Surlift
Surlift: instructions for use and reviews
- 1. Release form and composition
- 2. Pharmacological properties
- 3. Indications for use
- 4. Contraindications
- 5. Method of application and dosage
- 6. Side effects
- 7. Overdose
- 8. Special instructions
- 9. Application during pregnancy and lactation
- 10. Use in childhood
- 11. In case of impaired renal function
- 12. For violations of liver function
- 13. Drug interactions
- 14. Analogs
- 15. Terms and conditions of storage
- 16. Terms of dispensing from pharmacies
- 17. Reviews
- 18. Price in pharmacies
Latin name: Serlift
ATX code: N06AB06
Active ingredient: sertraline (Sertraline)
Manufacturer: San Pharmaceutical Industries Ltd. (Sun Pharmaceutical Industries Ltd.) (India)
Description and photo update: 2019-26-08
Prices in pharmacies: from 499 rubles.
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Surlift is a selective serotonin reuptake inhibitor, antidepressant.
Release form and composition
Serlift's dosage form - film-coated tablets: oval, white or almost white, with a scribble on one side and the engraved inscription "50" (tablets at a dose of 50 mg) or "100" (tablets at a dose of 100 mg) - on the other (10 pcs. in blisters, in a cardboard box 1 or 3 blisters; 14 pcs. in a blister, in a cardboard box 1 or 2 blisters).
Active substance: sertraline (in the form of hydrochloride), in 1 tablet - 50 or 100 mg.
Auxiliary components: hyprollose -L, microcrystalline cellulose (Avicel PH 101 and Avicel PH 102), calcium hydrogen phosphate, magnesium stearate, sodium carboxymethyl starch, purified water.
Shell composition: purified water, white opadry dye OY-S-58910 (macrogol 400, titanium dioxide, talc, hypromellose).
Pharmacological properties
Pharmacodynamics
Sertraline belongs to the group of antidepressant drugs and is a naphthylamine derivative. It is a selective serotonin reuptake inhibitor that enhances the effect of the latter on the body and slightly affects the reuptake of dopamine and norepinephrine. When used in therapeutic doses, Serlift interferes with the seizure of serotonin in human platelets.
Inhibition of serotonin reuptake activity activates serotonergic transmission, which leads to the subsequent inhibition of adrenergic activity, the center of which is the bluish place (locus ceruleus). Surlift's active ingredient also reduces the excitation of serotonin neurons localized in the suture region (located on the midline of the medulla oblongata), resulting in an initial increase in the activity of the bluish spot, which further leads to a decrease in the activity of presynaptic α 2 -adrenoreceptors and postsynaptic β-adrenergic receptors.
Surlift's reception does not provoke the development of drug dependence. No signs of cardiotoxic and m-cholin-blocking action were found during its application. Sertraline does not increase the activity of the sympathetic nervous system and does not have an affinity for GABA-, m-choline-, adreno-, histamine, dopamine, benzodiazepine or serotonin receptors, and is also not a monoamine oxidase (MAO) inhibitor.
Unlike treatment with tricyclic antidepressants, when Serlift is prescribed to patients with obsessive-compulsive disorders (obsessive-compulsive disorder) or depression, they do not experience an increase in body weight. The first effect from the course of antidepressant therapy becomes noticeable within 7 days after the start of admission, and the full one - after about 2-4 weeks.
Pharmacokinetics
The degree of absorption of sertraline is quite high, but this process is slow. The maximum concentration of the substance in the blood plasma is recorded 4.5-8.4 hours after oral administration. The equilibrium concentration of sertraline in blood plasma is established within a week, subject to a single daily dose. Eating food increases the bioavailability of the active ingredient by about 25%, but the time to reach the maximum concentration is reduced.
Sertraline binds to blood plasma proteins by 98%. The volume of distribution exceeds 20 l / kg. The substance is extensively metabolized during the first passage through the liver, participating in the processes of N-demethylation. The main metabolite is N-desmethylsertraline, which has a lower pharmacological activity than the parent compound. Metabolites are excreted through the kidneys and intestines in equal amounts. Approximately 0.2% of sertraline is excreted unchanged in the urine. The half-life of the drug varies from 22 to 36 hours; its value is not affected by the sex or age of the patient. For N-desmethylsertraline, this figure is 62-104 hours.
The area under the concentration-time curve (AUC) and elimination half-life are increased in patients with liver dysfunction. With the constant use of sertraline in patients with renal insufficiency, the pharmacokinetic parameters of the substance, regardless of its degree, remain unchanged.
Sertraline is determined in breast milk. There is no information about its ability to cross the blood-brain and placental barriers.
Sertraline is not excreted by dialysis.
Indications for use
- obsessive compulsive disorder;
- panic disorder, including agoraphobia;
- post-traumatic stress disorder;
- depressive states of various etiologies, including those accompanied by a feeling of anxiety (treatment and prevention).
Contraindications
- epilepsy during exacerbation;
- children under 6 years old;
- period of pregnancy and lactation;
- combined use of tryptophan, phenylfluramine, pimozide;
- simultaneous use of monoamine oxidase inhibitors, as well as within 14 days before their appointment or after their cancellation;
- hypersensitivity to the components of Serlift tablets.
Carefully:
- childhood;
- renal and / or hepatic impairment;
- epilepsy outside the exacerbation stage and in history;
- manic states;
- organic brain diseases, including mental retardation;
- decrease in body weight.
Instructions for the use of Serlift: method and dosage
Serlift tablets should be taken orally once a day (morning or evening). Food intake does not affect the effectiveness of the drug.
Adults with depression and obsessive-compulsive disorder are prescribed 50 mg / day. If there is no effect, the dose is gradually increased (by 50 mg per week) to 200 mg. In some cases, in the first 1-2 days, the doctor may prescribe 25 mg / day. It may take 8-12 weeks of treatment to achieve lasting results.
Adults with panic and post-traumatic stress disorders at the beginning of treatment are prescribed 25 mg / day. Then, within 1 week, the daily dose is increased to 50 mg. If the effect is insufficient, the dose is continued gradually (by 50 mg per week) to increase to 200 mg / day. An improvement in the condition is usually noted 7 days after the start of therapy, however, the full therapeutic effect can be achieved within 2-4 weeks of regular use of Serlift.
For long-term maintenance therapy, Serlift is prescribed in the minimum effective dose. Depending on the effect, it is subsequently corrected.
For patients with severely impaired liver function, the dose of the drug is reduced or the intervals between doses are increased.
Recommended doses for children with obsessive-compulsive disorder:
- children 6–12 years old: initial dose - 25 mg / day, if necessary, after 7 days the dose is increased to 50 mg;
- adolescents 13–17 years old: the initial dose is 50 mg, then, if necessary, it is gradually increased (by 50 mg per week) to the maximum permissible daily dose of 200 mg. When prescribing a dose of more than 50 mg / day, it should be borne in mind that in adolescents, body weight is usually less than in adults, therefore, careful medical supervision is required in order to identify the first signs of an overdose in time and cancel Surlift.
It may take 8-12 weeks of treatment to achieve a good result.
Side effects
- from the nervous system: drowsiness or insomnia, dizziness, anxiety, headache, mania, hypomania, movement disorders (extrapyramidal symptoms, change in gait), hypesthesia, paresthesia, akathisia, psychomotor agitation, hallucinations, tremors, aggressiveness, amnesia, depersonalization, psychosis, symptoms of depression, panic reactions, nervousness, yawning, seizures, serotonin syndrome;
- from the senses: visual impairment;
- from the cardiovascular system: flushing of the face or flushing of the skin, tachycardia, postural hypotension;
- on the part of the musculoskeletal system: myalgia, arthralgia;
- from the urinary system: urinary retention or incontinence;
- from the side of metabolism and the endocrine system: hyperprolactinemia, hyponatremia (syndrome of inadequate secretion of antidiuretic hormone);
- on the part of the hematopoietic system: purpura, bleeding (including nasal), thrombocytopenia;
- from the reproductive system: galactorrhea, dysmenorrhea, sexual dysfunction (decreased potency and / or libido, delayed ejaculation, anorgasmia);
- on the part of the skin: itching, rash, ecchymosis, angioedema, anaphylactoid reactions; rarely - photosensitization, exudative erythema multiforme;
- from the gastrointestinal tract: rarely - dry mouth, increased appetite (possibly due to elimination of depression), cramps in the stomach or abdomen, diarrhea, flatulence or abdominal pain, nausea, vomiting, anorexia;
- from the hepatobiliary system: rarely - jaundice, hepatitis, pancreatitis, asymptomatic increase in the activity of hepatic transaminases (aspartate aminotransferase and alanine aminotransferase), liver failure;
- others: rarely - malaise, increased sweating, withdrawal syndrome.
Overdose
Even when taking Serlift in high doses, an overdose of the drug is not accompanied by severe symptoms. However, when it is combined with ethanol or other drugs, severe intoxication may develop.
Surlift's overdose in some cases leads to the onset of serotonin syndrome. Its initial manifestations are expressed in such disorders of the central nervous system (CNS) as a violation of coordination tests, extrapyramidal symptoms (which include hyperreflexia, tremor, muscle tone, restlessness, disorientation), as well as myoclonic twitchings that occur first in the feet, and then spread throughout the body, and gastrointestinal (GI) disorders such as dyspepsia, nausea, vomiting, diarrhea, flatulence, abdominal cramps. When the condition worsens, a manic-like state is observed. The final stage of intoxication is similar to neuroleptic malignant syndrome: greasy face, mask-like face, profuse sweat, fever.
Sertraline has no specific antidotes. It is necessary to conduct intensive supportive therapy and constant monitoring of vital body functions. Induction of vomiting is not recommended. Taking activated charcoal may be more effective than gastric lavage. You should also ensure airway patency. Sertraline has a large volume of distribution, so forced diuresis, blood transfusion, or hemoperfusion / dialysis do not give the desired result.
special instructions
There is insufficient experience with the use of sertraline in patients undergoing electroconvulsive therapy.
Due to the risk of suicidal attempts, patients with depression should be closely monitored until significant improvement occurs as a result of the therapy.
Women of childbearing age receiving Surlift should use reliable contraceptive methods.
Influence on the ability to drive vehicles and complex mechanisms
Surlift can cause disturbances in psychomotor functions, therefore, during treatment, it is recommended to be careful when driving a car and performing other potentially hazardous activities that require increased attention and / or speed of psychophysical reactions.
Application during pregnancy and lactation
Adequate and well-controlled studies of the safety of sertraline in pregnant women have not been conducted, therefore, the appointment of Serlift is permissible only in cases where the potential benefits of treatment for the mother significantly outweigh the possible risks to the fetus.
It is not known whether the active component of Surlift is excreted in breast milk. For this reason, the drug should not be taken during lactation. According to the results of separate studies, in infants whose mothers received sertraline during lactation, its plasma level is insignificant or is below the detection limit, while the concentration of the substance in breast milk exceeds those in the mother's blood.
In experimental studies, no mutagenic or teratogenic effects of sertraline were found. However, when taken in doses approximately 2.5-10 times higher than the maximum allowable daily intake, the drug led to a delay in ossification of the fetal bone tissue, probably due to the effect on the mother's body. With the introduction of sertraline in doses approximately 5 times higher than the maximum therapeutic dose, there is a decrease in neonatal survival.
Pediatric use
According to the instructions, Serlift is contraindicated for the treatment of children under 6 years of age. The drug is used with caution in the treatment of OCD in children over 6 years of age in case of weight loss.
With impaired renal function
Patients with renal impairment need to be careful when taking Surlift.
For violations of liver function
Patients with hepatic impairment need to be careful when taking Surlift.
Drug interactions
- nonsteroidal anti-inflammatory drugs and acetylsalicylic acid: the risk of bleeding increases;
- monoamine oxidase inhibitors: severe complications occur, the development of serotonin syndrome is possible (this combination is contraindicated to be used simultaneously and within 14 days after discontinuation of one of the drugs);
- coumarin derivatives: there is a significant increase in prothrombin time (when using this combination, it is necessary to control the prothrombin time at the beginning of Serlift's administration and after its cancellation);
- cimetidine: sertraline clearance is significantly reduced;
- lithium preparations: the risk of tremor increases;
- sumatriptan: weakness, impaired coordination of movements, hyperreflexia occur (with the combined administration of drugs, careful monitoring of the patient's condition should be carried out);
- tolbutamide: its clearance decreases (it is necessary to control the level of glucose in the blood).
Sertraline is incompatible with phenifluramine, tryptophan, ethanol.
When replacing one serotonin reuptake inhibitor with another, there is no need for a "washout" period, but care must be taken.
Due to the fact that sertraline causes minimal induction of liver enzymes, its simultaneous use with antipyrine at a dose of 200 mg decreases the half-life of the latter, although this is noted only in 5% of cases.
The combined use of sertraline with drugs that depress the central nervous system requires medical supervision.
With the concomitant use of drugs that are metabolized by the isoenzyme 2D6 of cytochrome P 450 (desipramine, class 1C antiarrhythmic drugs (propafenone, flecainide), tricyclic antidepressants), Serlift should be prescribed in lower doses. After its cancellation, an increase in the doses of these drugs may be required.
Analogs
Surlift's analogs are: Torin, Stimuloton, Serenata, Zoloft, Asentra, Aleval, Fluoxetine, Siozam, Esoprex, Misol, etc.
Terms and conditions of storage
Store in a dry place, out of the reach of children, at a temperature not exceeding 25 ° C.
The shelf life is 3 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Surlift
On the Internet, reviews about Surlift are quite rare, since not all patients are ready to share their problems related to the psycho-emotional sphere. However, most patients recognize the effectiveness and safety of the drug. Only a specialist should prescribe Surlift, since the treatment regimen with such drugs is selected individually in accordance with the psychological characteristics of the patient.
Price for Surlift in pharmacies
The average price for Surlift per pack of 28 tablets is:
- dosage of 50 mg - 523-585 rubles;
- dosage of 100 mg - 768-860 rubles.
Surlift: prices in online pharmacies
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Drug name Price Pharmacy |
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Serlift 50 mg film-coated tablets 28 pcs. RUB 499 Buy |
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Serlift 100 mg film-coated tablets 28 pcs. 735 RUB Buy |
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Surlift tablets p.o. 100mg 28 pcs. 759 r Buy |
Maria Kulkes Medical journalist About the author
Education: First Moscow State Medical University named after I. M. Sechenov, specialty "General Medicine".
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
