sertraline hydrochloride tablets
Consumer Medicine Information
WHAT IS IN THIS LEAFLET
This leaflet answers some common questions about Sertraline Sandoz.
It does not contain all the available information. It does not take the place of talking to your doctor or pharmacist.
All medicines have risks and benefits. Your doctor has weighed the risks of you taking this medicine against the benefits they expect it will have for you.
If you have any concerns about taking this medicine, ask your doctor or pharmacist.
Keep this leaflet with the medicine. You may need to read it again.
WHAT SERTRALINE SANDOZ IS USED FOR
This medicine is used to treat depression and conditions called obsessive compulsive disorder (OCD) and panic disorder.
It contains the active ingredient sertraline hydrochloride.
Sertraline hydrochloride belongs to a group of medicines called selective serotonin reuptake inhibitors (SSRIs).
It works by blocking the uptake of a chemical called serotonin into nerve cells in the brain. Serotonin and other chemicals called amines are involved in controlling mood.
Ask your doctor if you have any questions about why this medicine has been prescribed for you. Your doctor may have prescribed it for another reason.
There is no evidence that Sertraline Sandoz is addictive.
BEFORE YOU TAKE SERTRALINE SANDOZ
When you must not take it
Do not take this medicine if you have an allergy to:
- sertraline hydrochloride, the active ingredient, or to any of the other ingredients listed at the end of this leaflet under Product description
- any other similar medicines such as other medicines in the same class (SSRIs).
Some of the symptoms of an allergic reaction may include:
- shortness of breath
- wheezing or difficulty breathing
- swelling of the face, lips, tongue or other parts of the body
- rash, itching or hives on the skin.
Do not take this medicine if you have or have had any of the following medical conditions:
- epilepsy not properly controlled by medication.
Do not take this medicine if you are taking another medicine for depression called a monoamine oxidase inhibitor (MAOI) or have been taking it within the last 14 days.
Taking Sertraline Sandoz with a MAOI such as moclobemide (Aurorix®), selegiline (Eldepryl®), phenelzine (Nardil®) and tranylcypromine (Parnate®) may cause a serious reaction with a sudden increase in body temperature, extremely high blood pressure and convulsions (fits).
Do not take this medicine if you are taking:
- tramadol, used for pain relief
- medicines used to treat migraine e.g. sumatriptan (Imigran®)
- phentermine, used to help weight loss.
These medicines can cause an exaggerated response to Sertraline Sandoz.
Do not take this medicine if you are taking pimozide (Orap®), used to treat disturbances in thinking, feeling and behaviour.
Ask your doctor or pharmacist if you are not sure if you have been taking one of these medicines.
Do not give this medicine to children unless the doctor has prescribed it for the treatment of OCD. Sertraline Sandoz is not suitable for children under 6 years of age.
Do not take this medicine after the expiry date printed on the pack or if the packaging is torn or shows signs of tampering. If it has expired or is damaged, return it to your pharmacist for disposal.
If you are not sure whether you should start taking this medicine, talk to your doctor.
Before you start to take it
Tell your doctor if you have allergies to any other medicines, foods, preservatives or dyes.
Tell your doctor if you are pregnant or plan to become pregnant. The effects of Sertraline Sandoz on the developing baby are not yet known. There have been reports that babies exposed to sertraline hydrochloride and other antidepressants during the second or third trimester of pregnancy may develop complications after birth.
Tell your doctor if you are breastfeeding or wish to breastfeed. Sertraline Sandoz passes into breast milk and may affect your baby.
Your doctor will discuss the risks and benefits of using this medicine when pregnant or breastfeeding.
Tell your doctor if you have or have had any of the following medical conditions:
- epilepsy or seizures (fits)
- liver or kidney problems
- any other mental illness
- a tendency to bleed more than normal.
If you have not told your doctor about any of the above, tell him/her before you start taking Sertraline Sandoz.
Taking other medicines
Tell your doctor or pharmacist if you are taking any other medicines, including any that you get without a prescription from your pharmacy, supermarket or health food shop.
Some medicines and Sertraline Sandoz may interfere with each other. These include:
- monoamine oxidase inhibitors (MAOIs), medicines used for the treatment of depression. Taking Sertraline Sandoz with, or within 14 days of stopping a MAOI may cause a serious reaction with a sudden increase in body temperature, extremely high blood pressure and convulsions.
- pimozide (Orap®), used to treat disturbances in thinking, feeling and behaviour
- medicines that can increase the effects of Sertraline Sandoz such as phentermine (weight-reducing medicines), medicines used to treat migraine e.g. sumatriptan, tramadol (used for pain relief) and tryptophan.
Tell your doctor if you are taking any of the following. You may respond differently to Sertraline Sandoz, or to some other medicines, if you take them together. These include (not all brands given):
- medicines used for depression, panic disorder, social anxiety disorder, obsessive illnesses (e.g. Prothiaden®, Prozac®, Aropax®, Luvox®, Cipramil®, Efexor®) or premenstrual dysphoric disorder (e.g. Prozac®, Lovan®)
- St John's wort, a herbal remedy used to treat mood disorders
- clozapine (e.g. Clozaril®), a medicine used to treat schizophrenia
- medicines used to relieve pain, swelling and other symptoms of inflammation, including arthritis (e.g. aspirin or NSAIDs such as ibuprofen or diclofenac)
- lithium (e.g. Lithicarb®), a medicine used to treat mood swings
- medicines for irregular heart beat e.g. flecainide (Tambocor®)
- warfarin (e.g. Marevan®, Coumadin®) or other medicines that stop the blood from clotting
- cimetidine (e.g. Tagamet®), a medicine used to treat reflux and ulcers
- phenytoin (e.g. Dilantin®), a medicine used to treat epilepsy
- sumatriptan (e.g. Imigran®), a medicine used to treat migraine
- diazepam or other medicines that act on the brain or nervous system (e.g. Serepax®, Valium®)
- methadone, a medicine used to treat drug addiction
- tolbutamide (e.g. Rastinon®), a medicine used to treat diabetes.
These medicines may be affected by Sertraline Sandoz, or may affect how well it works. You may need different amounts of your medicines, or you may need to take different medicines.
Your doctor or pharmacist has more information on medicines to be careful with or avoid while taking this medicine.
HOW TO TAKE SERTRALINE SANDOZ
Follow all directions given to you by your doctor or pharmacist carefully. They may differ from the information contained in this leaflet.
If you do not understand the instructions, ask your doctor or pharmacist for help.
How much to take
For depression in adults, the usual starting dose is one Sertraline Sandoz 50mg tablet each day. The dose can be increased gradually up to a maximum dose of 200mg a day if necessary.
For obsessive compulsive disorder in children (6-12 years) the usual starting dose is 25 mg per day (half a 50mg Sertraline Sandoz tablet), increasing to 50mg per day after one week.
For obsessive compulsive disorder in adults and adolescents (13-18 years) the usual starting dose is one 50mg Sertraline Sandoz tablet each day.
For panic disorder in adults the usual starting dose is 25mg per day (half a 50mg Sertraline Sandoz tablet), increasing to 50mg per day after one week.
The maximum recommended dose of Sertraline Sandoz for the conditions listed above is 200mg per day.
Ask your doctor or pharmacist if you are unsure of the correct dose for you. They will tell you exactly how much to take.
How to take it
Swallow the tablet(s) with a full glass of water.
The tablets can be broken in half, but should not be chewed.
If you need to break Sertraline Sandoz hold the tablet with both hands and snap along the break-line.
When to take Sertraline Sandoz
Take your medicine at about the same time each day, either in the morning or evening. Taking it at the same time each day will have the best effect. It will also help you remember when to take it.
Sertraline Sandoz can be taken with or without food.
How long to take Sertraline Sandoz
Continue taking your medicine for as long as your doctor tells you. Most medicines for depression take time to work, so do not be discouraged if you do not feel better straight away. It may take 2 to 4 weeks or even longer to feel the full benefit of this medicine.
Even when you feel well, you may need to take Sertraline Sandoz for several months or longer. Continue taking this medicine until your doctor tells you to stop.
If you forget to take it
Take your dose as soon as you remember, and continue to take it as you would normally.
If it is almost time for your next dose, skip the dose you missed and take your next dose when you are meant to.
Do not take a double dose to make up for the dose you missed. This may increase the chance of you getting an unwanted side effect.
If you are not sure what to do, ask your doctor or pharmacist.
If you have trouble remembering when to take your medicine, ask your pharmacist for some hints.
If you take too much (overdose)
Immediately telephone your doctor or the Poisons Information Centre (telephone 13 11 26 or New Zealand 0800 POISON or 0800 764766) for advice, or go to Accident and Emergency at the nearest hospital, if you think that you or anyone else has taken too much Sertraline Sandoz. Do this even if there are no signs of discomfort or poisoning. You may need urgent medical attention.
If you take too many tablets you may feel drowsy, sick in the stomach (nausea, vomiting or diarrhoea), have a fast heart beat, suffer from tremors, feel agitated or dizzy. Coma has also been reported with overdose.
WHILE YOU ARE TAKING SERTRALINE SANDOZ
Things you must do
If you are about to be started on any new medicine, remind your doctor and pharmacist that you are taking Sertraline Sandoz.
Tell any other doctors, dentists and pharmacists who treat you that you are taking this medicine.
If you become pregnant while taking this medicine, tell your doctor immediately. If you are a woman of child-bearing age, you should avoid becoming pregnant while taking Sertraline Sandoz.
Tell your doctor immediately if you have any suicidal thoughts or other mental/mood changes.
A worsening of depressive symptoms including thoughts of suicide or self-harm may occur in the first one or two months of you taking this medicine or when the doctor changes your dose. These symptoms should be controlled when the full effect of Sertraline Sandoz takes place.
Children, adolescents or young adults under the age of 24 years are more likely to experience these effects during the first few months of treatment.
Patients and caregivers should be alert and monitor for these effects.
Signs and symptoms of suicide include:
- thoughts or talk of death or suicide
- thoughts or talk of self-harm or harm to others
- any recent attempts of self-harm
- increase in aggressive behaviour, irritability or agitation
- worsening of depression.
Mentions of suicide or violence must be taken seriously.
If you or someone you know is demonstrating these warning signs of suicide while taking Sertraline Sandoz, contact your doctor or a mental health professional right away.
Things you must not do
Do not take Sertraline Sandoz to treat any other complaints unless your doctor tells you to.
Do not give your medicine to anyone else, even if they have the same condition as you.
Do not stop taking your medicine or change the dose without checking with your doctor. Suddenly stopping Sertraline Sandoz can cause dizziness, light headedness, numbness, unusual tingling feelings or shakiness.
Do not let yourself run out of tablets over the weekend or on holidays.
Things to be careful of
Be careful driving or operating machinery until you know how Sertraline Sandoz affects you. Some medicines for depression may affect your ability to drive or operate machinery or do things that could be dangerous if you are not alert.
Although drinking moderate amounts of alcohol is unlikely to affect your response to Sertraline Sandoz, your doctor may suggest avoiding alcohol while you are taking this medicine.
You should wait at least 14 days after stopping Sertraline Sandoz before starting medicines for depression or obsessive illnesses from the MAOI medicine group such as moclobemide (Aurorix®), selegiline (Eldepryl®), phenelzine (Nardil®) and tranylcypromine (Parnate®). All of the above precautions are important even after you have stopped taking Sertraline Sandoz.
The effects of Sertraline Sandoz may last for some days after you have stopped taking it.
Tell your doctor or pharmacist as soon as possible if you do not feel well while you are taking Sertraline Sandoz. All medicines can have side effects. Sometimes they are serious, most of the time they are not. You may need medical attention if you get some of the side effects.
Do not be alarmed by the following lists of side effects. You may not experience any of them.
Ask your doctor or pharmacist to answer any questions you may have.
Tell your doctor or pharmacist if you notice any of the following and they worry you:
- headache, dizziness, shakiness, tingling or numbness of the hands and feet, muscle stiffness or weakness, decrease or loss of touch or other senses
- dry mouth, increased sweating, feeling sick, diarrhoea, constipation, indigestion, vomiting, stomach pain
- tiredness, hot flushes, fever, feeling unwell
- weight increase or loss
- sleeping difficulties, sleepiness
- sexual problems
- agitation, nervousness, anxiety, frightening dreams, yawning, abnormal thinking, teeth grinding, loss of appetite, impaired concentration
- menstrual irregularities
- loss of control of your bladder
- shaking or tremors
- vision disturbance
- unusual hair loss or thinning
- swelling of hands, ankles or feet
- breast enlargement in men or the unusual secretion of breast milk in men or women
- increased sensitivity of the skin to sun
- ringing or other persistent noise in the ears
- unusually overactive.
These side effects are usually mild.
If any of the following happen tell your doctor immediately or go to Accident and Emergency at your nearest hospital:
- fits or seizures
- signs of allergy such as rash or hives, swelling of the face, lips or tongue, wheezing or difficulty breathing
- symptoms of agitation, anxiety, confusion, dizziness, feeling tense and restless, feeling of tiredness, drowsiness, or lack of energy, irritability, trouble sleeping, headache, nausea and tingling or numbness of the hands and feet after stopping Sertraline Sandoz
- symptoms of sudden fever with sweating, fast heart beat and muscle stiffness, which may lead to loss of consciousness
- palpitations, fainting or chest pain
- abnormal bleeding
- difficulty in passing urine or blood in the urine
- severe blisters and bleeding in the lips, eyes, mouth, nose and genitals
- fever, sore throat, swollen glands, mouth ulcers, unusual bleeding or bruising under the skin.
The above list includes very serious side effects. You may need urgent medical attention or hospitalisation. These side effects are usually rare.
Tell your doctor if you notice anything else that is making you feel unwell. Other side effects not listed above may also occur in some people.
AFTER TAKING SERTRALINE SANDOZ
Keep your medicine in the original container. If you take it out of its original container it may not keep well.
Keep your medicine in a cool dry place where the temperature stays below 25°C.
Do not store Sertraline Sandoz or any other medicine in the bathroom or near a sink. Do not leave it on a window sill or in the car. Heat and dampness can destroy some medicines.
Keep it where children cannot reach it. A locked cupboard at least one-and-a-half metres above the ground is a good place to store medicines.
If your doctor tells you to stop taking this medicine or the expiry date has passed, ask your pharmacist what to do with any medicine that is left over.
What it looks like
Sertraline Sandoz comes in two types of tablets:
- Sertraline Sandoz 50mg - white, capsule shaped, scored, film-coated tablet, marked with SE|50 on one side.
- Sertraline Sandoz 100mg - white, capsule shaped, scored, film-coated tablet, marked with SE|100 on one side.
Available in blisters of 30 tablets.
- Sertraline Sandoz 50mg - 50mg sertraline hydrochloride
- Sertraline Sandoz 100mg - 100mg sertraline hydrochloride.
- microcrystalline cellulose
- calcium hydrogen phosphate
- sodium starch glycollate
- magnesium stearate
- purified talc
- titanium dioxide.
This medicine does not contain lactose, sucrose, gluten, tartrazine or any other azo dyes.
Sandoz Pty Ltd
ABN 60 075 449 553
19 Harris St
Pyrmont NSW 2009
Tel: 1800 634 500
Novartis New Zealand Ltd
Private Bag 65904 Mairangi Bay
Tel: 0800 354 335
This leaflet was revised in September 2011.
Australian Register Numbers
50mg tablets: AUST R 98697 (blisters)
100mg tablets: AUST R 98698 (blisters)
Published by MIMS October 2012