Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Act Sertraline.
Bleeding: Act Sertraline may increase the risk of bleeding, especially if you are also taking medications such as acetylsalicylic acid (Asa), nonsteroidal anti-inflammatory drugs (NSAIDs; e.g., Ibuprofen, Naproxen, Ketoprofen), or Warfarin. If you experience easy bruising, pinpoint-sized red spots on the skin, or unusual bleeding while taking Act Sertraline, contact your doctor immediately.
Bones: Sertraline may increase the risk of bone fracture, especially if you are a senior or have Osteoporosis or other major risk factors for breaking a bone. Take extra care to avoid falls, especially if you get dizzy or have Low Blood Pressure. Your doctor may monitor your bones while you are taking Act Sertraline.
Diabetes: Sertraline may cause a loss of blood sugar control (increased or decreased blood sugar) for some people who have diabetes and glucose tolerance may change. If you have diabetes, monitor your blood sugar closely and report any changes to your doctor.
If you have diabetes or are at risk for developing diabetes, discuss with your doctor how Act Sertraline may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Act Sertraline, and whether any special monitoring is needed.
Drowsiness/reduced alertness: Act Sertraline may impair judgment, thinking, or motor skills. People using sertraline should avoid driving a car or operating hazardous machinery until they determine whether or not the medication affects them in this way.
Glaucoma: Sertraline may cause an increase in pressure in the eyes. It can cause symptoms of glaucoma to become worse. If you have glaucoma, discuss with your doctor how Act Sertraline may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Act Sertraline, and whether any special monitoring is needed.
Heart rhythm: Sertraline can cause changes to the normal rhythm of the heart, including an irregular heartbeat called QT prolongation. QT prolongation is a serious life-threatening condition that can cause fainting, seizures, and sudden death. If you are at risk for heart rhythm problems (e.g., people with heart failure, Angina, low potassium or magnesium levels, family history of QT prolongation), discuss with your doctor how Act Sertraline may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Act Sertraline, and whether any special monitoring is needed.
Liver function: Liver disease or reduced liver function may cause Act Sertraline to build up in the body, causing side effects. If you have liver problems, discuss with your doctor how Act Sertraline may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Act Sertraline, and whether any special monitoring is needed. Your doctor may want to test your liver function regularly with blood tests while you are taking Act Sertraline.
If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.
Mania: Sertraline may cause activation of mania. This means that people who are prone to mania may be more likely to have their mania start up again. If you have a history of mania or bipolar disorder, your doctor should closely monitor your condition while you are taking Act Sertraline.
Seizures: If you have a history of seizures, your doctor should closely monitor your condition while you are taking sertraline. If you develop seizures, stop taking the medication and contact your doctor.
Serotonin syndrome: Act Sertraline may cause a rare but potentially life-threatening condition called serotonin syndrome, especially when used with other medications that increase serotonin levels (e.g., Sumatriptan, Rizatriptan, Tramadol, St. John's wort). If you experience symptoms such as agitation, confusion, hallucinations, fast heart rate, fever, lack of coordination, increased body temperature, overactive reflexes, nausea, vomiting, and diarrhea, get immediate medical attention.
Sodium levels: Sertraline can occasionally cause low levels of sodium in the blood (hyponatremia). This is more likely to happen to seniors or people who are also taking diuretics (water pills). If you experience confusion, weakness, headache, and memory problems, talk to your doctor as soon as possible. If too much sodium is lost from the body, it can cause hallucinations, confusion, seizures, coma, breathing, and even death.
Stopping the medication: Stopping Act Sertraline suddenly may lead to side effects. If you are thinking of stopping the medication, check with your doctor or pharmacist first. See also "What side effects are possible with Act Sertraline?"
Suicidal or agitated behaviour: People taking Act Sertraline may feel agitated (restless, anxious, aggressive, emotional, and feeling not like themselves), or they may want to hurt themselves or others. These symptoms may occur within several weeks after people start taking Act Sertraline. Your doctor will monitor you closely for emotional and behavioural changes. If you feel suicidal or agitated or notice any other changes in behaviour, talk to your doctor. Family members or caregivers of people who are taking Act Sertraline should contact the person's doctor immediately if they notice unusual behaviour changes.
Pregnancy: Act Sertraline should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Act Sertraline, contact your doctor immediately. There have been some reports that women taking SSRIs such as sertraline during the second half of pregnancy may be associated with lung disorders in newborns. Talk to your doctor if you have any concerns.
Breast-feeding: It is not known if sertraline passes into breast milk. If you are a breast-feeding mother and are taking Act Sertraline, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children and adolescents: The safety and effectiveness of using Act Sertraline have not been established for people under the age of 18 years. The use of Act Sertraline by children below the age of 18 may cause behavioural and emotional changes, such as suicidal thoughts and behaviour.
Seniors: Seniors who take sertraline appear to be more likely to experience low sodium in their blood, which can cause problems with coordination, achy muscles, or confusion. If you experience anything unusual while taking sertraline, contact your doctor.
