Anxiety/OCD:
Indications for: ZOLOFT
Panic disorder (PD). Posttraumatic stress disorder (PTSD). Obsessive-compulsive disorder (OCD). Social anxiety disorder (SAD).
Adult Dosage:
Give once daily (AM or PM). PD, PTSD, SAD: initially 25mg/day. OCD: initially 50mg/day. For all: may increase by 25–50mg/day at 1-week intervals; max 200mg/day. Hepatic impairment (mild): reduce dose by ½; (moderate to severe): not recommended.
Children Dosage:
PD, PTSD, SAD: not established. OCD: <6yrs: not established. Give once daily (AM or PM). 6–12yrs: initially 25mg/day. 13–17yrs: initially 50mg/day. May increase by 25–50mg/day at 1-week intervals; max 200mg/day. Hepatic impairment (mild): reduce dose by ½; (moderate to severe): not recommended.
ZOLOFT Contraindications:
During or within 14 days of MAOIs; do not start an MAOI during or within 14 days of sertraline. Concomitant pimozide, linezolid, IV methylene blue. Oral soln: concomitant disulfiram.
Boxed Warning:
Suicidal thoughts and behaviors.
ZOLOFT Warnings/Precautions:
Increased risk of suicidal thinking and behavior in children, adolescents, and young adults; monitor for clinical worsening or unusual changes. Screen for bipolar disorder, mania, or hypomania. Monitor for serotonin syndrome; discontinue if occurs. Seizure disorders. QT prolongation. Risk for bleeding events. Angle-closure glaucoma; avoid. Monitor weight and growth in children. Discontinue if symptomatic hyponatremia occurs. Volume-depleted. Sexual dysfunction. Hepatic impairment. Write ℞ for smallest practical amount. Avoid abrupt cessation. Reevaluate periodically. Elderly. Labor & delivery. Pregnancy (during 3rd trimester; see full labeling for effects on neonates). Nursing mothers.
See Also:
ZOLOFT Classification:
SSRI.
ZOLOFT Interactions:
See Contraindications. Increased risk of serotonin syndrome with other serotonergic drugs (eg, other SSRIs, SNRIs, triptans, TCAs, fentanyl, lithium, tramadol, meperidine, methadone, tryptophan, buspirone, St. John's Wort) or with drugs that impair serotonin metabolism (eg, MAOIs, linezolid, IV methylene blue). Avoid alcohol. May potentiate or be potentiated by protein bound drugs (eg, warfarin); reduce dose if needed. May potentiate CYP2D6 substrates (eg, propafenone, flecainide, atomoxetine, desipramine, dextromethorphan, metoprolol, nebivolol, perphenazine, thioridazine, tolterodine, venlafaxine); reduce dose of these. Increased risk of bleeding with concomitant aspirin, NSAIDs, clopidogrel, heparin, warfarin, and others that affect coagulation. Avoid concomitant drugs known to prolong the QT interval (eg, ziprasidone, iloperidone, chlorpromazine, mesoridazine, droperidol, erythromycin, gatifloxacin, moxifloxacin, sparfloxacin, Class IA & III antiarrhythmics, pentamidine, methadone, mefloquine, and others). Monitor phenytoin, warfarin. May cause false (+) urine test for benzodiazepines.
Adverse Reactions:
Nausea, diarrhea, tremor, dyspepsia, decreased appetite, sweating, ejaculation failure, decreased libido, insomnia, weight loss, dry mouth; hyponatremia (esp. elderly). Children: also, hyperkinesia, fever, urinary incontinence, aggression, epistaxis, purpura, arthralgia, muscle twitching, anxiety.
Drug Elimination:
Renal, fecal. Half-life: ~26 hours.
Generic Drug Availability:
YES
How Supplied:
Tabs 25mg—30; 50mg, 100mg—30, 100; Soln—60mL (w. dropper)
Mood disorders:
Indications for: ZOLOFT
Major depressive disorder (MDD). Premenstrual dysphoric disorder (PMDD).
Adult Dosage:
Give once daily (AM or PM). MDD: initially 50mg/day, may increase by 25–50mg/day at 1-week intervals; max 200mg/day. PMDD: give either for entire menstrual cycle or only during luteal phase. Luteal phase dosing: initially 50mg/day; if no response, may increase up to max 100mg/day, starting each cycle at 50mg/day for 3 days. Entire cycle dosing: initially 50mg/day, if no response, may increase by 50mg/cycle to max 150mg/day.
Children Dosage:
Not established.
ZOLOFT Contraindications:
During or within 14 days of MAOIs; do not start an MAOI during or within 14 days of sertraline. Concomitant pimozide, linezolid, IV methylene blue. Oral soln: concomitant disulfiram.
Boxed Warning:
Suicidal thoughts and behaviors.
ZOLOFT Warnings/Precautions:
Increased risk of suicidal thinking and behavior in children, adolescents, and young adults; monitor for clinical worsening or unusual changes. Screen for bipolar disorder, mania, or hypomania. Monitor for serotonin syndrome; discontinue if occurs. Seizure disorders. QT prolongation. Risk for bleeding events. Angle-closure glaucoma; avoid. Monitor weight and growth in children. Discontinue if symptomatic hyponatremia occurs. Volume-depleted. Sexual dysfunction. Hepatic impairment. Write ℞ for smallest practical amount. Avoid abrupt cessation. Reevaluate periodically. Elderly. Labor & delivery. Pregnancy (during 3rd trimester; see full labeling for effects on neonates). Nursing mothers.
See Also:
ZOLOFT Classification:
SSRI.
ZOLOFT Interactions:
See Contraindications. Increased risk of serotonin syndrome with other serotonergic drugs (eg, other SSRIs, SNRIs, triptans, TCAs, fentanyl, lithium, tramadol, meperidine, methadone, tryptophan, buspirone, St. John's Wort) or with drugs that impair serotonin metabolism (eg, MAOIs, linezolid, IV methylene blue). Avoid alcohol. May potentiate or be potentiated by protein bound drugs (eg, warfarin); reduce dose if needed. May potentiate CYP2D6 substrates (eg, propafenone, flecainide, atomoxetine, desipramine, dextromethorphan, metoprolol, nebivolol, perphenazine, thioridazine, tolterodine, venlafaxine); reduce dose of these. Increased risk of bleeding with concomitant aspirin, NSAIDs, clopidogrel, heparin, warfarin, and others that affect coagulation. Avoid concomitant drugs known to prolong the QT interval (eg, ziprasidone, iloperidone, chlorpromazine, mesoridazine, droperidol, erythromycin, gatifloxacin, moxifloxacin, sparfloxacin, Class IA & III antiarrhythmics, pentamidine, methadone, mefloquine, and others). Monitor phenytoin, warfarin. May cause false (+) urine test for benzodiazepines.
Adverse Reactions:
Nausea, diarrhea, tremor, dyspepsia, decreased appetite, sweating, ejaculation failure, decreased libido, insomnia, weight loss, dry mouth; hyponatremia (esp. elderly).
Drug Elimination:
Renal, fecal. Half-life: ~26 hours.
Generic Drug Availability:
YES
How Supplied:
Tabs 25mg—30; 50mg, 100mg—30, 100; Soln—60mL (w. dropper)
