Sertraline is used to treat depression, obsessive-compulsive disorder (OCD), panic disorder, premenstrual dysphoric disorder (PMDD), posttraumatic stress disorder (PTSD), and social anxiety disorder (SAD).

Sertraline belongs to a group of medicines known as selective serotonin reuptake inhibitors (SSRIs). It works by increasing the activity of a chemical called serotonin in the brain.

This medicine is available only with your doctor's prescription.

Take this medicine only as directed by your doctor, to benefit your condition as much as possible. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

This medicine should come with a Medication Guide. It is very important that you read and understand this information. Be sure to ask your doctor about anything you do not understand.

The tablets may be taken with or without food.

If you are taking the oral liquid, use the dropper provided to measure your dose and mix it with 1/2 cup (4 ounces) of water, ginger ale, lemon-lime soda, lemonade, or orange juice. Do not mix this medicine with any other liquid. Drink it right away after mixing. Do not mix the medicine with the liquid until you are ready to take your dose. It is okay if the mixture looks hazy.

You may have to take this medicine for several months before you begin to feel better.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

Decreased sexual desire or ability

failure to discharge semen (in men)

Less common or rare

Aggressive reaction

breast tenderness or enlargement

confusion

convulsions

diarrhea

drowsiness

dryness of the mouth

fast talking and excited feelings or actions that are out of control

fever

inability to sit still

increase in body movements

increased sweating

increased thirst

lack of energy

loss of bladder control

mood or behavior changes

muscle spasm or jerking of all extremities

nosebleeds

overactive reflexes

racing heartbeat

red or purple spots on the skin

restlessness

shivering

skin rash, hives, or itching

sudden loss of consciousness

unusual or sudden body or facial movements or postures

unusual secretion of milk (in females)

Incidence not known

Abdominal or stomach pain

bleeding gums

blindness

blistering, peeling, or loosening of the skin

bloating

blood in the urine

bloody, black, or tarry stools

blue-yellow color blindness

blurred vision

chest pain or discomfort

chills

clay-colored stools

cough or hoarseness

darkened urine

decreased urine output

decreased vision

depressed mood

difficulty with breathing

difficulty with speaking

difficulty with swallowing

drooling

dry skin and hair

eye pain

fainting

feeling cold

feeling of discomfort

feeling, seeing, or hearing things that are not there

general feeling of discomfort, illness, tiredness, or weakness

hair loss

high fever

high or low blood pressure

hoarseness or husky voice

hostility

increased clotting times

indigestion

inflamed joints

irritability

joint or muscle pain

large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs

lethargy

lightheadedness

loss of appetite

loss of balance control

loss of bladder control

lower back or side pain

muscle aches

muscle cramps and stiffness

muscle trembling, jerking, or stiffness

muscle twitching

painful or difficult urination

pains in the stomach, side, or abdomen, possibly radiating to the back

pale skin

puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue

rapid weight gain

rash

red, irritated eyes

red, sore, or itching skin

right upper stomach pain and fullness

severe mood or mental changes

severe muscle stiffness

shuffling walk

sore throat

sores, ulcers, or white spots in the mouth or on the lips

sores, welting, or blisters

stiffness of the limbs

sweating

swelling of the face, ankles, or hands

swollen or painful glands

talking or acting with excitement you cannot control

tightness in the chest

troubled breathing

twisting movements of the body

twitching

uncontrolled movements, especially of the face, neck, and back

unexplained bleeding or bruising

unpleasant breath odor

unusual behavior

unusual tiredness or weakness

vomiting of blood

weight gain

yellow eyes and skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Acid or sour stomach

belching

decreased appetite or weight loss

diarrhea or loose stools

heartburn

sleepiness or unusual drowsiness

stomach or abdominal cramps, gas, or pain

trouble sleeping

Less common

Agitation, anxiety, or nervousness

bladder pain

burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings

changes in vision

cloudy urine

constipation

difficult, burning, or painful urination

flushing or redness of the skin, with feeling of warmth or heat

frequent urge to urinate

increased appetite

pain or tenderness around the eyes and cheekbones

stuffy or runny nose

Incidence not known

Flushed, dry skin

fruit-like breath odor

increased hunger

increased urination

redness or other discoloration of the skin

severe sunburn

swelling of the breasts (in women)

unexplained weight loss

unusual secretion of milk (in women)

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

It is very important that your doctor check your or your child's progress at regular visits. This is to allow for changes in your dose and to help reduce any side effects.

Do not take sertraline with a monoamine oxidase (MAO) inhibitor (eg, isocarboxazid [Marplan®], phenelzine [Nardil®], selegiline [Eldepryl®], tranylcypromine [Parnate®]). Do not start taking sertraline during the 2 weeks after you stop a MAO inhibitor and wait 2 weeks after stopping sertraline before you start taking a MAO inhibitor. If you take them together or do not wait 2 weeks, you may develop confusion, agitation, restlessness, stomach or intestinal symptoms, a sudden high body temperature, an extremely high blood pressure, or severe convulsions.

Do not use pimozide (Orap®) while you are taking this medicine. Do not use the oral liquid form of sertraline if you are also using disulfiram (Antabuse®). Using these medicines together can cause serious problems.

Sertraline may cause a serious condition called serotonin syndrome if taken together with some medicines. Do not use sertraline with buspirone (Buspar®), fentanyl (Abstral®, Duragesic®), linezolid (Zyvox®), lithium (Eskalith®, Lithobid®), methylene blue injection, tryptophan, St. John's wort, or some pain or migraine medicines (eg, rizatriptan, sumatriptan, tramadol, Frova®, Imitrex®, Maxalt®, Relpax®, Ultram®, Zomig®). Check with your doctor first before taking any other medicines with sertraline.

For some children, teenagers, and young adults, this medicine can increase thoughts of suicide. Tell your doctor right away if you or your child start to feel more depressed and have thoughts about hurting yourselves. Report any unusual thoughts or behaviors that trouble you or your child, especially if they are new or get worse quickly. Make sure the doctor knows if you or your child have trouble sleeping, get upset easily, have a big increase in energy, or start to act reckless. Also tell the doctor if you or your child have sudden or strong feelings, such as feeling nervous, angry, restless, violent, or scared. Let the doctor know if you, your child, or anyone in your family has bipolar disorder (manic-depressive) or has tried to commit suicide.

Sertraline may increase your risk for bleeding problems. Make sure your doctor knows if you or your child are also using other medicines that thin the blood, such as aspirin, NSAID pain or arthritis medicines (eg, diclofenac, ibuprofen, naproxen, Advil®, Aleve®, Celebrex®, Voltaren®), or warfarin (Coumadin®, Jantoven®).

This medicine may cause hyponatremia (low sodium in the blood). This is more common in elderly patients, those who are taking diuretic medicines for high blood pressure, or those who have decreased amounts of fluid in the body due to severe diarrhea or vomiting. Check with your doctor right away if you or your child have headache, trouble concentrating, memory problems, confusion, weakness, or unsteadiness.

This medicine may affect blood sugar levels. If you are diabetic and notice a change in the results of your blood or urine sugar tests, talk with your doctor.

The use of alcohol is not recommended in patients who are taking sertraline. .

This medicine may cause some people to become drowsy, to have trouble thinking, or to have problems with movement. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are not alert or well-coordinated.

The dropper dispenser for the oral liquid contains dry natural rubber (a derivative of latex). This may cause allergic reactions in people who are sensitive to latex. Tell your doctor if you or your child have a latex allergy before you start using this medicine.

Do not stop taking this medicine without checking first with your doctor. Your doctor may want you to gradually reduce the amount you are taking before stopping it completely. This is to decrease the chance of having side effects such as agitation, anxiety, dizziness, a feeling of constant movement of self or surroundings, headache, increased sweating, nausea, trembling or shaking, trouble with sleeping or walking, or unusual tiredness when you stop the medicine.

Before you have any medical tests, tell the medical doctor in charge that you or your child are taking this medicine. The results of some tests may be affected by this medicine.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.