sertraline, Zoloft (cont.)

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Medical and Pharmacy Editor:

Cimetidine (Tagamet) may increase the levels in blood of sertraline by reducing the elimination of sertraline by the liver. Increased levels of sertraline may lead to more side effects.

Sertraline 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 sertraline.

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

PREGNANCY: Use of sertraline during the 3rd trimester of pregnancy may lead to adverse effects in the newborn.

NURSING MOTHERS: Use of sertraline by nursing mothers has not been adequately evaluated.

SIDE EFFECTS: The most common side effects of sertraline are sleepiness, nervousness, insomnia, dizziness, nausea, tremor, skin rash, upset stomach, loss of appetite, headache, diarrhea, abnormal ejaculation, dry mouth and weight loss. Important side effects are irregular heartbeats, allergic reactions and activation of mania in patients with bipolar disorder.

If sertraline is discontinued abruptly, some patients experience symptoms such as abdominal cramps, flu-like symptoms, fatigue and memory impairment. Although this reaction is not well established, it is reasonable to gradually reduce the dose of sertraline when therapy is discontinued.

Medically Reviewed by a Doctor on 6/7/2013


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