Sertraline (Oral Route) Side Effects

Description and Brand Names

Drug information provided by: Merative, Micromedex®

US Brand Name

Zoloft

Descriptions

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.

This product is available in the following dosage forms:

Tablet
Solution
Capsule

Before Using

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of sertraline in children with depression, panic disorder, premenstrual dysphoric disorder (PMDD), posttraumatic stress disorder (PTSD), and social anxiety disorder (SAD), and in children younger than 6 years of age with obsessive-compulsive disorder. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of sertraline in the elderly. However, elderly patients are more likely to have hyponatremia (low sodium in the blood), age-related kidney, liver, or heart problems which may require caution and an adjustment in the dose for patients receiving sertraline.

Breastfeeding

Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding.

Drug Interactions

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Bepridil
Bromopride
Cisapride
Dronedarone
Eliglustat
Furazolidone
Iproniazid
Isocarboxazid
Levoketoconazole
Linezolid
Mesoridazine
Methylene Blue
Metoclopramide
Ozanimod
Phenelzine
Pimozide
Piperaquine
Procarbazine
Rasagiline
Safinamide
Saquinavir
Selegiline
Sparfloxacin
Terfenadine
Thioridazine
Toloxatone
Tranylcypromine
Ziprasidone

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Abciximab
Aceclofenac
Acemetacin
Acenocoumarol
Adagrasib
Alfentanil
Alfuzosin
Almotriptan
Amineptine
Amiodarone
Amisulpride
Amitriptyline
Amitriptylinoxide
Amoxapine
Amphetamine
Amtolmetin Guacil
Anagrelide
Anileridine
Apixaban
Apomorphine
Ardeparin
Argatroban
Aripiprazole
Aripiprazole Lauroxil
Arsenic Trioxide
Asenapine
Aspirin
Astemizole
Atazanavir
Atomoxetine
Azithromycin
Bedaquiline
Bemiparin
Benzhydrocodone
Benzphetamine
Betrixaban
Bivalirudin
Bromfenac
Brompheniramine
Bufexamac
Buprenorphine
Bupropion
Buserelin
Buspirone
Butorphanol
Cangrelor
Carbamazepine
Carvedilol
Celecoxib
Ceritinib
Certoparin
Chloroquine
Chlorpheniramine
Chlorpromazine
Choline Salicylate
Cilostazol
Ciprofloxacin
Citalopram
Clarithromycin
Clofazimine
Clomipramine
Clonixin
Clopidogrel
Clothiapine
Clozapine
Cobicistat
Cocaine
Codeine
Crizotinib
Cyclobenzaprine
Dabigatran Etexilate
Dabrafenib
Dalteparin
Danaparoid
Darunavir
Dasatinib
Degarelix
Delamanid
Desipramine
Desirudin
Deslorelin
Desmopressin
Desvenlafaxine
Deutetrabenazine
Dexfenfluramine
Dexibuprofen
Dexketoprofen
Dexmedetomidine
Dextroamphetamine
Dextromethorphan
Dibenzepin
Diclofenac
Difenoxin
Diflunisal
Dihydrocodeine
Diphenoxylate
Dipyridamole
Dipyrone
Disopyramide
Dofetilide
Dolasetron
Domperidone
Donepezil
Dothiepin
Doxepin
Doxorubicin
Doxorubicin Hydrochloride Liposome
Droperidol
Droxicam
Duloxetine
Ebastine
Edoxaban
Efavirenz
Eletriptan
Encainide
Encorafenib
Enoxaparin
Entrectinib
Epoprostenol
Eptifibatide
Eribulin
Erythromycin
Escitalopram
Ethylmorphine
Etodolac
Etofenamate
Etoricoxib
Etrasimod
Famotidine
Felbamate
Felbinac
Fenfluramine
Fenoprofen
Fentanyl
Fepradinol
Feprazone
Fexinidazole
Fingolimod
Flecainide
Floctafenine
Fluconazole
Flufenamic Acid
Fluoxetine
Flurbiprofen
Fluvoxamine
Fondaparinux
Formoterol
Foscarnet
Fosphenytoin
Fostemsavir
Frovatriptan
Galantamine
Gatifloxacin
Gemifloxacin
Gepirone
Gilteritinib
Glasdegib
Gonadorelin
Goserelin
Granisetron
Halofantrine
Haloperidol
Heparin
Histrelin
Hydrocodone
Hydromorphone
Hydroquinidine
Hydroxychloroquine
Hydroxytryptophan
Hydroxyzine
Ibuprofen
Ibutilide
Iloperidone
Iloprost
Imipramine
Indomethacin
Inotuzumab Ozogamicin
Iobenguane I 123
Iobenguane I 131
Itraconazole
Ivabradine
Ivosidenib
Ketobemidone
Ketoconazole
Ketoprofen
Ketorolac
Lapatinib
Lasmiditan
Lefamulin
Lenvatinib
Lepirudin
Leuprolide
Levofloxacin
Levomilnacipran
Levorphanol
Lisdexamfetamine
Lithium
Lofepramine
Lofexidine
Lorcaserin
Lornoxicam
Loxoprofen
Lumefantrine
Lumiracoxib
Macimorelin
Meclofenamate
Mefenamic Acid
Mefloquine
Melitracen
Meloxicam
Meperidine
Metaxalone
Methadone
Methamphetamine
Methotrimeprazine
Methoxyphenamine
Methylphenidate
Metoprolol
Metronidazole
Mexiletine
Mifepristone
Milnacipran
Mirtazapine
Mizolastine
Mobocertinib
Moricizine
Morniflumate
Morphine
Morphine Sulfate Liposome
Moxifloxacin
Nabumetone
Nadroparin
Nafarelin
Nalbuphine
Naproxen
Naratriptan
Nebivolol
Nefazodone
Nelfinavir
Nepafenac
Nicergoline
Nicomorphine
Niflumic Acid
Nilotinib
Nimesulide
Nimesulide Beta Cyclodextrin
Norfloxacin
Nortriptyline
Octreotide
Ofloxacin
Olanzapine
Oliceridine
Ondansetron
Opipramol
Opium
Opium Alkaloids
Osilodrostat
Osimertinib
Oxaliplatin
Oxaprozin
Oxcarbazepine
Oxycodone
Oxymorphone
Oxyphenbutazone
Pacritinib
Paliperidone
Palonosetron
Panobinostat
Papaveretum
Papaverine
Parecoxib
Paregoric
Parnaparin
Paroxetine
Pasireotide
Pazopanib
Pentamidine
Pentazocine
Perphenazine
Phenindione
Phenobarbital
Phenprocoumon
Phenylbutazone
Phenytoin
Piketoprofen
Pimavanserin
Pipamperone
Piritramide
Piroxicam
Pitolisant
Ponesimod
Posaconazole
Prajmaline
Pranoprofen
Prasugrel
Primidone
Probucol
Procainamide
Prochlorperazine
Proglumetacin
Promethazine
Propafenone
Propyphenazone
Proquazone
Protein C
Protriptyline
Quetiapine
Quinidine
Quinine
Quizartinib
Ranolazine
Relugolix
Remifentanil
Reviparin
Ribociclib
Risperidone
Ritonavir
Rivaroxaban
Rizatriptan
Rofecoxib
Salicylic Acid
Salsalate
Selexipag
Selpercatinib
Sertindole
Sevoflurane
Sibutramine
Siponimod
Sodium Phosphate
Sodium Phosphate, Dibasic
Sodium Phosphate, Monobasic
Sodium Salicylate
Solifenacin
Sorafenib
Sotalol
St John's Wort
Sufentanil
Sulfinpyrazone
Sulindac
Sulodexide
Sulpiride
Sultopride
Sumatriptan
Sunitinib
Tacrolimus
Tamoxifen
Tamsulosin
Tapentadol
Telaprevir
Telavancin
Telithromycin
Tenoxicam
Tetrabenazine
Tianeptine
Tiaprofenic Acid
Ticagrelor
Ticlopidine
Tilidine
Timolol
Tinzaparin
Tirofiban
Tolfenamic Acid
Tolmetin
Tolperisone
Tolterodine
Toremifene
Tramadol
Trazodone
Treprostinil
Triclabendazole
Trimipramine
Triptorelin
Tropisetron
Tryptophan
Valdecoxib
Vandetanib
Vardenafil
Vemurafenib
Venlafaxine
Vernakalant
Vilanterol
Vilazodone
Vinflunine
Voclosporin
Vorapaxar
Voriconazole
Vorinostat
Vortioxetine
Warfarin
Yohimbine
Zolmitriptan
Zolpidem
Zotepine
Zuclopenthixol

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Alprazolam
Cimetidine
Fluphenazine
Ginkgo
Lamotrigine
Rifampin

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

Grapefruit Juice

Proper Use

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. Follow the instructions carefully. Ask your doctor if you have any questions.

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.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For oral dosage forms (solution or tablets):
- For depression:
  - Adults—At first, 50 milligrams (mg) once a day, taken either in the morning or evening. Your doctor may adjust your dose as needed. However, the dose is usually not more than 200 mg per day.
  - Children—Use and dose must be determined by your doctor.
- For obsessive-compulsive disorder:
  - Adults and teenagers—At first, 50 milligrams (mg) once a day, taken either in the morning or evening. Your doctor may adjust your dose as needed. However, the dose is usually not more than 200 mg per day.
  - Children 6 to 12 years of age—At first, 25 mg once a day, taken either in the morning or evening. Your doctor may adjust your dose as needed. However, the dose is usually not more than 200 mg per day.
  - Children younger than 6 years of age—Use and dose must be determined by your doctor.
- For panic disorder, posttraumatic stress disorder, or social anxiety disorder:
  - Adults—At first, 25 milligrams (mg) once a day, taken either in the morning or evening. Your doctor may adjust your dose as needed. However, the dose is usually not more than 200 mg per day.
  - Children—Use and dose must be determined by your doctor.
- For premenstrual dysphoric disorder:
  - Adults—At first, 50 milligrams (mg) once a day throughout your menstrual cycle or just during the premenstrual time. Your doctor may adjust your dose as needed. However, the dose is usually not more than 150 mg per day throughout your menstrual cycle or 100 mg per day if you are only taking it during your premenstrual time.
  - Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions

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. Blood tests may be needed to check for unwanted 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 14 days after you stop a MAO inhibitor and wait 14 days after stopping sertraline before you start taking a MAO inhibitor. If you take them together or do not wait 14 days, 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, meperidine, methadone, rizatriptan, sumatriptan, tramadol, Demerol®, Frova®, Imitrex®, Maxalt®, Methadose®, 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, including 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, including NSAIDs (eg, aspirin, 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.

Check with your doctor right away if you have chest pain or discomfort, fainting, irregular or slow heart rate, or trouble breathing. These may be symptoms of heart rhythm problems, including QT prolongation and torsades de pointes.

Check with your doctor right away if you have decreased interest in sexual intercourse, delayed or inability to have and orgasm in women, inability to have or keep an erection in men, or loss in sexual ability, desire, drive, or performance. These could be symptoms of sexual dysfunction.

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 including 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.

Side Effects

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 interest in sexual intercourse
failure to discharge semen (in men)
inability to have or keep an erection
loss in sexual ability, desire, drive, or performance

Less common or rare

Aggressive reaction
breast tenderness or enlargement
confusion
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
seizures
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

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, discomfort, or tightness
chills
clay-colored stools
cough or hoarseness
darkened urine
decreased urine output
decreased vision
delayed or inability to have an orgasm
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
stomach pain
sweating
swelling of the face, ankles, or hands
swollen or painful glands
talking or acting with excitement you cannot control
trouble 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 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

Decrease in smell
flushed, dry skin
fruit-like breath odor
increased hunger
increased urination
loss of sense of smell
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.

Portions of this document last updated: April 01, 2024

Original article: https://www.mayoclinic.org/drugs-supplements/sertraline-oral-route/side-effects/drg-20065940

Sertraline (Oral Route)

Description and Brand Names

US Brand Name

Descriptions

Before Using

Allergies

Pediatric

Geriatric

Breastfeeding

Drug Interactions

Other Interactions

Other Medical Problems

Proper Use

Dosing

Missed Dose

Storage

Precautions

Side Effects

More common

Less common or rare

Incidence not known

More common

Less common

Incidence not known

Mayo Clinic Footer

Legal Conditions and Terms

Advertising

Reprint Permissions