Absorption of sertraline from the gastrointestinal tract significantly, but is slow. Maximum plasma concentration is achieved through 4,5-8,4 hours after ingestion of the drug.The equilibrium concentration of sertraline in blood plasma is achieved within a week for a single daily reception. Bioavailability food during reception increases by 25%, while the time to reach maximum concentration is shortened.
Distribution. Total binding sertraline plasma chlorodehydromethyltestosterone reviews for horrible bosses protein is 98%. The volume of distribution> 20L / kg. Metabolism and excretion. Sertraline is extensively metabolized during the first passage through the liver, subjected to N-demethylation. Its main metabolite active as compared to the parent compound. The metabolites are excreted with urine and faeces in equal amounts. About 0.2% of sertraline excreted by the kidneys unchanged. Half-life time is 22-36 hours, regardless of age or sex. For this figure is 62-104 hours. The half-life of sertraline time and area under the plasma concentration curve ( increase with abnormal liver function. Regardless of the severity of renal failure the pharmacokinetics of sertraline in his constant use is not changed. Sertraline passes into breast milk. Data about its ability to pass through the blood-placental barrier there. Sertraline is not dialyzed.
Indications for use:
- Depression different etiology (treatment and prevention)
- Obsessive-Compulsive Disorder
- Panic disorder (With or without agoraphobia).
- Post-traumatic stress disorder chlorodehydromethyltestosterone reviews for horrible bosses.Contraindications
- Hypersensitivity to the active substance or any other ingredients in the drug,
- concomitant use of sertraline inhibitors. When replacing one drug to another should avoid antidepressants within 14 days,
- concomitant use of sertraline with tryptophan or fenfluramine
- unstable epilepsy,
- Children under 6 years of age;
- pregnancy and lactation (see “Osobyeukazaniya.”).
- Precautions: organic brain disease (including mental retardation), manic state, epilepsy, liver and / or kidney failure, weight loss, in children older than 6 years.Dosing and Administration Depression Adults The initial dose is 50 mg Thorin once a day, morning or evening. The daily dose can be gradually, not earlier than one week increased to 50 mg, to a maximum daily dose of 200 mg.
- Panic disorders initial dose is 25 mg Thorin once a day, in the morning or evening. A week later, the doctor can increase the dose to 50 mg of sertraline once a day, and then gradually, not earlier than one week, the daily dose can be gradually increased from 50 mg up to a maximum daily dose of 200 mg. A satisfactory therapeutic results achieved typically after 7 days from the start of treatment. However, to achieve full therapeutic effect requires regular intake of the drug for 2-4 weeks.
- Patients chlorodehydromethyltestosterone reviews for horrible bosses with obsessive-compulsive disorder to achieve a good result may require 8-12 weeks. The minimum dose that provides the therapeutic effect is retained in the future as a support. Children for children from 6 to 12 years, the starting dose is 25 mg sertraline once a day, morning or evening. After one week, the dose can be increased to 50 mg once a day. For children aged 12 to 17 years of the initial dose is 50 mg once a day, in the morning or evening. The daily dose can be gradually, not earlier than one week increased to 50 mg, to a maximum daily dose of 200 mg. To avoid overdose, consideration should be given less weight in children than adults, and by increasing the dose of 50 mg / day should be carefully monitored for this category of patients, and at the first sign of overdose repeal the drug. In elderly patients there is no need for a special dose selection.
- Patients with liver function disorders require special attention in the treatment of Mr. sertrali. In severe liver function disorder the dose should be reduced dose or increase the interval between receptions. In patients with impaired renal function specially select a dose is not required
dry mouth, increased sweating, drowsiness, headache, dizziness, tremors, insomnia, anxiety, agitation, hypomania, mania, decreased appetite (rarely – increased) up to anorexia, dyspepsia (bloating, nausea, vomiting, diarrhea ), abdominal pain, weight loss, gait disturbance.
It is also possible weakness, redness, blurred vision, ejaculation disorder, decreased libido.
During sertraline treatment were marked extrapyramidal disorder, dyskinesia, tremor, cramps, menstrual disorders, hyperprolactinemia, galactorrhea, skin rash, occasionally erythema multiforme. Movement disorders were more common in patients with indications of their presence in the history or concomitant use of antipsychotics.
When stopping treatment with sertraline described rare cases of withdrawal. May appear paresthesia, gipostezii, depressive symptoms, hallucinations, aggressive reaction, agitation, anxiety or psychotic symptoms that are indistinguishable from symptoms of the underlying disease. Laboratory tests Data: rarely – in 0.8% of cases, with prolonged use – there is asymptomatic increase transaminase activity in serum. Cancel the drug in this case leads to the normalization of the activity of enzymes. During treatment with sertraline may occur transient hyponatremia. It occurs more frequently in elderly patients, as well as when taking diuretics or several other drugs. This side effect associated with the syndrome of inappropriate secretion of antidiuretic hormone.
Serious symptoms of an overdose chlorodehydromethyltestosterone reviews for horrible bosses of sertraline is not revealed even in the appointment of the drug in high doses. However, simultaneous administration with other drugs or ethanol may occur severe poisoning.
Overdose can cause serotonin syndrome with nausea, vomiting, somnolence, tachycardia, agitation, dizziness, agitation, diarrhea, sweating, myoclonus and hyperreflexia. Treatment: No specific antidote. It requires intensive supportive care and constant monitoring of vital body functions. Induce vomiting is not recommended. Introduction of the activated carbon can be more effective than gastric lavage. It is necessary to maintain airway patency. At the large volume of distribution of sertraline, in this regard, increased diuresis, dialysis, hemoperfusion or blood transfusion may be inconclusive.