Sertal
Generic Name
Sertraline 50 mg Tablet
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| sertal 50 mg tablet | ৳ 6.00 | ৳ 60.00 |
Description
Overview of the medicine
Sertal 50 mg Tablet contains Sertraline, a selective serotonin reuptake inhibitor (SSRI) antidepressant. It is used to treat major depressive disorder, obsessive-compulsive disorder (OCD), panic disorder, post-traumatic stress disorder (PTSD), social anxiety disorder (SAD), and premenstrual dysphoric disorder (PMDD).
Uses & Indications
Dosage
Adults
For most indications, initiate with 50 mg once daily. Dosage may be increased in increments of 50 mg at intervals of at least one week, up to a maximum of 200 mg/day.
Elderly
Lower initial doses (e.g., 25 mg/day) may be considered, with careful titration due to potential increased sensitivity.
Renal_impairment
No dosage adjustment is generally needed for mild to moderate renal impairment. Caution is advised in severe renal impairment due to limited data.
How to Take
Take Sertal 50 mg Tablet orally once daily, either in the morning or evening, with or without food. Consistent timing and food intake (or lack thereof) are recommended.
Mechanism of Action
Sertraline selectively inhibits the reuptake of serotonin (5-HT) by presynaptic neurons in the central nervous system, thereby increasing the concentration of serotonin in the synaptic cleft and enhancing serotonergic neurotransmission.
Pharmacokinetics
Onset
Therapeutic effects typically begin within 2-4 weeks, though some symptom improvement may be seen earlier.
Excretion
Excreted primarily in feces (approximately 45%) and urine (approximately 13%) as metabolites. Less than 0.2% is excreted unchanged in urine.
Half life
Approximately 26 hours for sertraline, and 62-104 hours for its active metabolite, desmethylsertraline.
Absorption
Well absorbed from the gastrointestinal tract, with peak plasma concentrations occurring 4.5 to 8.4 hours after administration.
Metabolism
Extensively metabolized in the liver, primarily via N-demethylation to desmethylsertraline, which has minimal pharmacological activity.
Side Effects
Contraindications
- Concomitant use with Monoamine Oxidase Inhibitors (MAOIs) or within 14 days of discontinuing an MAOI.
- Concomitant use with pimozide.
- Known hypersensitivity to sertraline or any component of the formulation.
Drug Interactions
Pimozide
Increased plasma levels of pimozide, leading to QT prolongation and cardiac arrhythmias.
Warfarin
Potentiation of anticoagulant effect, leading to increased bleeding risk.
NSAIDs, Aspirin
Increased risk of bleeding.
MAOIs (e.g., phenelzine, selegiline)
Risk of serious, sometimes fatal, serotonin syndrome.
Other serotonergic drugs (e.g., triptans, tramadol, fentanyl, lithium, St. John's Wort)
Increased risk of serotonin syndrome.
Storage
Store in a cool, dry place below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include somnolence, nausea, vomiting, tachycardia, tremor, agitation, dizziness, and rarely coma. Management is primarily supportive and symptomatic. There is no specific antidote. Gastric lavage and activated charcoal may be considered.
Pregnancy & Lactation
Pregnancy Category C (some sources consider D for third trimester). Use only if the potential benefit justifies the potential risk to the fetus. Sertraline is excreted in breast milk; a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
Side Effects
Contraindications
- Concomitant use with Monoamine Oxidase Inhibitors (MAOIs) or within 14 days of discontinuing an MAOI.
- Concomitant use with pimozide.
- Known hypersensitivity to sertraline or any component of the formulation.
Drug Interactions
Pimozide
Increased plasma levels of pimozide, leading to QT prolongation and cardiac arrhythmias.
Warfarin
Potentiation of anticoagulant effect, leading to increased bleeding risk.
NSAIDs, Aspirin
Increased risk of bleeding.
MAOIs (e.g., phenelzine, selegiline)
Risk of serious, sometimes fatal, serotonin syndrome.
Other serotonergic drugs (e.g., triptans, tramadol, fentanyl, lithium, St. John's Wort)
Increased risk of serotonin syndrome.
Storage
Store in a cool, dry place below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include somnolence, nausea, vomiting, tachycardia, tremor, agitation, dizziness, and rarely coma. Management is primarily supportive and symptomatic. There is no specific antidote. Gastric lavage and activated charcoal may be considered.
Pregnancy & Lactation
Pregnancy Category C (some sources consider D for third trimester). Use only if the potential benefit justifies the potential risk to the fetus. Sertraline is excreted in breast milk; a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from the date of manufacture. Refer to the packaging for the exact expiry date.
Availability
Pharmacies, hospitals
Approval Status
Approved
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Sertraline has undergone extensive clinical trials demonstrating its efficacy and safety across various indications, including major depressive disorder, obsessive-compulsive disorder, and panic disorder. Studies have shown its effectiveness in improving symptoms and quality of life for patients.
Lab Monitoring
- Monitor serum sodium levels, especially in elderly patients or those on diuretics, due to risk of hyponatremia.
- Liver function tests may be considered periodically, though severe hepatic injury is rare.
Doctor Notes
- Educate patients and caregivers about the black box warning regarding increased suicidal thoughts and behavior, especially at the initiation of therapy or dose changes.
- Monitor for signs of serotonin syndrome, particularly when co-administered with other serotonergic agents.
- Advise patients not to discontinue treatment abruptly to avoid withdrawal symptoms.
Patient Guidelines
- Do not stop taking Sertal abruptly without consulting your doctor, as withdrawal symptoms may occur.
- It may take 2-4 weeks to feel the full effects of the medication.
- Report any worsening of depression or suicidal thoughts to your doctor immediately.
- Avoid alcohol consumption while taking this medication.
- Take Sertal consistently, ideally at the same time each day.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose to catch up.
Driving Precautions
Sertal may cause dizziness, drowsiness, or impaired judgment. Patients should be cautious when driving or operating machinery until they know how the medication affects them.
Lifestyle Advice
- Engage in regular physical activity to help manage mood and stress.
- Maintain a balanced diet and ensure adequate sleep.
- Consider psychotherapy or counseling as an adjunct to medication for better outcomes.
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