Sertraline

Brand Ranbaxy Laboratories Ltd

In stock 1503 Items

Available since: 2019-09-19

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Clinical Pharmacology

Serlift - antidepressant, a derivative of naphthylamine. Selective blocker of reverse neuronal serotonin uptake in the brain. The neuronal uptake of norepinephrine and dopamine is virtually unaffected. Serlift does not have a specific affinity for adreno- and m-cholinergic receptors, GABA receptors, dopamine, histamine, serotonin, or benzodiazepine receptors. Does not inhibit MAO. Causes anorexia, effective in obsessive-compulsive disorders.

Indications

Treatment of depressive conditions of various genesis in patients with mono- and bipolar affective disorders. Prevention of recurrent episodes of depression.

Composition

1 tab. contains sertraline 50 mg

Sertraline is marketed under different brands and generic names, and comes in different dosage forms:

Brand name	Manufacturer	Country	Dosage form
Serlift	Ranbaxy Laboratories Ltd	India	pills
Serenata	Torrent	India	pills
Stimuloton	Egis	Hungary	pills
Ascentra	Krka dd Novo mesto AO	Slovenia	pills
Thorin	Veropharm	Russia	pills
Zoloft	Pfizer	USA	pills

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Dosage and Administration

For adults

For depression and obsessive-compulsive disorders

The drug is prescribed in a dose of 50 mg 1 time / day in the morning or in the evening. Gradually, not earlier than in a week, the daily dose can be increased to a maximum daily dose of 200 mg.

In patients with obsessive-compulsive disorders, it may take 8-12 weeks to achieve a good result. The minimum dose that provides a therapeutic effect is stored in the future as a supportive.

With panic disorders and post-traumatic stress disorders

It is necessary to begin treatment with a dose of 25 mg 1 time / day in the morning or in the evening. After a week, the daily dose can be increased to 50 mg, and then gradually, not earlier than in a week, the daily dose can be increased from 50 mg to a maximum daily dose of 200 mg.

A satisfactory therapeutic effect is usually achieved after 7 days from the start of treatment, but to achieve the full therapeutic effect, it is necessary to take the drug regularly for 2-4 weeks.

For children

In obsessive compulsive disorders

For children aged 6 to 12 years, the repair is prescribed in an initial dose of 25 mg 1 time / day in the morning or in the evening. A week later, the daily dose can be increased to 50 mg.

For children aged 12 to 17 years, the initial dose is 50 mg 1 time / day in the morning or evening. Gradually, not earlier than in a week, the daily dose can be increased to a maximum daily dose of 200 mg. In order to avoid overdose, lower body weight of children should be taken into account in comparison with adults, and with increasing doses of more than 50 mg / day, careful monitoring of children should be made and the drug should be discontinued at the first sign of overdose.

In elderly patients There is no need for a special selection of the dose.

With abnormal liver function the dose of the drug should be reduced or increased the intervals between doses.

In patients with impaired renal function no special dose selection is required.

Adverse reactions

From the side of the central nervous system: drowsiness, headache, dizziness, tremor, insomnia, anxiety, agitation, hypomania, mania, gait disturbances, blurred vision, convulsions, dyskinesias, extrapyramidal syndromes.

From the digestive system: dry mouth, decreased appetite (rarely, increased) up to anorexia, flatulence, nausea, vomiting, diarrhea, abdominal pain; rarely, a transient increase in liver transaminase activity.

From the reproductive system: ejaculatory disorders, decreased libido, menstrual disorders.

On the part of the endocrine system: hyperprolactinemia, galactorrhea, increased sweating, weight loss.

Dermatological reactions: hyperemia of the skin, skin rash, erythema multiforme.

Other: possible weakness, reversible hyponatremia, developing more often in elderly patients, as well as when taking diuretics or a number of other drugs.

Movement disorders were noted in patients with indications of their presence in history or with concomitant use of antipsychotics.

Carefully: organic brain diseases (including during mental retardation); manic states; epilepsy; hepatic and / or renal failure; weight loss; children over the age of 6 years.

Drug interactions

With simultaneous use of Stimoton with MAO inhibitors (including selective MAO inhibitors with a reversible type of action - selegilin and moclobemide), serotonin syndrome may develop, which is expressed in the development of hyperthermia, muscle rigidity, myoclonus, lability of the autonomic nervous system, changes in mental status (including confusion, increased irritability, marked excitement, which in some cases can turn into a delirious state and to whom).

Thus, sertraline should not be prescribed together with MAO inhibitors, as well as within 14 days after their withdrawal. Similarly, after the abolition of sertraline, MAO inhibitors are not prescribed for 14 days.

The combined use of Stimulotton with drugs that depress the central nervous system should be carried out only under the supervision of a physician, and alcoholic beverages during treatment with Stimoton should not be consumed.

With the simultaneous use of Stimuloton and coumarin derivatives, there is a significant increase in prothrombin time - in these cases it is recommended to monitor the prothrombin time at the beginning of treatment with Stimoton and after its withdrawal.

When used simultaneously with Stimuloton, cimetidine significantly reduces the clearance of sertraline.

Prolonged use of Stimuloton at a dose of 50 mg / day is accompanied by an increase in desipramine concentration.

Experiments to study the interaction in vitro showed that the beta-hydroxylation of endogenous cortisol carried out by the CYP3A4 isoenzyme, as well as the metabolism of carbamazepine and terfenadine with prolonged use of sertraline at a dose of 200 mg / day do not change. The concentration in plasma of tolbutamide, phenytoin and warfarin with prolonged use of sertraline in the same dose also does not change.

The pharmacokinetics of lithium do not change with the concomitant administration of sertraline. However, tremor is more common, suggesting the possibility of pharmacodynamic interaction. The combined use of sertraline with drugs that affect serotonergic transmission (for example, with lithium), requires increased caution.

Sertralin causes minimal induction of liver enzymes. The simultaneous administration of sertraline and antipyrine at a dose of 200 mg leads to a significant reduction in the half-life of antipyrine, although this occurs only in 5% of cases.

When combined with atenolol, Stimuloton does not affect its effectiveness.

With the introduction of sertraline in a daily dose of 200 mg together with glibenclamide and digoxin, drug interaction was not detected.

Pregnancy and Lactation

There are no controlled results of Stimuloton in pregnant women, therefore, it is necessary to prescribe the drug during pregnancy only if the expected benefit to the mother outweighs the potential risk to the fetus.

Women of reproductive age who are supposed to prescribe Stimoton should be advised to use effective contraceptives.

Sertralin is excreted in breast milk. There is no reliable data on the safety of its use during lactation. If necessary, the appointment of Stimuloton during lactation lactation should be discontinued.

Special instructions

It should be noted that in patients undergoing electroconvulsive therapy, sufficient experience with the use of Stimuloton is absent. Possible success or risk of such combined treatment has not been studied.

Patients with depression are at risk for suicidal attempts. This danger persists until the development of remission. Therefore, from the start of treatment and until the optimum clinical effect is achieved, patients should be provided with constant medical supervision.

When canceling Stimulotona described rare cases of withdrawal syndrome, manifested paresthesia, hypesthesia, symptoms of depression, hallucinations, aggressive reactions, psychomotor agitation, anxiety or symptoms of psychosis, which can not be distinguished from the symptoms of the underlying disease.

An asymptomatic increase in liver transaminase activity may appear 9 weeks after the start of treatment with Stimoton. Cancellation of the drug in this case leads to the normalization of the activity of enzymes.

Particular caution is required with the simultaneous appointment of Stimuloton with drugs that bind to plasma proteins (diazepam, tolbutamide, warfarin).

Application for violations of the liver

Caution should be prescribed for liver failure. In case of abnormal liver function, the dose of the drug should be reduced or the intervals between doses should be increased.

Application for violations of renal function

Precautions should be prescribed for renal failure. In patients with impaired renal function, there is no need to specifically select a dose.

Impact on the ability to drive vehicles and other mechanisms that require high concentration of attention

The purpose of sertraline is not accompanied by a violation of psychomotor functions. However, its use simultaneously with other drugs can lead to impaired attention and coordination of movements. Therefore, it is not recommended to drive vehicles, special equipment or engage in activities associated with increased risk during treatment with Stimulus.

Overdosage

Symptoms: serotonin syndrome with nausea, vomiting, drowsiness, tachycardia, agitation, dizziness, psychomotor agitation, diarrhea, increased sweating, myoclonus and hyperreflexia.

Treatment: specific antidotes are absent. Requires intensive supportive therapy and constant monitoring of the functions of vital organs. Vomiting is not recommended. The introduction of activated carbon may be more effective than gastric lavage. It is necessary to maintain airway patency. Sertraline has a large volume of distribution, and therefore, increased diuresis, dialysis, hemoperfusion, or blood transfusion may be unsuccessful.

It should be noted that even with the appointment of sertraline in large doses, life-threatening symptoms are not detected. However, the introduction of sertraline in high doses simultaneously with other drugs or ethanol can lead to severe poisoning.