{"id":60980,"date":"2024-02-28T07:18:58","date_gmt":"2024-02-28T07:18:58","guid":{"rendered":"https:\/\/medsname.com\/sertafine\/"},"modified":"2026-05-01T10:49:16","modified_gmt":"2026-05-01T10:49:16","slug":"sertafine","status":"publish","type":"product","link":"https:\/\/medsbase.com\/cs\/product\/sertafine\/","title":{"rendered":"Sertafine"},"content":{"rendered":"

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\u26a1 Rychl\u00e1 odpov\u011b\u010f \u2014 Co je Sertafine?<\/h3>\n
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Sertafine<\/strong> obsahuje sertralin hydrochlorid (50 mg \/ 100 mg)<\/strong> od v\u00fdrobce certifikovan\u00e9ho WHO-GMP (v\u00fdroba spole\u010dnosti Cipla) \u2014 SSRI<\/strong> s \u0161irokou \u00fa\u010dinnost\u00ed u depresivn\u00edch a \u00fazkostn\u00fdch poruch. Standardn\u00ed d\u00e1vka pro dosp\u011bl\u00e9: 50 mg jednou denn\u011b<\/strong> s j\u00eddlem (rozmez\u00ed 50\u2013200 mg\/den; zvy\u0161ovat po 50 mg ka\u017ed\u00fdch 1\u20132 t\u00fddny). \u00da\u010dinek nastupuje postupn\u011b: \u00fazkost\/sp\u00e1nek se \u010dasto zlep\u0161\u00ed za 1\u20132 t\u00fddny; pln\u00fd \u00fa\u010dinek na n\u00e1ladu nast\u00e1v\u00e1 za 4\u20136 t\u00fddn\u016f. \u010cast\u00e9 po\u010d\u00e1te\u010dn\u00ed vedlej\u0161\u00ed \u00fa\u010dinky<\/strong> \u2014 nevolnost, \u0159\u00eddk\u00e1 stolice, bolest hlavy, nervozita, p\u0159echodn\u00e1 nespavost nebo ospalost \u2014 tyto p\u0159\u00edznaky obvykle ustoup\u00ed do 7\u201314 dn\u016f. P\u0159etrv\u00e1vaj\u00edc\u00ed<\/strong>: sexu\u00e1ln\u00ed dysfunkce (~40 %), pocen\u00ed a m\u00edrn\u00e9 zm\u011bny hmotnosti. Sertralin m\u00e1 nej\u010dist\u0161\u00ed CYP profil ze v\u0161ech SSRI<\/strong> \u2014 slab\u0161\u00ed inhibici CYP2D6 ne\u017e paroxetin nebo fluoxetin, co\u017e z n\u011bj \u010din\u00ed rozumnou volbu u pacient\u016f u\u017e\u00edvaj\u00edc\u00edch v\u00edce l\u00e9k\u016f.<\/p>\n<\/div>\n

\nCo z\u00edsk\u00e1te s MedsBase:<\/strong> V\u00fdrobce certifikovan\u00fd WHO-GMP \u00b7 Diskr\u00e9tn\u00ed balen\u00ed \u00b7 Celosv\u011btov\u00e1 doprava \u00b7 V\u00edce ne\u017e 1 400 ov\u011b\u0159en\u00fdch recenz\u00ed z\u00e1kazn\u00edk\u016f<\/a>\n<\/div>\n

\ud83d\udce6 Ka\u017ed\u00e1 objedn\u00e1vka je pokryta na\u0161\u00ed Z\u00e1rukou op\u011btovn\u00e9ho odesl\u00e1n\u00ed<\/strong><\/a> \u2014 pokud va\u0161e z\u00e1silka nedoraz\u00ed do 20 pracovn\u00edch dn\u016f, p\u0159epos\u00edl\u00e1me ji.<\/p>\n

Pro\u010d objedn\u00e1vat z MedsBase<\/h3>\n

Na\u0161e generick\u00e9 l\u00e9ky poch\u00e1zej\u00ed od v\u00fdrobc\u016f certifikovan\u00fdch WHO-GMP a jsou expedov\u00e1ny po cel\u00e9m sv\u011bt\u011b v diskr\u00e9tn\u00edm, nen\u00e1padn\u00e9m balen\u00ed \u2013 na vn\u011bj\u0161\u00ed stran\u011b bal\u00edku nen\u00ed uveden n\u00e1zev l\u00e9ku. Platby kartou jsou sm\u011brov\u00e1ny prost\u0159ednictv\u00edm regulovan\u00e9ho procesoru (popisky na v\u00fdpisu zahrnuj\u00ed regulovan\u00e9ho procesora plateb kartou \u2013 nikdy \u201cMedsBase\u201d nebo n\u00e1zev l\u00e9ku). P\u0159ij\u00edm\u00e1me tak\u00e9 kryptom\u011bny a bankovn\u00ed p\u0159evody SEPA. Ka\u017ed\u00e1 objedn\u00e1vka je zaji\u0161t\u011bna na\u0161\u00ed politikou p\u0159eposl\u00e1n\u00ed.<\/p>\n<\/div>\n

D\u016fle\u017eit\u00e9 \u2014 nejedn\u00e1 se o l\u00e9k na situa\u010dn\u00ed \u00fazkost.<\/strong> Sertafine je selektivn\u00ed inhibitor zp\u011btn\u00e9ho vychyt\u00e1v\u00e1n\u00ed serotoninu (SSRI)<\/strong>, p\u0159edepisov\u00e1n a titrov\u00e1n po t\u00fddny pro z\u00e1va\u017enou depresivn\u00ed poruchu (MDD), obsedantn\u011b-kompulzivn\u00ed poruchu (OCD), panickou poruchu, soci\u00e1ln\u00ed \u00fazkostnou poruchu, posttraumatickou stresovou poruchu (PTSD) a premenstrua\u010dn\u00ed dysforickou poruchu (PMDD)<\/strong>. Nen\u00ed ne<\/strong> spr\u00e1vn\u00fdm l\u00e9kem pro akutn\u00ed, v\u00fdkonov\u011b souvisej\u00edc\u00ed \u00fazkost (l\u00e9t\u00e1n\u00ed, ve\u0159ejn\u00e9 vystupov\u00e1n\u00ed, zkou\u0161ky) \u2014 pro tyto p\u0159\u00edpady jsou klinicky vhodn\u011bj\u0161\u00ed betablok\u00e1tory (propranolol), benzodiazepiny nebo hydroxyzin. Pokud nem\u00e1te diagnostikovanou poruchu n\u00e1lady, \u00fazkostnou nebo psychiatrickou poruchu, neza\u010d\u00ednejte s u\u017e\u00edv\u00e1n\u00edm tohoto l\u00e9ku.<\/div>\n
FDA \u010dern\u00e9 varov\u00e1n\u00ed \u2014 sebevra\u017eednost.<\/strong> V\u0161echna antidepresiva nesou \u010dern\u00e9 varov\u00e1n\u00ed FDA pro zv\u00fd\u0161en\u00e9 riziko sebevra\u017eedn\u00e9ho my\u0161len\u00ed a chov\u00e1n\u00ed u d\u011bt\u00ed, dosp\u00edvaj\u00edc\u00edch a mlad\u00fdch dosp\u011bl\u00fdch do 25 let, zejm\u00e9na b\u011bhem prvn\u00edch t\u00fddn\u016f l\u00e9\u010dby nebo po zm\u011bn\u00e1ch d\u00e1vkov\u00e1n\u00ed. \u010clenov\u00e9 rodiny a p\u0159edepisuj\u00edc\u00ed l\u00e9ka\u0159i by m\u011bli pe\u010dliv\u011b sledovat zhor\u0161en\u00ed n\u00e1lady, agitovanost nebo sebevra\u017eedn\u00e9 my\u0161lenky v t\u00e9to v\u011bkov\u00e9 skupin\u011b.<\/div>\n

Co je Sertafine?<\/h2>\n

Sertafine je peror\u00e1ln\u00ed tableta obsahuj\u00edc\u00ed sertralin hydrochlorid (50 mg \/ 100 mg)<\/strong> vyr\u00e1b\u011bn\u00e1 spole\u010dnost\u00ed Cipla v r\u00e1mci certifikace WHO-GMP. Sertralin (obchodn\u00ed n\u00e1zev Zoloft<\/strong> v USA, Lustral<\/strong> ve Velk\u00e9 Brit\u00e1nii) je selektivn\u00ed inhibitor zp\u011btn\u00e9ho vychyt\u00e1v\u00e1n\u00ed serotoninu (SSRI)<\/strong> spu\u0161t\u011bn spole\u010dnost\u00ed Pfizer v roce 1991 a pat\u0159\u00ed mezi nej\u010dast\u011bji p\u0159edepisovan\u00e1 antidepresiva na sv\u011bt\u011b. Selektivn\u011b blokuje presynaptick\u00fd serotoninov\u00fd transport\u00e9r (SERT), \u010d\u00edm\u017e zvy\u0161uje synaptick\u00fd serotonin dostupn\u00fd pro vazbu na postsynaptick\u00e9 5-HT receptory b\u011bhem t\u00fddn\u016f l\u00e9\u010dby.<\/p>\n

Sertralin je doporu\u010dov\u00e1n jako l\u00e9\u010dba prvn\u00ed volby v doporu\u010den\u00edch NICE, APA a WFSBP pro velkou depresi u dosp\u011bl\u00fdch a je schv\u00e1len FDA jako SSRI prvn\u00ed volby pro d\u011btskou OCD (v\u011bk \u2265 6).<\/p>\n

Schv\u00e1len\u00e9 indikace<\/h2>\n
    \n
  • Hlavn\u00ed depresivn\u00ed porucha (MDD)<\/strong> u dosp\u011bl\u00fdch; kombinace sertralin-paroxetin a sertralin-mirtazapin se b\u011b\u017en\u011b pou\u017e\u00edvaj\u00ed u l\u00e9\u010debn\u011b rezistentn\u00ed deprese.<\/li>\n
  • obsedantn\u011b-kompulzivn\u00ed porucha (OCD)<\/strong> u dosp\u011bl\u00fdch a d\u011bt\u00ed ve v\u011bku 6+; d\u00e1vky jsou obvykle titrov\u00e1ny vy\u0161\u0161\u00ed ne\u017e u MDD (100\u2013200 mg\/den).<\/li>\n
  • panick\u00e1 porucha<\/strong> s agorafobi\u00ed nebo bez n\u00ed; za\u010dn\u011bte ni\u017e\u0161\u00ed d\u00e1vkou (12,5\u201325 mg), abyste p\u0159ede\u0161li \u010dasn\u00e9mu zhor\u0161en\u00ed paniky.<\/li>\n
  • Soci\u00e1ln\u00ed \u00fazkostn\u00e1 porucha (soci\u00e1ln\u00ed fobie)<\/strong> \u2014 chronick\u00fd\/generalizovan\u00fd typ, nikoli pouze v\u00fdkonov\u00fd.<\/li>\n
  • Posttraumatick\u00e1 stresov\u00e1 porucha (PTSD)<\/strong> \u2014 jeden ze dvou SSRI schv\u00e1len\u00fdch FDA pro tuto indikaci (spolu s paroxetinem).<\/li>\n
  • Premenstrua\u010dn\u00ed dysforick\u00e1 porucha (PMDD)<\/strong> \u2014 lze d\u00e1vkovat kontinu\u00e1ln\u011b nebo pouze v lute\u00e1ln\u00ed f\u00e1zi (dny cyklu 14\u201328).<\/li>\n<\/ul>\n

    Standardn\u00ed d\u00e1vkov\u00e1n\u00ed podle indikace<\/h2>\n\n\n\n\n\n\n\n\n\n
    Indikace<\/th>\nStart<\/th>\nC\u00edlov\u00e1 d\u00e1vka<\/th>\nTitrace<\/th>\n<\/tr>\n<\/thead>\n
    MDD, soci\u00e1ln\u00ed \u00fazkost, PTSD, PMDD<\/td>\n50 mg jednou denn\u011b s j\u00eddlem<\/td>\n50\u2013200 mg\/den<\/td>\nZvy\u0161ovat o 50 mg ka\u017ed\u00fdch 1\u20132 t\u00fddny, pokud je sn\u00e1\u0161eno a \u010d\u00e1ste\u010dn\u00e1 odpov\u011b\u010f<\/td>\n<\/tr>\n
    panick\u00e1 porucha<\/td>\n12,5\u201325 mg\/den \u00d7 1 t\u00fdden<\/td>\n50\u2013200 mg\/den<\/td>\nPomalej\u0161\u00ed titrace pro minimalizaci po\u010d\u00e1te\u010dn\u00ed nervozity a exacerbace paniky<\/td>\n<\/tr>\n
    25 mg HS \u00d7 1 t\u00fdden<\/td>\n50 mg jednou denn\u011b<\/td>\n100\u2013200 mg\/den<\/td>\n\u010casto vy\u017eaduje horn\u00ed hranici d\u00e1vkov\u00e9ho rozmez\u00ed; vyhodnocen\u00ed odpov\u011bdi za 8\u201312 t\u00fddn\u016f<\/td>\n<\/tr>\n
    OCD (d\u011btsk\u00fd v\u011bk 6\u201312 let)<\/td>\n25 mg jednou denn\u011b<\/td>\n25\u2013200 mg\/den<\/td>\nPomalu zvy\u0161ujte d\u00e1vkov\u00e1n\u00ed; hmotnostn\u011b omezen\u00e9 d\u00e1vky u mlad\u0161\u00edch d\u011bt\u00ed<\/td>\n<\/tr>\n
    Porucha funkce jater<\/td>\n25 mg jednou denn\u011b<\/td>\nA\u017e 100 mg s opatrnost\u00ed<\/td>\nSn\u00ed\u017een\u00e1 clearance \u2014 pou\u017eijte nejni\u017e\u0161\u00ed \u00fa\u010dinnou d\u00e1vku<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

    Vedlej\u0161\u00ed \u00fa\u010dinky<\/h2>\n

    B\u011b\u017en\u00e9, p\u0159etrv\u00e1vaj\u00edc\u00ed a vz\u00e1cn\u00e9 ne\u017e\u00e1douc\u00ed \u00fa\u010dinky<\/h2>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
    Frekvence<\/th>\n\u00da\u010dinek<\/th>\nPozn\u00e1mky \/ management<\/th>\n<\/tr>\n<\/thead>\n
    B\u011b\u017en\u00e9 (>10 %)<\/td>\nNevolnost, pr\u016fjem, \u0159\u00eddk\u00e1 stolice<\/td>\nU\u017e\u00edvejte s j\u00eddlem; obvykle ustoup\u00ed do 1\u20132 t\u00fddn\u016f<\/td>\n<\/tr>\n
    B\u011b\u017en\u00e9<\/td>\nNespavost nebo ospalost<\/td>\nVariabiln\u00ed \u2014 pokud p\u016fsob\u00ed aktiva\u010dn\u011b, d\u00e1vkujte r\u00e1no; pokud sedativn\u011b, d\u00e1vkujte p\u0159ed span\u00edm<\/td>\n<\/tr>\n
    B\u011b\u017en\u00e9<\/td>\nBolest hlavy, z\u00e1vrat\u011b<\/td>\nDostate\u010dn\u00e1 hydratace; obvykle p\u0159echodn\u00e9<\/td>\n<\/tr>\n
    B\u011b\u017en\u00e9<\/td>\nSexu\u00e1ln\u00ed dysfunkce (opo\u017ed\u011bn\u00fd orgasmus, sn\u00ed\u017een\u00e9 libido)<\/td>\nP\u0159etrv\u00e1v\u00e1 a\u017e u 40 %; zva\u017ete l\u00e9kovou pauzu, sn\u00ed\u017een\u00ed d\u00e1vky nebo p\u0159echod na bupropion\/mirtazapin p\u0159i nesn\u00e1\u0161enlivosti<\/td>\n<\/tr>\n
    B\u011b\u017en\u00e9<\/td>\nPocen\u00ed, sucho v \u00fastech<\/td>\nP\u0159etrv\u00e1vaj\u00edc\u00ed m\u00edrn\u00e9 obt\u011b\u017eov\u00e1n\u00ed<\/td>\n<\/tr>\n
    M\u00e9n\u011b \u010dast\u00e9<\/td>\nP\u0159\u00edr\u016fstek hmotnosti (m\u00edrn\u00fd, +1\u20133 kg b\u011bhem m\u011bs\u00edc\u016f)<\/td>\nM\u00e9n\u011b ne\u017e paroxetin nebo mirtazapin<\/td>\n<\/tr>\n
    M\u00e9n\u011b \u010dast\u00e9<\/td>\nMod\u0159iny, krv\u00e1cen\u00ed do GI traktu<\/td>\nSSRI sni\u017euj\u00ed p\u0159\u00edjem serotoninu krevn\u00edmi desti\u010dkami; opatrnost s NSAID \/ antikoagulancii<\/td>\n<\/tr>\n
    Vz\u00e1cn\u00e9<\/td>\nHyponatr\u00e9mie (SIADH)<\/td>\nNejvy\u0161\u0161\u00ed riziko u star\u0161\u00edch dosp\u011bl\u00fdch; zkontrolujte Na+ p\u0159i zmatenosti nebo k\u0159e\u010d\u00edch<\/td>\n<\/tr>\n
    Vz\u00e1cn\u00e9<\/td>\nSerotoninov\u00fd syndrom<\/td>\nViz sekce l\u00e9kov\u00fdch interakc\u00ed<\/td>\n<\/tr>\n
    Vz\u00e1cn\u00e9<\/td>\nProdlou\u017een\u00ed QT intervalu p\u0159i vysok\u00fdch d\u00e1vk\u00e1ch<\/td>\nDokumentujte v\u00fdchoz\u00ed EKG u pacient\u016f s kardiovaskul\u00e1rn\u00edm rizikem<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

    Interakce s l\u00e9\u010divy<\/h2>\n

    Absolutn\u00ed kontraindikace<\/strong>: inhibitory monoaminooxid\u00e1zy (MAOI) v\u010detn\u011b selegilinu, rasagilinu, linezolidu (antibiotikum s MAOI aktivitou), methylenov\u00e9 mod\u0159i \u2014 dodr\u017ete 14 dn\u00ed<\/strong> vylu\u010dovac\u00ed interval p\u0159ed nebo po sertralinu. Sou\u010dasn\u00e9 pod\u00e1v\u00e1n\u00ed pimozidu je kontraindikov\u00e1no kv\u016fli riziku QT prodlou\u017een\u00ed.<\/p>\n

    Riziko serotoninov\u00e9ho syndromu \u2014 kombinujte opatrn\u011b a pouze pod dohledem p\u0159edepisuj\u00edc\u00edho l\u00e9ka\u0159e<\/strong>: triptany (sumatriptan, rizatriptan), tramadol, petidin (meperidin), dextromethorfan, t\u0159ezalka te\u010dkovan\u00e1, lithium, dal\u0161\u00ed serotonergn\u00ed antidepresiva.<\/p>\n

    Riziko krv\u00e1cen\u00ed \u2014 kombinujte opatrn\u011b<\/strong>: NSAID, aspirin, warfarin, DOAC \u2014 SSRI sni\u017euj\u00ed p\u0159\u00edjem serotoninu krevn\u00edmi desti\u010dkami.<\/p>\n

    Zm\u011bny hladin v plazm\u011b<\/strong>: sertralin m\u00edrn\u011b inhibuje CYP2D6 (m\u00e9n\u011b ne\u017e paroxetin \/ fluoxetin) \u2014 m\u00edrn\u00e1 interakce s metoprololem, kodeinem, tamoxifenem, atomoxetinem.<\/p>\n

    Syndrom z vysazen\u00ed<\/h2>\n

    Sertralin m\u00e1 st\u0159edn\u00ed polo\u010das rozpadu (~26 h)<\/strong> \u2014 abstinen\u010dn\u00ed p\u0159\u00edznaky jsou m\u00edrn\u011bj\u0161\u00ed ne\u017e u paroxetinu nebo venlafaxinu, ale re\u00e1ln\u00e9<\/strong>. P\u0159\u00edznaky (mnemonika FINISH): ch\u0159ipkov\u00e9 bolesti, nespavost, nevolnost, nerovnov\u00e1ha\/z\u00e1vrat\u011b, smyslov\u00e9 poruchy (\u201cmozkov\u00e9 v\u00fdboje\u201d), hyperarousal. Obvykle za\u010d\u00ednaj\u00ed 2\u20134 dny po vynech\u00e1n\u00ed d\u00e1vky nebo n\u00e1hl\u00e9m vysazen\u00ed a ustupuj\u00ed b\u011bhem 1\u20133 t\u00fddn\u016f. Postupn\u00e9 vysazov\u00e1n\u00ed<\/strong>: sni\u017eujte o 25\u201350 mg ka\u017ed\u00e9 2\u20134 t\u00fddny; u dlouhodob\u00fdch u\u017eivatel\u016f (> 12 m\u011bs\u00edc\u016f) vysazujte pomaleji pomoc\u00ed hyperbolick\u00fdch krok\u016f, abyste p\u0159ede\u0161li prodlou\u017een\u00e9mu abstinen\u010dn\u00edmu syndromu.<\/p>\n

    T\u011bhotenstv\u00ed a kojen\u00ed<\/h2>\n

    Sertralin je jedn\u00edm z preferovan\u00fdch SSRI v t\u011bhotenstv\u00ed<\/strong> kdy\u017e je indikov\u00e1na l\u00e9\u010dba antidepresivy \u2014 nejrozs\u00e1hlej\u0161\u00ed registry data a doporu\u010den\u00ed ACOG podporuj\u00ed pokra\u010dov\u00e1n\u00ed u\u017e\u00edv\u00e1n\u00ed u st\u0159edn\u011b t\u011b\u017ek\u00e9 a\u017e t\u011b\u017ek\u00e9 MDD. Expozice v pozdn\u00edm t\u0159et\u00edm trimestru nese mal\u00e9 riziko neonat\u00e1ln\u00edho adapta\u010dn\u00edho syndromu<\/strong> (neklid, pot\u00ed\u017ee s krmen\u00edm \u2014 obvykle vymiz\u00ed b\u011bhem 1\u20132 t\u00fddn\u016f). Sertralin p\u0159ech\u00e1z\u00ed do mate\u0159sk\u00e9ho ml\u00e9ka minim\u00e1ln\u011b a je preferovan\u00fdm SSRI p\u0159i kojen\u00ed<\/strong>.<\/p>\n

    Volba sertralinu vs. jin\u00e1 SSRI<\/h2>\n

    Ve srovn\u00e1n\u00ed s jin\u00fdmi b\u011b\u017en\u011b pou\u017e\u00edvan\u00fdmi SSRI<\/h2>\n\n\n\n\n\n\n\n\n
    L\u00e9k<\/th>\nV\u00fdznamn\u00e9 p\u0159ednosti<\/th>\nV\u00fdznamn\u00e9 nev\u00fdhody<\/th>\n<\/tr>\n<\/thead>\n
    Sertraline<\/td>\nNej\u010dist\u0161\u00ed CYP profil; preferov\u00e1n v t\u011bhotenstv\u00ed\/kojen\u00ed; \u0161irok\u00e9 indikace<\/td>\nGI ne\u017e\u00e1douc\u00ed \u00fa\u010dinky v\u00fdrazn\u011bj\u0161\u00ed na za\u010d\u00e1tku<\/td>\n<\/tr>\n
    Paroxetin (Xepar)<\/td>\nVhodn\u00fd pro GAD a paniku; sedativn\u00ed \u00fa\u010dinky \u2014 pom\u00e1h\u00e1 p\u0159i nespavosti<\/td>\nNejhor\u0161\u00ed abstinen\u010dn\u00ed syndrom; p\u0159ib\u00edr\u00e1n\u00ed na v\u00e1ze; t\u011bhotensk\u00e1 kategorie D<\/td>\n<\/tr>\n
    Escitalopram<\/td>\nNej\u010dist\u0161\u00ed sn\u00e1\u0161enlivost; dob\u0159e prostudov\u00e1n u GAD<\/td>\nD\u00e1vkov\u011b z\u00e1visl\u00e9 prodlou\u017een\u00ed QT intervalu; max 20 mg, 10 mg u senior\u016f<\/td>\n<\/tr>\n
    Fluoxetine<\/td>\nDlouh\u00fd polo\u010das rozpadu zm\u00edr\u0148uje n\u00e1sledky vysazen\u00ed; aktivuje<\/td>\nInhibice CYP2D6; vyplavov\u00e1n\u00ed trv\u00e1 d\u00e9le p\u0159i p\u0159echodu na jin\u00fd l\u00e9k<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

    \u010casto kladen\u00e9 dotazy<\/h2>\n

    Jak dlouho trv\u00e1, ne\u017e Sertafine za\u010dne \u00fa\u010dinkovat?<\/h3>\n

    \u00dazkost, sp\u00e1nek a somatick\u00e9 p\u0159\u00edznaky se \u010dasto zlep\u0161\u00ed b\u011bhem 1\u20132 t\u00fddn\u016f. \u00dapln\u00e1 odezva n\u00e1lady u MDD se obvykle objev\u00ed za 4\u20136 t\u00fddn\u016f. U OCD je \u010dasto pot\u0159eba 8\u201312 t\u00fddn\u016f v horn\u00ed d\u00e1vkov\u00e9 hranici. Nehodno\u0165te \u00fa\u010dinnost p\u0159ed 6 t\u00fddny p\u0159i adekv\u00e1tn\u00ed d\u00e1vce.<\/p>\n

    Mohu p\u0159estat u\u017e\u00edvat Sertafine, kdy\u017e se budu c\u00edtit l\u00e9pe?<\/h3>\n

    P\u0159i prvn\u00edm epizod\u011b MDD doporu\u010duj\u00ed pokyny pokra\u010dovat alespo\u0148 6\u20139 m\u011bs\u00edc\u016f po remisi. U opakuj\u00edc\u00ed se MDD nebo chronick\u00e9 \u00fazkosti jsou b\u011b\u017en\u00e9 del\u0161\u00ed l\u00e9\u010debn\u00e9 k\u00fary (1\u20132+ roky). V\u017edy sni\u017eujte d\u00e1vku postupn\u011b, nikoli n\u00e1hle.<\/p>\n

    Zp\u016fsobuje Sertafine p\u0159ib\u00edr\u00e1n\u00ed na v\u00e1ze?<\/h3>\n

    Sertralin zp\u016fsobuje pouze m\u00edrn\u00e9 p\u0159ib\u00edr\u00e1n\u00ed na v\u00e1ze v pr\u016fb\u011bhu m\u011bs\u00edc\u016f \u2014 mnohem m\u00e9n\u011b ne\u017e paroxetin nebo mirtazapin. N\u011bkte\u0159\u00ed pacienti zpo\u010d\u00e1tku hubnou kv\u016fli gastrointestin\u00e1ln\u00edm ne\u017e\u00e1douc\u00edm \u00fa\u010dink\u016fm.<\/p>\n

    Zp\u016fsobuje Sertafine sexu\u00e1ln\u00ed ne\u017e\u00e1douc\u00ed \u00fa\u010dinky?<\/h3>\n

    Ano \u2014 SSRI jako t\u0159\u00edda mohou u p\u0159ibli\u017en\u011b 40 % u\u017eivatel\u016f zp\u016fsobit opo\u017ed\u011bn\u00fd orgasmus, sn\u00ed\u017een\u00e9 libido a erektiln\u00ed pot\u00ed\u017ee. Pokud p\u0159etrv\u00e1vaj\u00ed a jsou obt\u011b\u017euj\u00edc\u00ed, mo\u017enosti zahrnuj\u00ed sn\u00ed\u017een\u00ed d\u00e1vky, p\u0159est\u00e1vky v u\u017e\u00edv\u00e1n\u00ed (po konzultaci s l\u00e9ka\u0159em) nebo p\u0159echod na bupropion nebo mirtazapin.<\/p>\n

    Mohu p\u00edt alkohol p\u0159i u\u017e\u00edv\u00e1n\u00ed Sertafine?<\/h3>\n

    Lehk\u00e1, p\u0159\u00edle\u017eitostn\u00e1 konzumace alkoholu je obecn\u011b tolerov\u00e1na, ale alkohol zhor\u0161uje depresi a \u00fazkost, zvy\u0161uje sedaci a je spojov\u00e1n s disinhibovan\u00fdm nebo impulzivn\u00edm chov\u00e1n\u00edm b\u011bhem prvn\u00edch t\u00fddn\u016f l\u00e9\u010dby. Vyhn\u011bte se nadm\u011brn\u00e9mu u\u017e\u00edv\u00e1n\u00ed.<\/p>\n

    Co se stane, kdy\u017e vynech\u00e1m d\u00e1vku?<\/h3>\n

    Vezm\u011bte si ho, jakmile si vzpomenete, pokud nen\u00ed bl\u00edzko dal\u0161\u00ed d\u00e1vky \u2014 nikdy nezdvojujte d\u00e1vku. Vynech\u00e1n\u00ed jedn\u00e9 d\u00e1vky z\u0159\u00eddka zp\u016fsob\u00ed probl\u00e9my vzhledem k 26hodinov\u00e9mu polo\u010dasu rozpadu sertralinu.<\/p>\n

    Je Sertafine bezpe\u010dn\u00fd v t\u011bhotenstv\u00ed?<\/h3>\n

    Sertralin je jedn\u00edm z preferovan\u00fdch SSRI, kdy\u017e je v t\u011bhotenstv\u00ed pot\u0159ebn\u00e1 l\u00e9\u010dba antidepresivy. Proberte p\u0159\u00ednosy a rizika individu\u00e1ln\u011b s p\u0159edepisuj\u00edc\u00edm l\u00e9ka\u0159em, zejm\u00e9na v prvn\u00edm trimestru a kolem porodu.<\/p>\n

    Lze Sertafine kombinovat s jin\u00fdmi antidepresivy?<\/h3>\n

    Kombinace (nap\u0159. s mirtazapinem v tzv. \u201ckalifornsk\u00e9 raketov\u00e9 sm\u011bsi\u201d) se pou\u017e\u00edvaj\u00ed u l\u00e9\u010debn\u011b rezistentn\u00ed deprese, ale pouze pod dohledem l\u00e9ka\u0159e. Kombinace s inhibitory MAO, linezolidem, methylenovou mod\u0159\u00ed nebo nadm\u011brn\u00fdm mno\u017estv\u00edm serotoninergn\u00edch l\u00e1tek (triptany, tramadol, t\u0159ezalka te\u010dkovan\u00e1) zvy\u0161uje riziko serotoninov\u00e9ho syndromu.<\/p>\n

    Jak se Sertafine li\u0161\u00ed od alternativ jako Sertima nebo Zosert?<\/h3>\n

    V\u0161echny zna\u010dky sertralinu jsou farmakologicky toto\u017en\u00e9 na molekul\u00e1rn\u00ed \u00farovni. Rozd\u00edly mezi zna\u010dkami spo\u010d\u00edvaj\u00ed v v\u00fdrobci, vzhledu tablet, pomocn\u00fdch l\u00e1tk\u00e1ch a cen\u011b. Nab\u00edz\u00edme generika certifikovan\u00e1 WHO-GMP od indick\u00fdch v\u00fdrobc\u016f pod r\u016fzn\u00fdmi zna\u010dkami, aby si z\u00e1kazn\u00edci mohli vybrat, co je skladem.<\/p>\n

    Jak by se m\u011bl Sertafine skladovat?<\/h3>\n

    Skladujte p\u0159i teplot\u011b 15\u201330 \u00b0C v p\u016fvodn\u00edm blistrov\u00e9m obalu, mimo dosah vlhkosti a p\u0159\u00edm\u00e9ho slune\u010dn\u00edho sv\u011btla. Uchov\u00e1vejte mimo dosah d\u011bt\u00ed \u2013 p\u0159ed\u00e1vkov\u00e1n\u00ed sertralinem, i kdy\u017e je m\u00e9n\u011b nebezpe\u010dn\u00e9 ne\u017e u TCA, m\u00e1 v\u00fdznamn\u00e9 zdravotn\u00ed d\u016fsledky.<\/p>\n

    Zdravotn\u00ed upozorn\u011bn\u00ed:<\/strong> Informace na t\u00e9to str\u00e1nce jsou ur\u010deny dosp\u011bl\u00fdm u\u017e\u00edvaj\u00edc\u00edm p\u0159edepsan\u00e9 psychiatrick\u00e9 l\u00e9ky a nenahrazuj\u00ed individu\u00e1ln\u00ed l\u00e9ka\u0159skou p\u00e9\u010di. Antidepresiva, antipsychotika a p\u0159\u00edbuzn\u00e9 l\u00e9ky mohou interagovat s jin\u00fdmi l\u00e9ky, alkoholem a st\u00e1vaj\u00edc\u00edmi zdravotn\u00edmi stavy. Jak\u00e9koli nov\u00e9 l\u00e9ky, zm\u011bnu d\u00e1vkov\u00e1n\u00ed nebo pl\u00e1novan\u00e9 vysazen\u00ed konzultujte s kvalifikovan\u00fdm l\u00e9ka\u0159em. Pokud se u v\u00e1s objev\u00ed sebevra\u017eedn\u00e9 my\u0161lenky, m\u00e1nie, t\u011b\u017ek\u00e1 akathisie, p\u0159\u00edznaky serotoninov\u00e9ho syndromu (vysok\u00e1 hore\u010dka, zmatenost, svalov\u00e1 ztuhlost, zrychlen\u00fd srde\u010dn\u00ed tep) nebo neuroleptick\u00fd malign\u00ed syndrom, vyhledejte okam\u017eit\u011b l\u00e9ka\u0159skou pomoc.<\/div>\n

    <\/p>\n

    Souvisej\u00edc\u00ed alternativy<\/h3>\n

    Dal\u0161\u00ed produkty v Chronick\u00e1 onemocn\u011bn\u00ed<\/strong> kter\u00e9 z\u00e1kazn\u00edci tak\u00e9 prohl\u00ed\u017eej\u00ed:<\/p>\n