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Reporting a Medication Error

Warning! Dilute sertraline oral concentrate

Published July 26, 2019

A medicine commonly used to treat depression, sertraline (Zoloft), is available as a tablet or a concentrated oral liquid. The oral liquid form is very potent and must first be diluted in a specific beverage to make it easier to swallow. However, many healthcare providers and consumers are unfamiliar with the need to dilute this medicine before use. If it is swallowed undiluted, it can make your mouth and tongue feel numb for at least a day or two, even if you rinse your mouth.

Figure 1. The warning to dilute this medicine before use is more prominent on the Zoloft (sertraline) label (left) than on other generic product labels.

We received a report of a young teen who took a dose of the oral liquid form undiluted. The pharmacy label did not have instructions to add the liquid medicine to a specific beverage before taking it. His mouth and tongue became numb, and he became upset from these unpleasant effects.

Most sertraline products have a warning to dilute the liquid medicine before use on the front of the carton and bottle label (Figure 1). Mixing instructions are also provided on the side or back of the label.  

Here’s what you can do: If you, or a family member, are given a prescription for the liquid form of sertraline, it must be diluted immediately before use. When picking up the medicine, talk to the pharmacist to make sure you understand how to dilute it before taking (or giving) it. Learn how much medicine is needed for each dose and how to use the dropper to measure each dose. Always use the dropper that comes with the medicine to measure the required amount of liquid. Then mix the liquid medicine with 4 ounces (½ cup or approximately 120 mL) of water, ginger ale, lemon/lime soda, lemonade, or orange juice only. Other liquids should not be used to dilute this medicine. A slight haze may appear after mixing, which is normal. If you have any other questions, be sure to call your pharmacist or healthcare provider.

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