Liquid Zoloft (sertraline oral concentrate) comes at a concentration of 20 mg per milliliter and must be diluted in a specific liquid before you drink it. The process is straightforward, but there are a few rules about what you can and can’t mix it with that matter for the medication to work properly.
How to Measure Your Dose
The bottle comes with a calibrated dropper built into the cap. Use only this dropper to measure your dose. For reference, a typical starting dose for depression or OCD is 50 mg per day, which equals 2.5 mL on the dropper. For panic disorder, PTSD, or social anxiety disorder, the starting dose is usually lower at 25 mg (1.25 mL), increasing to 50 mg after one week. Your prescriber may adjust your dose in 50 mg steps up to a maximum of 200 mg per day.
What to Mix It With
After measuring your dose, squeeze the dropper into half a cup (4 ounces) of one of these five approved liquids:
- Water
- Ginger ale
- Lemon-lime soda
- Lemonade
- Orange juice
Do not mix it with anything else. Other liquids haven’t been tested and could interact with the concentrate in ways that affect how the medication works. The mixture may look slightly hazy after stirring, which is normal.
Two timing rules are important here. First, don’t mix the dose ahead of time. Only combine the concentrate with liquid when you’re ready to take it. Second, drink the entire mixture right away after mixing. Don’t sip it over the course of an hour or save half for later.
Taking It With or Without Food
You can take liquid sertraline on an empty stomach or with a meal. Unlike some medications that need food for absorption, sertraline works either way. If you find it causes mild nausea, taking it with a snack or after eating can help, but it’s not required.
Improving the Taste
The concentrate contains menthol, and many people find the taste strong or unpleasant. Mixing with ginger ale, lemon-lime soda, or lemonade instead of plain water can help mask it. If you’re giving it to a child (it’s approved for OCD in children ages 6 to 17), a few additional strategies can help. Having your child suck on a popsicle right before taking the dose partially numbs the taste buds. Following the medication with a favorite drink like chocolate milk, or chasing it with something sweet like a couple of jelly beans, can also make the experience easier. Coating the tongue with a spoonful of peanut butter or maple syrup beforehand is another option.
Just keep in mind that the concentrate itself must only go into one of the five approved liquids listed above. The taste-masking strategies work best as something you use before or after the dose, not mixed into it.
Important Safety Details
Liquid sertraline contains 12% alcohol. This has three practical implications worth knowing about.
If you take disulfiram (a medication used to support alcohol abstinence), you cannot use the liquid form of sertraline. The alcohol content will trigger a disulfiram reaction, which can cause severe nausea, flushing, and rapid heartbeat. The tablet form of sertraline doesn’t contain alcohol and would be the alternative.
During pregnancy, the liquid form is not recommended because of this alcohol content. There is no known safe level of alcohol exposure during pregnancy, and each dose delivers a small amount. If you become pregnant while taking liquid sertraline, talk to your prescriber about switching to tablets.
The dropper dispenser also contains dry natural rubber. If you have a latex sensitivity, handle it with care or ask your pharmacist about alternative ways to measure the dose.
Storing the Bottle
The concentrate doesn’t need refrigeration or any special temperature conditions. Store it at room temperature, away from direct light. Once you open the bottle, use or discard it within 30 days. Writing the date you opened it on the label is a simple way to keep track.
If You Miss a Dose
Take the missed dose as soon as you remember, unless it’s close to the time for your next scheduled dose. In that case, skip the missed one and continue with your regular timing. Don’t double up to make up for a missed dose. Sertraline works best when taken consistently at roughly the same time each day, so building it into a daily routine (morning coffee, brushing your teeth at night) helps with consistency.