It is important that your doctor check your progress at regular visits, to allow for changes in your dose and to help reduce any side effects.

Do not take sertraline with or within 14 days of taking an MAO inhibitor (furazolidone, phenelzine, procarbazine, selegiline, tranylcypromine). Do not take an MAO inhibitor within 14 days of taking sertraline. If you do, you may develop extremely high blood pressure or convulsions (seizures).

Avoid drinking alcoholic beverages while taking sertraline.

ZOLOFT may cause some people to become drowsy, to have trouble thinking, or to have problems with movement. Make sure you know how you react to sertraline before you drive, use machines, or do anything else that could be dangerous if you are not alert or well-coordinated.

Sertraline may cause some people to be agitated, irritable or display other abnormal behaviors. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed. If you or your caregiver notice any of these adverse effects, tell your doctor right away.

Do not stop taking ZOLOFT without first checking with your doctor. Your doctor may want you to reduce gradually the amount you are taking before stopping completely. This is to decrease the chance of having discontinuation symptoms such as agitation, anxiety, dizziness, feeling of constant movement of self or surroundings, headache, increased sweating, nausea, trembling or shaking, trouble in sleeping or walking, or unusual tiredness.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. One rare, but very serious, effect that may occur is the serotonin syndrome. This syndrome (group of symptoms) is more likely to occur shortly after an increase in sertraline dose.

Check with your doctor as soon as possible if any of the following side effects occur:

• More common
  • Decreased sexual desire or ability;  failure to discharge semen (in men) 
  
  

• Less common or rare
  • Aggressive reaction;  breast tenderness or enlargement;  fast, pounding, irregular, or slow heartbeat;  fast talking and excited feelings or actions that are out of control;  fever;  inability to sit still;  increase in body movements ;  loss of bladder control;  low blood sodium (confusion, convulsions [seizures], drowsiness, dryness of mouth, increased thirst, lack of energy);  muscle spasm or jerking of all extremities;  nose bleeds ;  red or purple spots on skin;  restlessness;  serotonin syndrome (diarrhea, fever, increased sweating, mood or behavior changes, overactive reflexes, racing heartbeat, restlessness, shivering or shaking);  skin rash, hives, or itching;  sudden loss of consciousness ;  unusual or sudden body or facial movements or postures ;  unusual secretion of milk (in females) 
  
  

• Incidence not known
  • Abdominal or stomach pain;  bleeding gums;  blindness;  blistering, peeling, loosening of skin;  bloating;  bloody, black, tarry stools;  blood in urine;  blue-yellow color blindness;  blurred vision;  chest pain or discomfort ;  chills;  clay-colored stools ;  coma;  cough or hoarseness ;  darkened urine;  decreased urine output;  decreased vision;  depressed mood;  difficulty in breathing;  difficulty in speaking;  difficulty swallowing ;  drooling;  dry skin and hair;  eye pain;  fainting ;  feeling cold;  feeling of discomfort;  feeling that others can hear your thoughts;  feeling that others are watching you or controlling your behavior;  feeling, seeing, or hearing things that are not there;  fixed position of eye ;  general feeling of discomfort, illness, tiredness, or weakness;  hair loss;  high fever;  high or low blood pressure;  hoarseness or husky voice;  hostility ;  increased coagulation times;  indigestion;  inflammation of joints;  irritability;  joint or muscle pain;  large, hive-like swelling on face, eyelids, lips, tongue, throat, hands, legs, feet, and sex organs;  lethargy;  light-colored stools;  lightheadedness ;  loss of appetite;  loss of balance control;  loss of bladder control;  lower back or side pain;  muscle aches ;  muscle cramps and stiffness;  muscle trembling, jerking or stiffness;  muscle twitching ;  painful or difficult urination;  pains in stomach, side, or abdomen, possibly radiating to the back;  pale skin;  palpitations;  puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue;  rapid weight gain;  rash;  red, irritated eyes;  red skin lesions often with a purple center;  redness, soreness or itching skin;  right upper abdominal pain and fullness;  seizures;  severe mood or mental changes;  severe muscle stiffness ;  shortness of breath;  shuffling walk;  sore throat;  sores, ulcers, or white spots in mouth or on lips;  sores, welting or blisters;  stiffness of limbs;  stupor;  sweating;  swelling of face, ankles, or hands;  swollen lymph glands;  swollen or painful glands;  talking or acting with excitement you cannot control;  tightness in chest;  troubled breathing;  twisting movements of body;  twitching ;  uncontrolled movements, especially of face, neck, and back;  unexplained bleeding or bruising;  unpleasant breath odor;  unusual behavior ;  unusual tiredness or weakness;  upper right abdominal pain;  vomiting of blood;  weight gain;  wheezing;  yellow eyes and skin 
  
  

• Symptoms of overdose--may be more severe than side effects occurring at regular doses or several may occur together
  • Actions that are out of control;  agitation;  anxiety;  bloating;  blurred vision;  change in consciousness;  chest pain or discomfort;  chills;  coma;  confusion;  confusion as to time or place or person holding false beliefs that cannot be changed by fact;  constipation;  convulsions (seizures);  darkened urine;  decreased awareness or responsiveness;  dizziness or fainting;  drowsiness;  fever;  hallucinations;  headache;  indigestion;  irritability;  lightheadedness;  loss of appetite;  loss of consciousness;  nausea;  nervousness;  pains in stomach, side, or abdomen, possibly radiating to the back;  pounding in ears;  seeing, hearing, or feeling things that are not there;  serotonin syndrome (diarrhea, fever, increased sweating, mood or behavior changes, overactive reflexes, racing heartbeat, restlessness, shivering or shaking);  severe sleepiness;  shakiness in legs, arms, hands, feet;  shortness of breath;  slow or irregular heartbeat;  sweating ;  trembling or shaking of hands or feet;  unusual excitement, or restlessness;  unusual tiredness or weakness;  unusually fast heartbeat ;  unusually large pupils;  vomiting;  yellow eyes or skin 
  
  

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:

• More common
  • Acid or sour stomach;  belching;  decreased appetite or weight loss;  diarrhea or loose stools;  dizziness;  drowsiness;  dryness of mouth;  headache;  heartburn;  increased sweating;  nausea;  sleepiness or unusual drowsiness;  stomach or abdominal cramps, gas, or pain;  trembling or shaking;  trouble in sleeping 
  
  

• Less common
  • Agitation, anxiety, or nervousness;  bladder pain;  burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings;  changes in vision, including blurred vision;  cloudy urine;  constipation;  difficult, burning, or painful urination;  flushing or redness of skin, with feeling of warmth or heat;  frequent urge to urinate;  increased appetite;  pain or tenderness around eyes and cheekbones;  stuffy or runny nose;  vomiting 
  
  

• Incidence not known
  • flushed, dry skin;  fruit-like breath odor;  increased hunger;  increased thirst;  increased urination;  redness or other discoloration of skin;  severe sunburn;  swelling of breasts (in women);  unexplained weight loss;  unusual secretion of milk (in women) 
  
  

After you stop taking sertraline or when your dose is decreased, your body may need time to adjust. The length of time this takes depends on the amount of medicine you were using and how long you used it. During this period of time, check with your doctor if you notice any of the following side effects:

• Abnormal dreams;  agitation;  anxiety;  burning, crawling, itching, numbness, prickling, "pins and needles" , or tingling feelings ;  dizziness;  electric shock sensations;  failure to discharge semen (in men);  feeling of constant movement of self or surroundings;  headache;  increased sweating;  nausea;  sleepiness or unusual drowsiness ;  trembling or shaking;  trouble in sleeping;  trouble in walking;  unusual tiredness 

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, sertraline is used in certain patients with the following medical conditions:

• Premature ejaculation