Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes Zoloft (Sertraline). If you are concerned about side effects, discuss the risks and benefits of Zoloft (Sertraline) with your doctor.

The following side effects have been reported by at least 1% of people taking Zoloft (Sertraline). Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• decreased sexual desire or ability
• Diarrhea
• dizziness
• drowsiness
• Dry Mouth
• headache
• loss of appetite
• nausea
• nervousness
• sleep disturbance
• tremor (shakiness)

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

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

• behaviour changes (e.g., anger, anxiety, violent thoughts)
• changes in vision, including blurred vision or eye pain
• fast talking and excited feelings or actions that are out of control
• inability to sit still
• liver problems (yellowing of the eyes or skin, abdominal pain, nausea, vomiting, dark urine)
• low blood sodium (e.g., tiredness, weakness, and confusion combined with achy, stiff, or uncoordinated muscles)
• symptoms of low blood sugar (weakness, hunger, sweating, anxiety, numbness/tingling in arms/legs)
• paranoia (suspicions of people, organizations, or situations, with no basis in reality)
• restlessness
• signs of clotting problems (e.g., unusual nosebleeds, bruising, blood in urine, coughing blood, bleeding gums, cuts that don't stop bleeding)
• symptoms of high blood sugar (e.g., frequent urination, increased thirst, excessive eating, unexplained weight loss, poor wound healing, infections, fruity breath odour)
• symptoms of mania (e.g., decreased need for sleep, elevated or irritable mood, racing thoughts)
• unusual or sudden body or facial movements or postures

Stop taking the medication and seek immediate medical attention if any of the following occur:

• seizure
• serotonin syndrome (diarrhea, Fever, increased sweating, mood or behaviour changes, overactive reflexes, racing heartbeat, restlessness, shivering, or shaking)
• signs of an allergic reaction (Hives; difficulty breathing; swelling of the face, tongue, or throat)
• signs of bleeding in the stomach (e.g., bloody, black, or tarry stools; spitting up of blood; vomiting blood or material that looks like coffee grounds)
• symptoms of irregular heartbeat (e.g., chest pain, dizziness, rapid, pounding heartbeat, shortness of breath)
• thoughts of suicide or self-harm

After you stop taking Zoloft (Sertraline), your body may need time to adjust. The length of time this takes depends on the amount of medication 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
• difficulty concentrating
• dizziness
• headache
• increased sweating
• nausea
• trembling or shaking
• sensations similar to electric shocks

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking Zoloft (Sertraline).

25 mg
Each yellow capsule contains Zoloft (Sertraline) HCl equivalent to 25 mg of Zoloft (Sertraline). Nonmedicinal ingredients: cornstarch, lactose (anhydrous), magnesium stearate, and sodium lauryl sulfate; capsule shell: D&C Yellow No. 10, FD&C Yellow No. 6, gelatin, and titanium dioxide. Zoloft (Sertraline) does not contain gluten or tartrazine.

50 mg
Each white and yellow capsule contains Zoloft (Sertraline) HCl equivalent to 50 mg of Zoloft (Sertraline). Nonmedicinal ingredients: cornstarch, lactose (anhydrous), magnesium stearate, and sodium lauryl sulfate; capsule shell: D&C Yellow No. 10, FD&C Yellow No. 6, gelatin, and titanium dioxide. Zoloft (Sertraline) does not contain gluten or tartrazine.

100 mg
Each orange capsule contains Zoloft (Sertraline) HCl equivalent to 100 mg of Zoloft (Sertraline). Nonmedicinal ingredients: cornstarch, lactose (anhydrous), magnesium stearate, and sodium lauryl sulfate; capsule shell: D&C Yellow No. 10, FD&C Red No. 40, gelatin, and titanium dioxide. Zoloft (Sertraline) does not contain gluten or tartrazine.

Do not take Zoloft (Sertraline) if you:

• are allergic to Zoloft (Sertraline) or any ingredients of the medication
• are taking a MAO inhibitor (e.g., Phenelzine, Tranylcypromine, Moclobemide) or have taken a MAO inhibitor within the last 14 days
• are taking Pimozide

There may be an interaction between Zoloft (Sertraline) and any of the following:

• acetylsalicylic acid (ASA)
• alcohol
• Amiodarone
• amphetamines (e.g., Dextroamphetamine, Lisdexamfetamine)
• antihistamines (e.g., cetirizine, doxylamine, Diphenhydramine, Hydroxyzine, Loratadine)
• antipsychotic medications (e.g., Chlorpromazine, Clozapine, Haloperidol, Olanzapine, pimozide, Quetiapine, Risperidone)
• Apalutamide
• Apixaban
• barbiturates (e.g., butalbital, pentobarbital, Phenobarbital)
• benzodiazepines (e.g., Alprazolam, Diazepam, Lorazepam)
• beta-blockers (e.g. Pindolol, Propranolol, Sotalol)
• Bromocriptine
• Bupropion
• Buspirone
• Celecoxib
• chloral hydrate
• chloroquine
• Clopidogrel
• dabigatran
• Degarelix
• Desmopressin
• dexmethylphenidate
• Dextromethorphan
• diabetes medications (e.g., chlorpropamide, Glyburide, insulin, Metformin, Rosiglitazone)
• Dipyridamole
• Disopyramide
• disulfiram
• dofetilide
• Domperidone
• Dronedarone
• Edoxaban
• efavirenz
• Enzalutamide
• ergot alkaloids (e.g., ergotamine, Dihydroergotamine)
• Flecainide
• glucosamine
• grapefruit juice
• Heparin
• Linezolid
• lithium
• low molecular weight heparins (e.g., Dalteparin, Enoxaparin, Tinzaparin)
• macrolide antibiotics (e.g., clarithromycin, erythromycin)
• Methadone
• methylene blue
• methamphetamine
• Metoclopramide
• mifepristone
• Mirtazapine
• monoamine oxidase inhibitors (M.O.S. e.g., moclobemide, Rasagiline, Selegiline, tranylcypromine)
• multivitamins
• muscle relaxants (e.g., Baclofen, Cyclobenzaprine, methocarbamol, orphenadrine)
• narcotic pain relievers (e.g., Codeine, Fentanyl, Morphine, Oxycodone)
• non-steroidal anti-inflammatory medications (NSAIDs; e.g., Diclofenac, ibuprofen, naproxen)
• Obinutuzumab
• Octreotide
• omega-3 fatty acids
• Pentoxifylline
• Prasugrel
• procainamide
• quinidine
• quinine
• quinolone antibiotics (e.g., ciprofloxacin, Ofloxacin, sparfloxacin)
• rifabutin
• rifampin
• Rivaroxaban
• St. John's wort
• scopolamine
• seizure medications (e.g., Carbamazepine, Clobazam, Levetiracetam, phenobarbital, Phenytoin, primidone, Topiramate, Valproic acid, zonisamide)
• serotonin antagonists (anti-emetic medications; e.g., Granisetron, Ondansetron)
• serotonin/norepinephrine reuptake inhibitors (SNRIs; e.g., Desvenlafaxine, Duloxetine, Venlafaxine)
• other selective serotonin reuptake inhibitors (SSRIs; e.g., Citalopram, Fluoxetine, Paroxetine, Zoloft (Sertraline))
• sotalol
• Tapentadol
• Tetrabenazine
• thiazide diuretics (water pills; e.g., Hydrochlorothiazide, Indapamide, Metolazone)
• Thyroid replacements (e.g., desiccated thyroid, Levothyroxine)
• Ticagrelor
• Ticlopidine
• Tizanidine
• tramadol
• Trazodone
• tricyclic antidepressants (e.g., Amitriptyline, Imipramine, Nortriptyline)
• "triptan" migraine medications (e.g., Eletriptan, sumatriptan)
• Tryptophan
• tyrosine kinase inhibitors (e.g., Dasatinib, Lapatinib, Nilotinib, Pazopanib, Sunitinib)
• vitamin E
• warfarin
• Zolpidem
• Zopiclone

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Zoloft (Sertraline). Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Zoloft (Sertraline).

Bleeding: Zoloft (Sertraline) may increase the risk of bleeding, especially if you are also taking medications such as acetylsalicylic acid (Asa), nonsteroidal anti-inflammatory drugs (NSAIDs; e.g., Ibuprofen, Naproxen, Ketoprofen), or Warfarin. If you experience easy bruising, pinpoint-sized red spots on the skin, or unusual bleeding while taking Zoloft (Sertraline), contact your doctor immediately.

Bones: Zoloft (Sertraline) may increase the risk of bone fracture, especially if you are a senior or have Osteoporosis or other major risk factors for breaking a bone. Take extra care to avoid falls, especially if you get dizzy or have Low Blood Pressure. Your doctor may monitor your bones while you are taking Zoloft (Sertraline).

Diabetes: Zoloft (Sertraline) may cause a loss of blood sugar control (increased or decreased blood sugar) for some people who have diabetes and glucose tolerance may change. If you have diabetes, monitor your blood sugar closely and report any changes to your doctor.

If you have diabetes or are at risk for developing diabetes, discuss with your doctor how Zoloft (Sertraline) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Zoloft (Sertraline), and whether any special monitoring is needed.

Drowsiness/reduced alertness: Zoloft (Sertraline) may impair judgment, thinking, or motor skills. People using Zoloft (Sertraline) should avoid driving a car or operating hazardous machinery until they determine whether or not the medication affects them in this way.

Glaucoma: Zoloft (Sertraline) may cause an increase in pressure in the eyes. It can cause symptoms of glaucoma to become worse. If you have glaucoma, discuss with your doctor how Zoloft (Sertraline) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Zoloft (Sertraline), and whether any special monitoring is needed.

Heart rhythm: Zoloft (Sertraline) can cause changes to the normal rhythm of the heart, including an irregular heartbeat called QT prolongation. QT prolongation is a serious life-threatening condition that can cause fainting, seizures, and sudden death. If you are at risk for heart rhythm problems (e.g., people with heart failure, Angina, low potassium or magnesium levels, family history of QT prolongation), discuss with your doctor how Zoloft (Sertraline) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Zoloft (Sertraline), and whether any special monitoring is needed.

Liver function: Liver disease or reduced liver function may cause Zoloft (Sertraline) to build up in the body, causing side effects. If you have liver problems, discuss with your doctor how Zoloft (Sertraline) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Zoloft (Sertraline), and whether any special monitoring is needed. Your doctor may want to test your liver function regularly with blood tests while you are taking Zoloft (Sertraline).

If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.

Mania: Zoloft (Sertraline) may cause activation of mania. This means that people who are prone to mania may be more likely to have their mania start up again. If you have a history of mania or bipolar disorder, your doctor should closely monitor your condition while you are taking Zoloft (Sertraline).

Seizures: If you have a history of seizures, your doctor should closely monitor your condition while you are taking Zoloft (Sertraline). If you develop seizures, stop taking the medication and contact your doctor.

Serotonin syndrome: Zoloft (Sertraline) may cause a rare but potentially life-threatening condition called serotonin syndrome, especially when used with other medications that increase serotonin levels (e.g., Sumatriptan, Rizatriptan, Tramadol, St. John's wort). If you experience symptoms such as agitation, confusion, hallucinations, fast heart rate, fever, lack of coordination, increased body temperature, overactive reflexes, nausea, vomiting, and diarrhea, get immediate medical attention.

Sodium levels: Zoloft (Sertraline) can occasionally cause low levels of sodium in the blood (hyponatremia). This is more likely to happen to seniors or people who are also taking diuretics (water pills). If you experience confusion, weakness, headache, and memory problems, talk to your doctor as soon as possible. If too much sodium is lost from the body, it can cause hallucinations, confusion, seizures, coma, breathing, and even death.

Stopping the medication: Stopping Zoloft (Sertraline) suddenly may lead to side effects. If you are thinking of stopping the medication, check with your doctor or pharmacist first. See also "What side effects are possible with Zoloft (Sertraline)?"

Suicidal or agitated behaviour: People taking Zoloft (Sertraline) may feel agitated (restless, anxious, aggressive, emotional, and feeling not like themselves), or they may want to hurt themselves or others. These symptoms may occur within several weeks after people start taking Zoloft (Sertraline). Your doctor will monitor you closely for emotional and behavioural changes. If you feel suicidal or agitated or notice any other changes in behaviour, talk to your doctor. Family members or caregivers of people who are taking Zoloft (Sertraline) should contact the person's doctor immediately if they notice unusual behaviour changes.

Pregnancy: Zoloft (Sertraline) should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Zoloft (Sertraline), contact your doctor immediately. There have been some reports that women taking SSRIs such as Zoloft (Sertraline) during the second half of pregnancy may be associated with lung disorders in newborns. Talk to your doctor if you have any concerns.

Breast-feeding: It is not known if Zoloft (Sertraline) passes into breast milk. If you are a breast-feeding mother and are taking Zoloft (Sertraline), it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children and adolescents: The safety and effectiveness of using Zoloft (Sertraline) have not been established for people under the age of 18 years. The use of Zoloft (Sertraline) by children below the age of 18 may cause behavioural and emotional changes, such as suicidal thoughts and behaviour.

Seniors: Seniors who take Zoloft (Sertraline) appear to be more likely to experience low sodium in their blood, which can cause problems with coordination, achy muscles, or confusion. If you experience anything unusual while taking Zoloft (Sertraline), contact your doctor.