Sertraline
ApoSerta contains the active substance sertraline. Sertraline belongs to a group of medicines called selective serotonin reuptake inhibitors (SSRIs); these medicines are used to treat depression and/or anxiety disorders.
depression and prevention of depression relapse (in adults),
social anxiety disorder (in adults),
post-traumatic stress disorder (PTSD) (in adults),
panic disorder (in adults),
obsessive-compulsive disorder (OCD) (in adults and children and adolescents aged 6-17 years).
Depression is a condition in which you may feel sad, have sleep problems, and/or lose interest in activities that previously brought you pleasure.
Obsessive-compulsive disorder (OCD) and panic disorder are anxiety-related conditions, characterized by persistent, intrusive thoughts (obsessions), which cause repetitive behaviors (compulsive acts).
Post-traumatic stress disorder (PTSD) is a condition that can occur after a traumatic experience and is characterized by symptoms similar to depression and anxiety. Social anxiety disorder (social phobia) is an anxiety-related condition, characterized by feelings of intense anxiety or stress in social situations (such as talking to strangers, speaking in front of a group of people, eating or drinking in front of others, or fear of potentially embarrassing behavior).
Your doctor has decided that this medicine is suitable for treating your condition. You should consult your doctor if you are unsure why you have been prescribed ApoSerta.
if you are allergic to sertraline or any of the other ingredients of this medicine (listed in section 6);
if you are taking or have taken monoamine oxidase inhibitors (MAOIs, e.g., selegiline, moklobemide) or other MAOI-like drugs (e.g., linezolid). If you stop taking sertraline, you should wait at least one week before starting an MAOI. After stopping an MAOI, you should wait at least two weeks before starting sertraline;
if you are taking pimozide (a medicine used to treat certain psychiatric disorders, such as psychosis).
Before taking ApoSerta, discuss this with your doctor or pharmacist.
Medicines do not always work in the same way for everyone.
Before taking ApoSerta, tell your doctor or pharmacist if you have or have had any of the following conditions:
Medicines like ApoSerta (SSRIs or SNRIs) may cause sexual dysfunction (see section 4). In some cases, these symptoms have persisted after stopping treatment.
Sertraline treatment has been associated with the development of a condition characterized by restlessness, feeling compelled to move, and an inability to sit or stand still (akathisia). This condition usually occurs within the first few weeks of treatment. Increasing the dose may be harmful; if such symptoms occur, you should discuss them with your doctor.
Discontinuation symptoms (withdrawal symptoms) are common, especially if treatment is stopped abruptly (see section 3: Stopping ApoSerta and section 4: Possible side effects). The risk of withdrawal symptoms depends on the duration of treatment, dosage, and rate of dose reduction. These symptoms are usually mild or moderate, but in some patients, they can be severe. They usually occur within the first few days after stopping treatment. They usually resolve on their own within two weeks, but in some patients, they can persist for longer (2-3 months or longer). If your doctor decides to stop your treatment with sertraline, it is recommended to gradually reduce the dose over several weeks or months, and you should always discuss the best way to stop treatment with your doctor.
Patients with depression or anxiety disorders may sometimes have thoughts of self-harm or suicide. Such symptoms or behavior may worsen at the beginning of treatment with antidepressant medicines, as these medicines start to work usually after 2 weeks, sometimes later.
If you experience suicidal thoughts or self-harm, you should immediately contact your doctor or go to the hospital.
Sertraline should not be used in children and adolescents under 18 years of age, except for patients with obsessive-compulsive disorder (OCD). In patients under 18 years of age, the use of medicines of this type has been associated with an increased risk of side effects, such as suicidal attempts, suicidal thoughts, and hostility (mainly aggressive, oppositional, and angry behavior). However, your doctor may decide to prescribe ApoSerta to a patient under 18 years of age if it is in the patient's best interest. If your doctor prescribes ApoSerta to a patient under 18 years of age and the patient's caregiver wants to discuss this, they should contact the doctor. Furthermore, if the patient under 18 years of age experiences any of the above symptoms while taking ApoSerta, the caregiver should inform the doctor. In a long-term observational study lasting 3 years, involving over 900 children aged 6-16 years, the safety of long-term sertraline treatment was evaluated in terms of its effect on growth, maturation, learning (cognitive function), and behavior. In general, the study results showed that children treated with sertraline developed normally, except for a small increase in body weight in children treated with a higher dose.
Tell your doctor about all medicines you are taking now or have taken recently, as well as any medicines you plan to take.
Some medicines may affect the way ApoSerta works or ApoSerta may reduce the effectiveness of other medicines taken at the same time.
Some medicines may increase the side effects of ApoSerta and sometimes cause very serious reactions. While taking ApoSerta, do not take any other medicines without consulting your doctor, especially:
ApoSerta film-coated tablets can be taken with or without food.
During treatment with ApoSerta, you should avoid consuming alcohol.
You should not take ApoSerta with grapefruit juice, as it may increase the levels of sertraline in your body.
If you are pregnant or breastfeeding, think you may be pregnant, or plan to have a baby, ask your doctor or pharmacist for advice before taking this medicine.
The safety of sertraline in pregnant women has not been fully established. Sertraline may be taken during pregnancy if your doctor considers that the benefits to you outweigh the potential risks to your unborn child.
Taking ApoSerta in the last months of pregnancy may increase the risk of severe bleeding from the uterus, occurring shortly after delivery, especially if you have a history of bleeding disorders. If you are taking ApoSerta, you should inform your doctor or midwife so that they can give you appropriate advice. Treatment with medicines like ApoSerta during pregnancy, especially in the last trimester, may increase the risk of a serious condition in the baby called persistent pulmonary hypertension of the newborn (PPHN), characterized by rapid breathing and blue discoloration of the skin. These symptoms usually occur within the first day of life. If your baby experiences these symptoms, you should immediately contact your midwife or doctor.
Other complications may also occur in newborns, usually within the first 24 hours after birth. Symptoms may include:
If your baby experiences any of these symptoms or if you are concerned about your baby's health, you should contact your doctor or midwife, who will give you advice.
Sertraline passes into breast milk. The medicine can be used in breastfeeding women if your doctor considers that the benefits to you outweigh the potential risks to your baby.
Some medicines, such as sertraline, may decrease sperm quality in animal studies. This could theoretically affect fertility, but no effect on fertility has been observed in humans.
Psychotropic medicines, such as sertraline, may affect your ability to drive or operate machinery. You should wait until you know how ApoSerta affects you before performing these activities.
The medicine contains less than 1 mmol (23 mg) of sodium per film-coated tablet, which is essentially "sodium-free".
Always take this medicine exactly as your doctor or pharmacist has told you. If you are not sure, ask your doctor or pharmacist.
The usual effective dose for treating depression and OCD is 50 mg/day. The daily dose can be increased gradually, by 50 mg, at intervals of at least one week, over several weeks. The maximum recommended dose is 200 mg/day.
Treatment of panic disorder, social anxiety disorder, and post-traumatic stress disorder should start with a dose of 25 mg/day, which can be increased to 50 mg/day after one week. The daily dose can then be increased gradually, by 50 mg, over several weeks. The maximum recommended dose is 200 mg/day.
ApoSerta can be used to treat children and adolescents with obsessive-compulsive disorder (OCD) aged 6-17 years.
Children aged 6-12 years:The recommended starting dose is 25 mg/day. After one week, your doctor may increase the dose to 50 mg/day. The maximum dose is 200 mg/day.
Adolescents aged 13-17 years:The recommended starting dose is 50 mg/day. The maximum dose is 200 mg/day.
Patients with liver or kidney disease should inform their doctor and follow their advice.
Administration:
ApoSerta film-coated tablets can be taken with or without food.
Take the medicine once a day, in the morning or evening.
Your doctor will tell you how long you should take the medicine. The treatment period depends on the type of disease and your response to treatment. Improvement may occur only after several weeks of treatment. Treatment of depression should usually last 6 months from the time improvement is observed.
If you accidentally take too much ApoSerta, you should immediately contact your doctor or go to the emergency department of the nearest hospital. You should take the medicine package with you, regardless of whether there is any medicine left in it or not.
Overdose symptoms may include drowsiness, nausea, and vomiting, rapid heart rate, muscle tremors, agitation, dizziness, and in rare cases, loss of consciousness.
Do not take a double dose of the medicine to make up for a missed dose. If you forget to take a tablet, do not take the missed tablet. Simply take the next tablet at the right time.
You should not stop taking ApoSerta on your own. Your doctor should gradually reduce the dose of ApoSerta over several weeks, until you finally stop taking it. If you suddenly stop taking the medicine, you may experience side effects, such as dizziness, numbness, sleep disturbances, agitation or anxiety, headaches, nausea, vomiting, and muscle tremors. If you experience any of these side effects or any other side effects after stopping ApoSerta, you should contact your doctor.
If you have any further questions about taking this medicine, ask your doctor or pharmacist.
Like all medicines, ApoSerta can cause side effects, although not everybody gets them.
The most common side effect is nausea. Side effects depend on the dose and usually disappear or decrease as treatment continues.
If you experience any of the following symptoms after taking this medicine, as they can be serious:
if you develop a severe skin rash, which can cause blistering (erythema multiforme; blisters can occur in the mouth and on the tongue). These can be symptoms of a condition called Stevens-Johnson syndrome or toxic epidermal necrolysis. In such cases, your doctor will stop treatment.
if you experience an allergic reaction or allergy, with symptoms such as: itchy skin rash, breathing difficulties, wheezing, swelling of the eyelids, face, or lips.
if you experience: agitation, confusion, diarrhea, high temperature and blood pressure, excessive sweating, and rapid heart rate. These are symptoms of serotonin syndrome. In rare cases, this condition can occur when you take certain medicines at the same time as sertraline. Your doctor may then stop the treatment.
if you experience yellowing of the skin and eyes, which may indicate liver damage.
if you experience symptoms of depression with thoughts of self-harm or suicide (suicidal thoughts).
if you start to feel restless and cannot sit or stand still. If you experience such restlessness, you should tell your doctor.
if you experience a seizure (convulsion).
if you experience manic episodes (see section 2 "Warnings and precautions").
The following side effects have been reported in clinical trials with adults and after marketing authorization:
common (may affect up to 1 in 10 people):
cold, sore throat, runny nose,
loss of appetite, increased appetite,
anxiety, depression, agitation, decreased interest in sex, nervousness, feeling strange, nightmares, teeth grinding,
tremors, muscle movement problems (such as increased movement, increased muscle tone, difficulty walking and stiffness, convulsions (muscle contractions without affecting normal muscle movement)), feeling of numbness and tingling, concentration problems, taste disturbances,
vision disturbances,
ringing in the ears,
rapid heartbeat,
hot flushes,
yawning,
gastrointestinal disturbances, constipation, abdominal pain, vomiting, gas,
increased sweating, rash,
back pain, joint pain, muscle pain,
irregular menstrual periods, erectile dysfunction,
general feeling of being unwell, chest pain, weakness, fever,
weight gain,
injuries.
uncommon (may affect up to 1 in 100 people):
diverticulitis, lymphadenopathy, decreased thyroid hormone levels,
allergic reactions, seasonal allergy,
increased cholesterol levels, difficulty controlling blood sugar levels (diabetes), decreased blood sugar levels, increased blood sugar levels*,
decreased sodium levels in the blood*,
physical symptoms caused by stress or emotions, terrifying nightmares*,
drug dependence, sleepwalking, premature ejaculation,
coma, abnormal movements, difficulty moving, increased sensitivity, sudden severe headache (which may be a symptom of a serious condition called reversible cerebral vasoconstriction syndrome, RCVS)*, sensory disturbances, visual disturbances*, glaucoma*, double vision*, eye pain caused by light*, blood in the eye*, uneven pupil size*, vision disturbances*, problems with tear production*,
heart attack, dizziness, fainting or discomfort in the chest, which may be symptoms of changes in heart electrical activity (visible on an electrocardiogram) or abnormal heart rhythm*, slow heart rate,
circulation problems in the arms and legs,
rapid breathing, progressive scarring of lung tissue (interstitial lung disease)*,
throat obstruction, difficulty speaking, slow breathing, hiccups,
a lung condition in which eosinophils (a type of white blood cell) appear in the lungs in increased numbers (eosinophilic pneumonia),
mouth ulcers, pancreatitis*, blood in stool, mouth ulcers, mouth pain,
liver function disturbances, severe liver function disturbances*, yellowing of the skin and whites of the eyes (jaundice)*,
sunburn*, skin swelling*, abnormal hair structure, abnormal skin odor, hairy skin rash,
muscle breakdown*, bone disturbances,
inability to urinate continuously, decreased urine output,
breast discharge, vaginal dryness, vaginal discharge, breast tenderness, and penile pain and redness,
prolonged erection of the penis*,
hernia, decreased tolerance to the medicine,
increased cholesterol levels in the blood, abnormal laboratory test results*,
abnormal semen analysis, bleeding problems*.
rare (may affect up to 1 in 1,000 people):
appendicitis, lymphadenopathy, decreased platelet count*,
decreased white blood cell count*,
severe allergic reaction,
endocrine disorders*,
high cholesterol levels, difficulty controlling blood sugar levels (diabetes), low blood sugar levels, high blood sugar levels*,
low sodium levels in the blood*,
physical symptoms caused by stress or emotions, terrifying nightmares*,
drug dependence, sleepwalking, premature ejaculation,
coma, abnormal movements, difficulty moving, increased sensitivity, sudden severe headache (which may be a symptom of a serious condition called reversible cerebral vasoconstriction syndrome, RCVS)*, sensory disturbances, visual disturbances*, glaucoma*, double vision*, eye pain caused by light*, blood in the eye*, uneven pupil size*, vision disturbances*, problems with tear production*,
heart attack, dizziness, fainting or discomfort in the chest, which may be symptoms of changes in heart electrical activity (visible on an electrocardiogram) or abnormal heart rhythm*, slow heart rate,
circulation problems in the arms and legs,
rapid breathing, progressive scarring of lung tissue (interstitial lung disease)*,
throat obstruction, difficulty speaking, slow breathing, hiccups,
a lung condition in which eosinophils (a type of white blood cell) appear in the lungs in increased numbers (eosinophilic pneumonia),
mouth ulcers, pancreatitis*, blood in stool, mouth ulcers, mouth pain,
liver function disturbances, severe liver function disturbances*, yellowing of the skin and whites of the eyes (jaundice)*,
sunburn*, skin swelling*, abnormal hair structure, abnormal skin odor, hairy skin rash,
muscle breakdown*, bone disturbances,
inability to urinate continuously, decreased urine output,
breast discharge, vaginal dryness, vaginal discharge, breast tenderness, and penile pain and redness,
prolonged erection of the penis*,
hernia, decreased tolerance to the medicine,
increased cholesterol levels in the blood, abnormal laboratory test results*,
abnormal semen analysis, bleeding problems*.
frequency not known (frequency cannot be estimated from the available data):
jaw pain*,
bedwetting*,
partial loss of vision*,
inflammation of the colon (causing diarrhea),
severe bleeding from the uterus, occurring shortly after delivery (postpartum hemorrhage), see additional information in subsection Pregnancy, breastfeeding, and fertility in section 2.
* Side effects reported after marketing authorization.
In clinical trials with children and adolescents, side effects were generally similar to those in adults (see above). The most common side effects in children and adolescents were headaches, insomnia, diarrhea, and nausea.
After stopping treatment with ApoSerta, you may experience side effects, such as dizziness, numbness, sleep disturbances, agitation or anxiety, headaches, nausea, vomiting, and muscle tremors (see section 3. Stopping ApoSerta).
Patient groups treated with this type of medicine have shown an increased risk of bone fractures.
If you experience any side effects, including those not listed in this leaflet, you should inform your doctor or pharmacist. Side effects can be reported directly to the Department of Drug Safety, Urząd Rejestracji Produktów Leczniczych, Wyrobów Medycznych i Produktów Biobójczych, Al. Jerozolimskie 181C, 02-222 Warsaw, tel.: +48 22 49 21 301, fax: +48 22 49 21 309, website: https://smz.ezdrowie.gov.pl
Side effects can also be reported to the representative of the marketing authorization holder.
Reporting side effects will help to gather more information on the safety of this medicine.
Keep this medicine out of the sight and reach of children.
Do not use this medicine after the expiry date stated on the blister and carton after "EXP". The expiry date refers to the last day of that month.
There are no special storage instructions for this medicine.
Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. This will help protect the environment.
The active substance is sertraline.
ApoSerta, 50 mg, film-coated tablets:
Each film-coated tablet contains sertraline hydrochloride, equivalent to 50 mg of sertraline.
ApoSerta, 100 mg, film-coated tablets:
Each film-coated tablet contains sertraline hydrochloride, equivalent to 100 mg of sertraline.
Other ingredients are:
Tablet core:microcrystalline cellulose (PH-101), sodium carboxymethylcellulose (type A), hydroxypropylcellulose, calcium phosphate dihydrate, magnesium stearate.
Tablet coating:Opadry White OY-S-7355 containing titanium dioxide (E 171), hypromellose 5cp (low viscosity), macrogol 400, polysorbate 80.
Film-coated tablets.
ApoSerta, 50 mg, film-coated tablets
White, biconvex, capsule-shaped, with "A" embossed on one side and a score line between the "8" and "1" on the other. Size: 10.5 mm x 4.3 mm.
The tablet can be divided into equal doses.
ApoSerta, 100 mg, film-coated tablets
White, biconvex, capsule-shaped, with "A" embossed on one side and "82" on the other. Size: 13.3 mm x 5.3 mm.
ApoSerta film-coated tablets are available in blisters, packed in cardboard boxes.
Pack sizes: 20, 30, 60, or 100 film-coated tablets.
Not all pack sizes may be marketed.
Aurovitas Pharma Polska Sp. z o.o.
ul. Sokratesa 13D lokal 27
01-909 Warsaw
e-mail: medicalinformation@aurovitas.pl
APL Swift Services (Malta) Limited
HF26, Hal Far Industrial Estate, Hal Far
Birzebbugia, BBG 3000
Malta
Generis Farmacêutica, S.A.
Rua João de Deus, 19
2700-487 Amadora
Portugal
Czech Republic: Sertraline Aurovitas
Malta: Sertraline Aurobindo 50 mg/100 mg film-coated tablets
Poland: ApoSerta
Portugal: Sertralina Aurovitas
Spain: Sertralina Aurovitas 50 mg/100 mg film-coated tablets EFG
Need help understanding this medicine or your symptoms? Online doctors can answer your questions and offer guidance.