Zosert 25 mg Tablet

SSRI antidepressant for:

• Major depression (treatment and relapse prevention)
• Obsessive-compulsive disorder (adults and children 6 years and over)
• Panic disorder, social anxiety disorder
• Post-traumatic stress disorder (PTSD)
• Premenstrual dysphoric disorder (off-label in some countries)

Adults:

• Depression and OCD: 50 mg once daily; increase by 50 mg at intervals of at least 1 week up to 200 mg daily.
• Panic, PTSD, social anxiety: start 25 mg daily for 1 week, then 50 mg; increase as needed up to 200 mg.

Children (OCD): 6–12 years: start 25 mg daily; 13–17 years: start 50 mg daily; max 200 mg.

• Once daily, morning or evening, with or without food.
• Improvement usually starts in 2–4 weeks; continue at least 6 months after recovery.
• Do not stop suddenly — taper gradually.
• Liver impairment: lower doses.

• Use with MAO inhibitors (or within 14 days), linezolid, methylene blue
• Use with pimozide
• Allergy to sertraline

Very common: nausea, diarrhoea, insomnia, drowsiness, dizziness, headache, dry mouth, tiredness, sexual problems (delayed ejaculation, reduced libido).

Common: sweating, tremor, indigestion, loss of appetite, anxiety or agitation at the start, palpitations, yawning.

Rare but serious: suicidal thoughts (especially under 25), serotonin syndrome, low sodium (elderly), bleeding, seizures, mania, QT prolongation, angle-closure glaucoma.

• Watch closely for worsening mood or suicidal thoughts in the first weeks and with dose changes.
• Epilepsy, bipolar disorder, bleeding disorders, liver disease, elderly: caution.
• May affect driving initially; avoid alcohol.
• Withdrawal symptoms (dizziness, irritability, "electric shock" sensations) if stopped abruptly.

Often the preferred SSRI when treatment is needed in pregnancy and breastfeeding (low levels in milk); decide with the doctor. Newborns exposed late may have temporary withdrawal or breathing symptoms.

• MAO inhibitors, linezolid (contraindicated); tramadol, triptans, other antidepressants, lithium, St John's wort (serotonin syndrome)
• Aspirin, NSAIDs, warfarin, clopidogrel (bleeding)
• Pimozide (contraindicated); other QT drugs
• Rifampicin, carbamazepine (lower levels)
• Alcohol

Drowsiness, nausea, vomiting, fast heartbeat, tremor, agitation, seizures; serotonin syndrome. Emergency care.

Store below 30°C.