Sertraline is used to treat many conditions including the following; depression, obsessive-compulsive disorder (OCD), panic disorder, premenstrual dysphoric disorder (PMDD), posttraumatic stress disorder (PTSD), social anxiety disorder (SAD) and Premature Ejaculation(PE).

Though the exact cause of PE is not known, serotonin may play a role. Serotonin is a natural substance made by nerves. High amounts of serotonin in the brain increase the time to ejaculation. Low amounts can shorten the time to ejaculation, and lead to PE.

Doctors noticed that men and women on antidepressants have delayed orgasms. Drugs such as fluoxetine, paroxetine, sertraline and clomipramine affect serotonin levels. Doctors began to use these drugs “off-label” (for a different reason than the drug’s original use) to treat PE.

Sertraline belongs to a group of medicines known as selective serotonin reuptake inhibitors (SSRIs). It works by increasing the activity of serotonin in the brain.

This medicine is available only with your doctor’s prescription.

Drugs for PE can be taken every day or only before sex. Most doctors suggest a single dose from 4 to 8 hours before sex. If drugs such as Sertraline are taken every day then the risk of adverse effects and drug interactions is increased. Therefore, our Thrones physicians DO NOT recommend using this medicine everyday and prefer an “as needed” approach to treatment.

Proper Use of this medication

Take this medicine only as directed by your doctor, to benefit your condition as much as possible. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

This medicine should come with a Medication Guide. It is very important that you read and understand this information. Be sure to ask your doctor about anything you do not understand.

The tablets may be taken with or without food.

Dosing of Sertraline for PE

Our Thrones physicians recommend a single 50mg tablet to be taken 4-8 hours before sex.

You will be provided with a total of 5 pills per month initially. We are NOT recommending the daily use of Sertraline for PE at this time.

Use & Storage of Sertraline

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.

Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Before using Sertraline for PE

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:


Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Older Population

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of sertraline in the elderly. However, elderly patients may be more sensitive to the effects of this medicine than younger adults, and are more likely to have hyponatremia (low sodium in the blood), which may require caution and an adjustment in the dose for patients receiving sertraline.

Drug Interactions with Sertraline

Please note that these possible interactions will be more common if you take Sertraline daily. We do NOT recommend daily use for PE at this time. Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take:

  • Bepridil

  • Bromopride

  • Cisapride

  • Clorgyline

  • Dronedarone

  • Eliglustat

  • Furazolidone

  • Iproniazid

  • Isocarboxazid

  • Linezolid

  • Mesoridazine

  • Methylene Blue

  • Metoclopramide

  • Moclobemide

  • Nialamide

  • Pargyline

  • Phenelzine

  • Pimozide

  • Piperaquine

  • Procarbazine

  • Rasagiline

  • Saquinavir

  • Selegiline

  • Sparfloxacin

  • Terfenadine

  • Thioridazine

  • Toloxatone

  • Tranylcypromine

  • Ziprasidone

Using Sertraline with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines:

  • Alprazolam

  • Cimetidine

  • Fluphenazine

  • Ginkgo

  • Lamotrigine

  • Propranolol

  • Rifampin

  • Zolpidem

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

  • Grapefruit Juice

If you uncertain about the possibility of a drug interaction with Sertraline please consult with your doctor.


Important Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Bipolar disorder (mood disorder with mania and depression), or risk of or

  • Bleeding problems or

  • Diabetes or

  • Glaucoma, angle-closure, or history of or

  • Hyponatremia (low sodium in the blood) or

  • Mania or hypomania, history of or

  • Purpura (purplish or brownish-red discoloration of the skin), history of or

  • Seizures, history of—Use with caution. May make these conditions worse.

  • Liver disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

Special Precautions

Do not take sertraline with a monoamine oxidase (MAO) inhibitor (eg, isocarboxazid [Marplan®], phenelzine [Nardil®], selegiline[Eldepryl®], tranylcypromine [Parnate®]). Do not start taking sertraline during the 2 weeks after you stop a MAO inhibitor and wait 2 weeks after stopping sertraline before you start taking a MAO inhibitor. If you take them together or do not wait 2 weeks, you may develop confusion, agitation, restlessness, stomach or intestinal symptoms, a sudden high body temperature, an extremely high blood pressure, or severe convulsions.

Sertraline may cause a serious condition called Serotonin Syndrome if taken together with some medicines. Do not use sertraline with buspirone (Buspar®), fentanyl (Abstral®, Duragesic®), linezolid (Zyvox®), lithium (Eskalith®, Lithobid®), methylene blue injection, tryptophan, St. John’s wort, or some pain or migraine medicines (eg, rizatriptan, sumatriptan, tramadol, Frova®, Imitrex®, Maxalt®, Relpax®, Ultram®, Zomig®). Check with your doctor first before taking any other medicines with sertraline.

For some children, teenagers, and young adults, this medicine can increase thoughts of suicide. Tell your doctor right away if you start to feel more depressed and have thoughts about hurting yourself. Report any unusual thoughts or behaviors that trouble you especially if they are new or get worse quickly. Make sure the doctor knows if you have trouble sleeping, get upset easily, have a big increase in energy, or start to act reckless. Also tell the doctor if you have sudden or strong feelings, such as feeling nervous, angry, restless, violent, or scared. Let the doctor know if you or anyone in your family has bipolar disorder (manic-depressive) or has tried to commit suicide.

Sertraline may increase your risk for bleeding problems. Make sure your doctor knows if you are also using other medicines that thin the blood, such as aspirin, NSAID pain or arthritis medicines (eg, diclofenac, ibuprofen, naproxen, Advil®, Aleve®, Celebrex®, Voltaren®), or warfarin (Coumadin®, Jantoven®).

This medicine may cause hyponatremia (low sodium in the blood). This is more common in elderly patients, those who are taking diuretic medicines for high blood pressure, or those who have decreased amounts of fluid in the body due to severe diarrhea or vomiting. Check with your doctor right away if you have headache, trouble concentrating, memory problems, confusion, weakness, or unsteadiness.

This medicine may affect blood sugar levels. If you are diabetic and notice a change in the results of your blood or urine sugar tests, talk with your doctor.

The use of alcohol is not recommended in patients who are taking sertraline.

This medicine may cause some people to become drowsy, to have trouble thinking, or to have problems with movement. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are not alert or well-coordinated.

Before you have any medical tests, tell the medical doctor in charge that you or are taking this medicine.

The results of some tests may be affected by this medicine.

What happens if I overdose

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

  • Alcohol (Ethyl)

  • Alfuzosin

  • Alprostadil

  • Amiodarone

  • Amyl Nitrite (Poppers)

  • Anagrelide

  • Arsenic Trioxide

  • Azithromycin

  • Boceprevir

  • Butalbital

  • Capsaicin

  • Carbamazepine

  • Chloramphenicol

  • Chloroquine

  • Chlorpromazine

  • Cilostazol

  • Ciprofloxacin

  • Citalopram

  • Clarithromycin

  • Cobicistat

  • Cocaine

  • Conivaptan

  • Dabrafenib

  • Dapoxetine

  • Disopyramide

  • Dofetilide

  • Domperidone

  • Donepezil

  • Doxazosin

  • Dronedarone

  • Droperidol

  • Efavirenz

  • Enzalutamide

  • Erythromycin

  • Escitalopram

  • Flecainide

  • Fluconazole

  • Fusidic Acid (Systemic)

  • Haloperidol

  • Ibutilide

  • Idelalisib

  • Indinavir

  • Itraconazole

  • Ketoconazole

  • Levofloxacin

  • Methadone

  • MiFEPRIStone

  • Mitotane

  • Modafinil

  • Molsidomine

  • Moxifloxacin

  • Nefazodone

  • Nelfinavir

  • Nevirapine

  • Nitroprusside

  • Ondansetron

  • Oxaliplatin

  • Oxcarbazepine

  • Papaverine

  • Pentamidine

  • Phenobarbital

  • Phenytoin

  • Pimozide

  • Pioglitazone

  • Posaconazole

  • Prazosin

  • Procainamide

  • Propofol

  • Quercetin

  • Quinidine

  • Rifabutin

  • Rifampicin

  • Riociguat

  • Ritonavir

  • Saint John’s Wort

  • Saquinavir

  • Sevoflurane

  • Silodosin

  • Sotalol

  • Stiripentol

  • Tamsulosin

  • Telaprevir

  • Telithromycin

  • Terazosin

  • Thioridazine

  • Topiramate

  • Troglitazone

  • Vandetanib

  • Vasodilators (Organic Nitrates)

  • Voriconazole


Accurate Information

Your healthcare provider has evaluated the specific health information you provided and is making their recommendations based on it. If you forgot to provide or incorrectly provided that information your healthcare provider may misdiagnose or fail to diagnose conditions that you may have which could affect their recommendation for treatment. If you need to clarify or update any information about your health you can message or call us anytime.

Treatment Failure

This treatment is not 100% effective. It may not work or may only partially resolve the condition for which you are seeking treatment. If the treatment is not working, or if you are experiencing new or worsening symptoms, give us a call or message us anytime. If it is an emergency call 911 or seek immediate medical help in-person. You may need to seek alternative treatment such as those listed below or in the follow-up plan.

Misdiagnosis or Delayed Diagnosis

There is also a risk that your healthcare provider will misdiagnose or fail to diagnose conditions that you may have which could affect their recommendation for treatment. This risk exists with a doctor in-person as well but they may have additional signs and symptoms to aid their evaluation. The healthcare providers practicing through the Thrones platform use evidence based practice and guidelines as well as clinical decision support to minimize these risks. Here are some other diagnoses that they attempt to rule out:

  • Cardiovascular disease

  • Major anxiety or depression

  • Peyronie’s disease

  • Testosterone deficiency

Accepting or Declining Our Recommendation

Your healthcare provider is recommending this treatment for you because the potential benefits outweigh the risks. You should evaluate this information as well as the manufacturer’s insert, any input from your in-person healthcare team, and any other relevant information to decide if this treatment plan is appropriate for you. You are free to not follow the recommendations from your healthcare provider although there may also be risks associated with no treatment.

Alternative Treatment

Your healthcare provider has based their recommendation on your specific case and medical guidelines, but there may be alternative treatments or strategies that may be helpful to you. Some may be more or less effective than what has been provided to you. Some treatments may require an in-person exam or procedure which is not available through the platform. Message us or talk to your doctor in-person to discuss alternative treatments. Here are some other treatments or strategies that you might consider:

  • Cognitive behavioral therapy

  • Penile injection therapy

  • Penile re-vascularization surgery

Self Care

  • Drug and alcohol treatment – both drug and alcohol abuse cause worsening of ED, and cause long-term problems

  • Exercise – regular exercise helps with stress, weight loss or maintenance and increases blood flow

  • Quit smoking – if you are a smoker, over-the-counter products may help

  • Therapy – a trained healthcare specialist can assist with talking through any underlying concerns that may be affecting sexual health or relationship issues

  • Weight loss – being overweight can cause or make ED worse