Available Dose Forms of Sertraline (Zoloft)
Sertraline is available as oral tablets, oral solution concentrate, and capsules in various strengths to accommodate different dosing needs. 1
Oral Tablet Formulations
- Tablets: 25 mg, 50 mg, 100 mg 2
- These are the most commonly prescribed formulations
Oral Solution Concentrate
- Oral concentrate: 20 mg/mL in a multidose 60 mL bottle 1
- Must be diluted prior to administration
- Contains propylene glycol as an inactive ingredient
- Provides flexibility for patients who have difficulty swallowing tablets
Dosing Considerations
Standard Dosing
- Initial dose typically starts at 50 mg once daily 3
- Dose can be increased in 50 mg increments at intervals of no less than one week
- Maximum dose: 200 mg daily
- Can be administered as a single daily dose at any time of day 3
Special Populations
- No specific dose adjustments are required for elderly patients, unlike some other antidepressants 4
- Dosing should be adjusted based on clinical response and tolerability rather than age alone
Clinical Applications
Sertraline is prescribed for various conditions with different dosing protocols:
- Depression: 50-200 mg daily (typically starting at 50 mg) 3
- Premature ejaculation: 25-200 mg daily or situationally (50 mg taken 4-8 hours before intercourse) 2
- Pruritus in cholestatic liver disease: Used as fourth-line treatment (up to 100 mg daily) 2
Pharmacokinetic Properties
- Slowly absorbed following oral administration
- Undergoes extensive first-pass metabolism
- Forms N-desmethyl-sertraline (weakly active metabolite)
- Elimination half-life: 22-36 hours, allowing for once-daily dosing 5
- Wide interpatient variability in steady-state plasma concentrations (up to 15-fold) with standard dosing
Clinical Considerations
- Low potential for drug interactions compared to some other SSRIs 4
- Well-tolerated across different age groups
- Common side effects include dry mouth, headache, diarrhea, nausea, insomnia, and somnolence 4
Sertraline's multiple formulations provide flexibility in dosing and administration, making it suitable for various patient populations and clinical scenarios.