Patient/caregiver was educated on precautions to be exercised while taking zoloft as follows:
- Zoloft intake can thin the blood and increase risk for bleeding in the skin and mucus membranes. Patients can present with bleeding spots on the skin, internal abdominal bleeding with fresh blood or partially digested blood in the stool, and bleeding in the urine staining the urine brownish red. This risk is further more in individuals concurrently taking blood thinners and anticoagulants, such as, aspirin, warfarin, Xarelto, and Eliquis. Some other antidepressants and antipsychotic medications also contribute to thinning of blood and episodes of bleeding. Administration of zoloft along with these medications can precipitate dangerous bleeding episodes. Check with your physician on the safety with zoloft use and the possibility for interaction with other medications on your list. While taking zoloft, keep a close watch on the stool and urine color for any red discoloration, indicating fresh bleeds. Report to your physician regarding any bleeding spots in the skin, episodes of fresh bleed with the stool and urine, after starting to take zoloft. Partially digested blood from internal abdominal bleeding can stain the stool black and tarry, which also must be reported to the physician.
- Zoloft intake can also induce a life-threatening reaction called Neuroleptic Malignant Syndrome (NMS). Individuals with NMS can present with high fever, episodes of confusion, intense muscle rigidity and contractions, elevated blood pressure, and rapid heart rate. Uncontrolled seizure activity and intense muscle contractions from zoloft use can lead to muscle damage and breakdown. Potassium ion from within the damaged muscle cells can leak out into the blood and body fluids, thus causing an acute increase in blood potassium levels. This acute elevation of potassium levels in the blood from zoloft use can lead to life-threatening cardiac arrhythmias. Individuals can present with episodes of chest pain, intense shortness of breath, altered heartbeat, ineffective heart contractions, dizziness/loss of consciousness from arrhythmias. Report the cardiac arrhythmias to your physician promptly for any appropriate measures to be considered.
- If you miss a dose, try taking it at the earliest notice of noncompliance. If it is time for the next dose, skip the missed dose and take the dose scheduled. Do not take an extra dose to try making up for the missed dose. Notify your doctor and other health care personnel regarding your dose noncompliance.
