Zoloft (sertraline)

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

What is the dosage for Zoloft (sertraline)?

  • The recommended dose of sertraline is 25-200 mg once daily. Treatment of depression, OCD, panic disorder, PTSD, and social anxiety disorder is initiated at 25-50 mg once daily. Doses are increased at weekly intervals until the desired response is seen.
  • The recommended dose for PMDD is 50-150 mg every day of the menstrual cycle or for 14 days before menstruation.
  • Sertraline may be taken with or without food.

Which drugs or supplements interact with Zoloft (sertraline)?

All SSRIs, including Zoloft, should not be taken with any of the monoamine oxidase inhibitor (MAOI) class of antidepressants, for example

  • isocarboxazid (Marplan),
  • phenelzine (Nardil),
  • tranylcypromine (Parnate),
  • selegiline (Eldepryl, Emsam, Elazar), and
  • procarbazine (Matulane).

Other drugs that inhibit monoamine oxidase include

Such combinations may lead to confusion, high blood pressure, tremor, hyperactivity, coma, and death. (A period of 14 days without treatment should lapse when switching between Zoloft and MAOIs.) Similar reactions occur when Zoloft is combined with other drugs for example, tryptophan, St. John's wort, meperidine (Demerol, Meperitab), tramadol (ConZip, Synapryn FusePaq, Ultram) that increase serotonin in the brain.

Cimetidine (Cimetidine Acid Reducer, Tagamet HB ) may increase the levels in blood of Zoloft by reducing the elimination of Zoloft by the liver. Increased levels of Zoloft may lead to more side effects.

Zoloft increases the blood level of pimozide (Orap) by 40%. High levels of pimozide can affect electrical conduction in the heart and lead to sudden death. Therefore, patients should not receive treatment with both pimozide and Zoloft.

Through unknown mechanisms, Zoloft may increase the blood thinning action of warfarin (Coumadin, Jantoven). The effect of warfarin should be monitored when Zoloft is started or stopped.

Is Zoloft (sertraline) safe to use during pregnancy or while breastfeeding?

  • Use of sertraline during the 3rd trimester of pregnancy may lead to adverse effects in the newborn.
  • Use of sertraline by nursing mothers has not been adequately evaluated.

What else should I know about Zoloft (sertraline)?

What preparations of Zoloft (sertraline) are available?
  • Tablets: 25, 50, and 100 mg
  • Oral concentrate: 20 mg/ml
How should I keep Zoloft (sertraline) stored?
  • Sertraline should be stored at room temperature between 15 C and 30 C (59 F and 86 F).
How does Zoloft (sertraline) work?
  • Serotonin is a neurotransmitter (a chemical messenger) produced by nerve cells in the brain that is used by the nerves to communicate with one another. A nerve releases the serotonin it produces into the space surrounding it. The serotonin either travels across the space and attaches to receptors on the surface of nearby nerves, or it attaches to receptors on the surface of the nerve that produced it. It is then taken up by the nerve and released again (a process referred to as re-uptake). A serotonin balance is reached between attachment to the nearby nerves and reuptake. Selective serotonin inhibitors block the reuptake of serotonin, therefore changing the level of serotonin in the brain.
  • It is believed that some illnesses such as depression are caused by disturbances in the balance between serotonin and other neurotransmitters. The leading theory is that drugs such as sertraline restore the chemical balance among neurotransmitters in the brain.
When was Zoloft (sertraline) approved by the FDA?
  • The FDA approved sertraline in December 1991.

Reference: FDA Prescribing Information

Medically Reviewed by a Doctor on 11/29/2016

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