Patient Info - Sertraline
Sertraline is used to treat many conditions including the following; depression, obsessive-compulsive disorder (OCD), panic disorder, premenstrual dysphoric disorder (PMDD), posttraumatic stress disorder (PTSD), social anxiety disorder (SAD) and Premature Ejaculation(PE).
Though the exact cause of PE is not known, serotonin may play a role. Serotonin is a natural substance made by nerves. High amounts of serotonin in the brain increase the time to ejaculation. Low amounts can shorten the time to ejaculation, and lead to PE.
Doctors noticed that men and women on antidepressants have delayed orgasms. Drugs such as fluoxetine, paroxetine, sertraline and clomipramine affect serotonin levels. Doctors began to use these drugs "off-label" (for a different reason than the drug's original use) to treat PE.
Sertraline belongs to a group of medicines known as selective serotonin reuptake inhibitors (SSRIs). It works by increasing the activity of serotonin in the brain. This medicine is available only with your doctor's prescription.
Drugs for PE can be taken every day or only before sex. Most doctors suggest a single dose from 4 to 8 hours before sex. If drugs such as Sertraline are taken every day then the risk of adverse effects and drug interactions is increased. Therefore, our hims physicians DO NOT recommend using this medicine everyday and prefer an “as needed” approach to treatment.
Proper Use of this medication
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. It is very important that you read and understand this information. Be sure to ask your doctor about anything you do not understand. The tablets may be taken with or without food.
Dosing of Sertraline for PE
Our hims physicians recommend a single 50mg tablet to be taken 4-8 hours before sex. You will be provided with a total of 5 pills per month initially. We are NOT recommending the daily use of Sertraline for PE at this time.
Use & Storage of Sertraline
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 Do not keep outdated medicine or medicine no longer needed.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.
Before using Sertraline for PE
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:
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.
Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of sertraline in the elderly. However, elderly patients may be more sensitive to the effects of this medicine than younger adults, and are more likely to have hyponatremia (low sodium in the blood), which may require caution and an adjustment in the dose for patients receiving sertraline.
Drug Interactions with Sertraline
Please note that these possible interactions will be more common if you take Sertraline daily. We do NOT recommend daily use for PE at this time. 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;
- Methylene Blue
Using Sertraline 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;
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
If you uncertain about the possibility of a drug interaction with Sertraline please consult with your doctor. You can also use an online drug-to-drug interaction checker.
Important Medical Problems
The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially;
- Bipolar disorder (mood disorder with mania and depression), or risk of or
- Bleeding problems or
- Diabetes or
- Glaucoma, angle-closure, or history of or
- Hyponatremia (low sodium in the blood) or
- Mania or hypomania, history of or
- Purpura (purplish or brownish-red discoloration of the skin), history of or
- Seizures, history of—Use with caution. May make these conditions worse.
- Liver disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.
Do not take sertraline with a monoamine oxidase (MAO) inhibitor (eg, isocarboxazid Marplan®, phenelzine Nardil®, selegilineEldepryl®, tranylcypromine Parnate®). Do not start taking sertraline during the 2 weeks after you stop a MAO inhibitor and wait 2 weeks after stopping sertraline before you start taking a MAO inhibitor. If you take them together or do not wait 2 weeks, you may develop confusion, agitation, restlessness, stomach or intestinal symptoms, a sudden high body temperature, an extremely high blood pressure, or severe convulsions.
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, rizatriptan, sumatriptan, tramadol, Frova®, Imitrex®, Maxalt®, 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 start to feel more depressed and have thoughts about hurting yourself. Report any unusual thoughts or behaviors that trouble you especially if they are new or get worse quickly. Make sure the doctor knows if you have trouble sleeping, get upset easily, have a big increase in energy, or start to act reckless. Also tell the doctor if you have sudden or strong feelings, such as feeling nervous, angry, restless, violent, or scared. Let the doctor know if you 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 are also using other medicines that thin the blood, such as aspirin, NSAID pain or arthritis medicines (eg, 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 have headache, trouble concentrating, memory problems, confusion, weakness, or unsteadiness.
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.
Before you have any medical tests, tell the medical doctor in charge that you or are taking this medicine.
The results of some tests may be affected by this medicine.
What happens if I overdose
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
To learn more about Sertraline we recommend accessing the Prescribers Digital Reference (PDR).
Information reviewed by Adrian Rawlinson MD, Vice President of Medical Affairs, Hims,Inc.