Brand
name: Lupisert
Pronounced: ZOE-loft
Generic name: Sertraline
Why is Lupisert prescribed?
Lupisert is prescribed for major depression--a persistently low mood
that interferes with everyday living. Symptoms may include loss of
interest in your usual activities, disturbed sleep, change in appetite,
constant fidgeting or lethargic movement, fatigue, feelings of worthlessness
or guilt, difficulty thinking or concentrating, and recurrent thoughts
of suicide.
Lupisert is also used to treat the following:
* Premenstrual dysphoric disorder (PMDD), a condition marked by a
depressed mood, anxiety or tension, emotional instability, and anger
or irritability in the two weeks preceding menstruation.
* Obsessive-compulsive disorder (unwanted thoughts that won't go away and an
irresistible urge to keep repeating certain actions, such as hand-washing or
counting).
* Panic disorder (unexpected attacks of overwhelming anxiety, accompanied by
fear of their return).
* Social anxiety disorder (extreme shyness in social situations that interferes
with an individual's work and social life).
* Post-traumatic stress disorder (re-experiencing a dangerous or life-threatening
event through intrusive thoughts, flashbacks, and intense psychological distress).
Lupisert belongs to a class of drugs called selective serotonin re-uptake
inhibitors (SSRIs). Serotonin is one of the chemical messengers believed
to govern moods. Ordinarily, it is quickly reabsorbed after its release
at the junctures between nerves. Re-uptake inhibitors such as Lupisert
slow this process, thereby boosting the levels of serotonin available
in the brain.
Most important fact about Lupisert
Do not take Lupisert within 2 weeks of taking any drug classified as
an MAO inhibitor. Drugs in this category include the antidepressants
Marplan, Nardil, and Parnate. When serotonin boosters such as Lupisert
are combined with MAO inhibitors, serious and sometimes fatal reactions
can occur. In addition, you should not combine Lupisert with the drug
pimozide (Orap).
How should you take Lupisert?
Take Lupisert exactly as prescribed: once a day, in either the morning
or the evening.
Lupisert is available in capsule and oral concentrate forms. To prepare
Lupisert oral concentrate, use the dropper provided. Measure out the
amount of concentrate prescribed by your doctor and mix it with 4 ounces
of water, ginger ale, lemon/lime soda, lemonade, or orange juice. (Do
not mix the concentrate with any other type of beverage.) Drink the
mixture immediately; do not prepare it in advance for later use. At
times, a slight haze may appear after mixing, but this is normal.
Improvement with Lupisert may not be seen for several days to a few
weeks. You should expect to keep taking it for at least several months.
Lupisert may make your mouth dry. For temporary relief suck a hard candy,
chew gum, or melt bits of ice in your mouth.
If you miss a dose...
Take the forgotten dose as soon as you remember. If several hours
have passed, skip the dose. Never try to "catch up" by doubling
the dose.
Storage instructions...
Store at room temperature.
Lupisert side effects
Side effects cannot be anticipated. If any develop or change in intensity,
inform your doctor as soon as possible. Only your doctor can determine
if it is safe for you to continue taking Lupisert.
* Side effects may include:
Abdominal pain, agitation, anxiety, constipation, decreased sex drive, diarrhea
or loose stools, difficulty with ejaculation, dizziness, dry mouth, fatigue,
gas, headache, decreased appetite, increased sweating, indigestion, insomnia,
nausea, nervousness, pain, rash, sleepiness, sore throat, tingling or pins
and needles, tremor, vision problems, vomiting
Many people lose a pound or two of body weight while taking Lupisert.
This usually poses no problem but may be a concern if your depression
has already caused you to lose a great deal of weight.
In a few people, Lupisert may trigger the grandiose, inappropriate,
out-of-control behavior called mania or the similar, but less dramatic, "hyper" state
called hypomania.
Why should Lupisert not be prescribed?
Do not use Lupisert while taking an MAO inhibitor or the drug pimozide
(Orap) (see "Most important fact about Lupisert"). Avoid Lupisert
if it causes an allergic-type reaction.
Special warnings about Lupisert
In clinical studies, antidepressants increased the risk of suicidal
thinking and behavior in children and adolescents with depression and
other psychiatric disorders. Anyone considering the use of Lupisert or
any other antidepressant in a child or adolescent must balance this
risk with the clinical need. Lupisert is only approved for treating obsessive-compulsive
disorder in children 6 years and older.
Additionally, the progression of major depression is associated with
a worsening of symptoms and/or the emergence of suicidal thinking or
behavior in both adults and children, whether or not they are taking
antidepressants. Individuals being treated with Lupisert and their caregivers
should watch for any change in symptoms or any new symptoms that appear
suddenly--especially agitation, anxiety, hostility, panic, restlessness,
extreme hyperactivity, and suicidal thinking or behavior--and report
them to the doctor immediately. Be especially observant at the beginning
of treatment or whenever there is a change in dose.
Use Lupisert cautiously and under close medical supervision if you have
a history of kidney or liver disorders, heart disease, seizures, or
bleeding problems. Your doctor may limit your dosage if you have one
of these conditions.
Lupisert could cause weight loss in children. The manufacturer recommends
regular monitoring of weight and growth during long-term treatment
in children.
SSRI antidepressants could potentially cause stomach bleeding, especially
when combined with nonsteroidal anti-inflammatory drugs (NSAIDs) such
as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), and ketoprofen
(Orudis KT). Consult your doctor before combining Lupisert with NSAIDs
or blood-thinning medications.
Like all antidepressants, Lupisert could trigger a manic episode. Let
the doctor know if you've ever had this problem.
Lupisert has not been found to impair the ability to drive or operate
machinery. Nevertheless, the manufacturer recommends caution until
you know how the drug affects you.
If you are sensitive to latex, use caution when handling the dropper
provided with the oral concentrate.
Possible food and drug interactions when taking Lupisert
Remember that Lupisert must never be combined with pimozide (Orap) or
an MAO inhibitor (see "Most important fact about Lupisert").
You should not drink alcoholic beverages while taking Lupisert. Use
over-the-counter remedies with caution. Although none is known to interact
with Lupisert, interactions remain a possibility.
If Lupisert is taken with certain other drugs, the effects of either
could be increased, decreased, or altered. It is especially important
to check with your doctor before combining Lupisert with the following:
Antidepressants that boost serotonin such as Paxil and Prozac
Other antidepressants, including tricyclics such as Elavil and Pamelor
Cimetidine (Tagamet)
Diazepam (Valium)
Digitoxin (Crystodigin)
Flecainide (Tambocor)
Lithium (Eskalith, Lithobid)
Over-the-counter drugs such as cold remedies
Propafenone (Rythmol)
Sumatriptan (Imitrex)
Tolbutamide (Orinase)
Warfarin (Coumadin)
If you are using the oral concentrate form of Lupisert, do not take
disulfiram (Antabuse)
Special information if you are pregnant or breastfeeding
The effects of Lupisert during pregnancy have not been adequately studied.
If you are pregnant or plan to become pregnant, inform your doctor
immediately. Lupisert should be taken during pregnancy only if it is
clearly needed. It is not known whether Lupisert appears in breast milk.
Caution is advised when using Lupisert during breastfeeding.
Recommended dosage for Lupisert
ADULTS
Overdosage
Any medication taken in excess can have serious consequences. An overdose
of Lupisert can be fatal. If you suspect an overdose, seek medical attention
immediately.
* Common symptoms of Lupisert overdose include:
Agitation, dizziness, nausea, rapid heartbeat, sleepiness, tremor, vomiting
Other possible symptoms include coma, stupor, fainting, convulsions,
delirium, hallucinations, mania, high or low blood pressure, and slow,
rapid, or irregular heartbeat
