Sertlin
Generic Name
Sertraline
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| sertlin 100 mg tablet | ৳ 10.00 | ৳ 100.00 |
Description
Overview of the medicine
Sertraline 100 mg Tablet is an antidepressant belonging to the Selective Serotonin Reuptake Inhibitor (SSRI) class. It is primarily used to treat major depressive disorder, obsessive-compulsive disorder, panic disorder, post-traumatic stress disorder, social anxiety disorder, and premenstrual dysphoric disorder by increasing the levels of serotonin in the brain.
Uses & Indications
Dosage
Adults
For MDD: Initial 50 mg once daily, may increase up to 200 mg/day. For OCD/PD/PTSD/SAD: Initial 25 mg once daily, increase to 50 mg/day after one week, then may increase up to 200 mg/day. For PMDD: 50 mg/day continuously or during luteal phase.
Elderly
Generally, start with a lower dose (e.g., 25 mg/day) and titrate carefully due to potentially decreased clearance and increased sensitivity.
Renal_impairment
No dosage adjustment is generally required for mild to moderate renal impairment. Use with caution in severe renal impairment (CrCl <30 mL/min).
How to Take
Sertraline tablets should be taken orally once daily, either in the morning or evening, with or without food. Swallow the tablet whole with water. Do not crush, chew, or break the tablet.
Mechanism of Action
Sertraline selectively inhibits the reuptake of serotonin (5-HT) by the presynaptic neuron, leading to an increased concentration of serotonin in the synaptic cleft. This potentiation of serotonergic neurotransmission is believed to be responsible for its antidepressant, anxiolytic, and anti-obsessive effects.
Pharmacokinetics
Onset
Initial therapeutic effects typically seen within 1-2 weeks; full antidepressant effects may take 4-6 weeks.
Excretion
Approximately 40-45% excreted in urine and 40-45% in feces, largely as metabolites.
Half life
Sertraline: approximately 26 hours. Desmethylsertraline (active metabolite): 62-104 hours.
Absorption
Well absorbed from the gastrointestinal tract; food increases bioavailability slightly.
Metabolism
Extensively metabolized in the liver, primarily via CYP2C19, CYP2B6, CYP2D6, CYP3A4, and CYP2C9, to an active metabolite (desmethylsertraline) and other inactive metabolites.
Side Effects
Contraindications
- Concomitant use with Monoamine Oxidase Inhibitors (MAOIs) or within 14 days of discontinuing an MAOI.
- Concomitant use with pimozide.
- Hypersensitivity to sertraline or any component of the formulation.
- Concomitant use with disulfiram (for oral solution formulation due to alcohol content).
Drug Interactions
MAOIs
Increased risk of serotonin syndrome, which can be fatal.
NSAIDs
Increased risk of bleeding.
Pimozide
Increased plasma levels of pimozide, leading to QTc prolongation and potential cardiac arrhythmias.
Warfarin
Potentiation of anticoagulant effect, monitor INR.
Cimetidine
Decreased sertraline clearance.
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 of overdose include somnolence, nausea, vomiting, tachycardia, tremor, agitation, dizziness, and rarely, convulsions, coma, and serotonin syndrome. There is no specific antidote. Treatment should be supportive and symptomatic. Gastric lavage, activated charcoal, and airway management 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. Sertraline is excreted in breast milk; caution should be exercised when administered to a nursing mother.
Side Effects
Contraindications
- Concomitant use with Monoamine Oxidase Inhibitors (MAOIs) or within 14 days of discontinuing an MAOI.
- Concomitant use with pimozide.
- Hypersensitivity to sertraline or any component of the formulation.
- Concomitant use with disulfiram (for oral solution formulation due to alcohol content).
Drug Interactions
MAOIs
Increased risk of serotonin syndrome, which can be fatal.
NSAIDs
Increased risk of bleeding.
Pimozide
Increased plasma levels of pimozide, leading to QTc prolongation and potential cardiac arrhythmias.
Warfarin
Potentiation of anticoagulant effect, monitor INR.
Cimetidine
Decreased sertraline clearance.
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 of overdose include somnolence, nausea, vomiting, tachycardia, tremor, agitation, dizziness, and rarely, convulsions, coma, and serotonin syndrome. There is no specific antidote. Treatment should be supportive and symptomatic. Gastric lavage, activated charcoal, and airway management 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. 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
Shelf Life
2-3 years from the date of manufacture
Availability
Available in pharmacies nationwide
Approval Status
Approved by regulatory authorities (e.g., FDA, DGDA)
Patent Status
Off-patent (generic available)
WHO Essential Medicine
YesClinical Trials
Sertraline has undergone extensive clinical trials demonstrating its efficacy and safety across various psychiatric conditions, including major depressive disorder, OCD, panic disorder, PTSD, social anxiety disorder, and PMDD in adults. Ongoing research continues to explore its use in other conditions and populations.
Lab Monitoring
- Monitor liver function tests periodically, especially in patients with pre-existing hepatic impairment.
- Monitor serum sodium in patients at risk for hyponatremia.
- Consider monitoring weight, especially in children and adolescents.
- Monitor blood glucose in diabetic patients, as sertraline may affect glycemic control.
Doctor Notes
- Advise patients about the delayed onset of therapeutic effects and the importance of continued adherence.
- Educate on potential withdrawal symptoms if medication is stopped abruptly and counsel on gradual tapering.
- Screen for bipolar disorder before initiating treatment with an antidepressant to avoid precipitating mania/hypomania.
- Regularly monitor for suicidal ideation, especially at the beginning of treatment and during dose adjustments.
- Consider drug-drug interactions, particularly with other serotonergic agents, MAOIs, and drugs affecting CYP enzymes.
Patient Guidelines
- Take exactly as prescribed by your doctor. Do not stop taking sertraline abruptly, as this can lead to withdrawal symptoms.
- It may take several weeks for the full therapeutic effect to be observed.
- Report any worsening depression, suicidal thoughts, or unusual changes in mood or behavior to your doctor immediately.
- Avoid alcohol while taking sertraline.
- Be cautious when driving or operating machinery until you know how this medicine affects you.
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 take a double dose to make up for a missed one.
Driving Precautions
Sertraline may cause dizziness, drowsiness, or visual disturbances. Patients should be advised to exercise caution when driving or operating hazardous machinery until they are reasonably certain that sertraline does not adversely affect their ability to engage in such activities.
Lifestyle Advice
- Engage in regular physical activity to support mental well-being.
- Maintain a balanced diet and adequate sleep hygiene.
- Practice stress-reduction techniques such as mindfulness or meditation.
- Build a strong support system with friends and family.
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