and activated charcoal may be considered. Monitor cardiac rhythm and vital signs.
Pregnancy & Lactation
Pregnancy Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Small amounts are excreted in breast milk; caution advised when administering to a nursing mother. Consult a doctor.
Side Effects
Contraindications
- Concomitant use with MAOIs (Monoamine Oxidase Inhibitors) or within 14 days of discontinuing an MAOI
- Concomitant use with pimozide
- Known hypersensitivity to sertraline or any component of the formulation
- Concomitant use with disulfiram (due to alcohol content in oral concentrate)
Drug Interactions
MAOIs
Serious, sometimes fatal, reactions including hyperthermia, rigidity, myoclonus, autonomic instability, and mental status changes, including extreme agitation progressing to delirium and coma.
Pimozide
Increased pimozide levels and cardiotoxicity; contraindicated.
Warfarin
Increased prothrombin time/INR and bleeding risk.
CYP2D6 Substrates (e.g., Tricyclic Antidepressants, some antipsychotics)
Sertraline is a moderate CYP2D6 inhibitor, potentially increasing levels of co-administered drugs.
Other Serotonergic Drugs (e.g., Triptans, Fentanyl, Lithium, Tramadol, 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 include somnolence, vomiting, tachycardia, nausea, dizziness, agitation, tremor, and coma. Management involves supportive care, ensuring adequate airway, oxygenation, and ventilation. Gastric lavage and activated charcoal may be considered. Monitor cardiac rhythm and vital signs.
Pregnancy & Lactation
Pregnancy Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Small amounts are excreted in breast milk; caution advised when administering to a nursing mother. Consult a doctor.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 months from manufacturing date
Availability
Pharmacies, hospitals
Approval Status
FDA Approved, DGDA Approved
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Numerous clinical trials have established the efficacy and safety of sertraline in various psychiatric conditions including MDD, OCD, PD, SAD, PTSD, and PMDD. Studies demonstrate significant improvement in symptom scores compared to placebo.
Lab Monitoring
- Monitor serum sodium levels periodically, especially in elderly patients or those on diuretics.
- Monitor for signs of bleeding, particularly if on anticoagulants.
Doctor Notes
- Consider baseline and periodic monitoring for suicidality, especially during initial therapy and dose changes.
- Educate patients about the signs of serotonin syndrome.
- Counsel patients on potential sexual side effects and management strategies.
- Gradual tapering is essential upon discontinuation to avoid withdrawal symptoms.
Patient Guidelines
- Do not stop taking Salost suddenly, as this may lead to withdrawal symptoms. Consult your doctor.
- It may take several weeks to feel the full benefits of this medicine.
- Report any unusual mood changes or suicidal thoughts to your doctor immediately.
- Avoid driving or operating heavy machinery until you know how Salost affects you.
Missed Dose Advice
If a dose is missed, take it as soon as you remember. If it is close to the time for your next dose, skip the missed dose and continue with your regular schedule. Do not double the dose.
Driving Precautions
Salost may cause dizziness, drowsiness, or impaired judgment. Patients should be cautious when driving or operating machinery until they know how the drug affects them.
Lifestyle Advice
- Maintain a healthy diet and exercise routine.
- Practice stress-reduction techniques.
- Ensure adequate sleep.
- Limit caffeine intake.
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