Crushing Zoloft (Sertraline) Tablets
Yes, Zoloft (sertraline) tablets can be safely crushed for patients who have difficulty swallowing or require administration through feeding tubes.
Administration Options for Crushed Sertraline
When crushing sertraline tablets is necessary, follow these specific guidelines:
For oral administration:
- Crush the tablet completely and mix with a small amount of soft food (applesauce, pudding)
- Administer immediately after crushing to ensure full dosage delivery
- Do not mix with foods that might interact with medications (grapefruit, high-fat foods)
For nasogastric/gastric feeding tube administration:
- Crush tablets completely and suspend in 50-60 mL of water
- Administer immediately after preparation
- Follow with adequate water flush to ensure complete delivery
Important Considerations
Formulation Specifics
- Only immediate-release sertraline tablets should be crushed
- Do not crush any controlled-release or extended-release formulations of sertraline (if they exist)
- The crushed medication maintains its pharmacological properties when administered properly 1
Patient Populations
- Particularly useful for:
- Patients with dysphagia
- Patients with feeding tubes
- Elderly patients with swallowing difficulties
- Children who cannot swallow tablets
Precautions
- Crushing should be done immediately before administration
- Use proper protective equipment when crushing psychiatric medications to avoid exposure
- Clean crushing equipment between patients to prevent cross-contamination 2
- Avoid mixing with caffeinated beverages like coffee, which may affect absorption
Alternative Options
If crushing is problematic, consider these alternatives:
- Sertraline is available as an oral concentrate (20 mg/mL) that can be mixed with water, ginger ale, lemon/lime soda, lemonade, or orange juice
- Consult with a pharmacist about liquid formulations that may be commercially available
- For patients requiring twice-daily dosing (particularly at low doses), dividing the dose may improve tolerability 3
Common Pitfalls to Avoid
- Do not pre-crush tablets for later administration as this may affect stability
- Avoid mixing crushed sertraline with foods or liquids that could interact with the medication
- Never crush sertraline to administer through tubes positioned distal to the stomach, as this could affect absorption
- Do not crush and administer with laxatives, as this may accelerate transit time and reduce effectiveness 2
Sertraline is one of the safer medications to crush, unlike some other psychiatric medications that have specific formulation concerns. When administered properly, crushed sertraline maintains its efficacy and safety profile for treating depression and anxiety disorders.