Can Zoloft (sertraline) be compounded? (3 options)

Can Zoloft (sertraline) be compounded?

Yes, Zoloft or sertraline can be compounded. Compounded sertraline is a customised pharmaceutical product created by compounding pharmacists to meet the needs of a specific patient. These formulations are not commercially available and are not manufactured on large scales. 

They are typically compounded based on a healthcare provider’s prescription to help a patient who can’t take the available dosage forms of the medication. Antidepressant compounding is not that common compared to other types of medications; however, sertraline can still be compounded but not without a prescription (1,2).

What can sertraline be compounded into? 

Sertraline can be compounded into the following dosage forms:

Compounded formulationsDetails 
Transdermal GelsTopical formulations are designed to be applied to the skin, facilitating the absorption of medication through the skin barrier.
Liquid PreparationsCustomised liquid forms, such as suspensions or solutions, provide flexibility in dosage and ease of administration.
CapsulesCustomised oral dosage forms enclosed in a hard-shell capsule

Transdermal gels

Sertraline can be compounded into transdermal gels or can be added to a gel base such as Lipoderm, which delivers the active pharmaceutical drug through the transdermal route or the skin. 

The carefully calculated dose of sertraline is mixed into the gel base with other ingredients if deemed fit by the compounding pharmacist. Such preparations are designed to be used topically and can have health benefits for certain individuals. 

Transdermal sertraline can avoid the first-pass metabolism by the liver, which breaks down the medication when taken orally (3). This can reduce the bioavailability of the medication, and using it through the transdermal route can help avoid that. 

However, it’s still not considered as good as oral sertraline intake, and people who do not have any issues consuming Zoloft tablets should stick to it.

Liquid formulations

Sertraline can also be compounded into liquid dosage forms. The calculated dose of the antidepressant can be added to a liquid base or vehicles in which it is most dissolvable or dispersible. Such liquid preparations can be helpful for children who can’t consume higher doses and prefer liquid formulations over solid ones. 

However, these preparations are only compounded if prescribed by a healthcare professional, and dose calculation is crucial to ensure that individuals receive just the right amount of sertraline, not any more or less than the prescribed dose.

Capsules

Zoloft can also be compounded into capsules. The right amount of dose is carefully calculated and enclosed in a hard-shell capsule. The compounding pharmacist can make as many capsules as needed to fill your prescription according to the doctor’s instructions. 

Zoloft capsules can be helpful for people who may experience a bad after-taste or altered sense of taste with this medication, as the capsule is dissolved once it reaches your stomach, releasing the active drug.

What are the benefits of compounding Zoloft preparations?

Compounding Zoloft can offer some benefits, including: (2)

  • Compounded sertraline lets you get the exact dosage you need. If standard 25 mg, 50 mg, or 100 mg options don’t suit you, a compounded preparation can be created as per your needs.
  • Individuals who face challenges with solid dosage forms can benefit from compounded liquid sertraline preparations.
  • Transdermal gel formulations provide a convenient alternative for individuals who cannot take Zoloft orally due to physical or psychological reasons. The application of the gel directly onto the skin is the easiest route of administration for such people.
  • Compounded capsules offer a solution for individuals who experience a bitter taste or mouth-related side effects with Zoloft tablets. 
  • Compounding sertraline can help you avoid any inactive ingredient that you’re allergic to, making it easier for you to take this medication.

Compounded Zoloft and its uses

In my experience as a pharmacist, compounded sertraline can help a lot of people who can’t take the commercially available Zoloft for some reason. However, not every pharmacy is a compounding pharmacy, and not every pharmacist can compound medications properly. 

It is also important to note that medications like sertraline should be compounded based on the details provided by a mental healthcare professional, which includes dose, dosage form, and if there is a need to exclude a certain inactive component. 

If you think you can do better with a compounded sertraline formulation, specifically created to meet your needs, please reach out to your doctor.

References

  1. The Food and Drug Administration (FDA). HIGHLIGHTS OF PRESCRIBING INFORMATION. ZOLOFT (sertraline hydrochloride) tablets, for oral use. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/019839s74s86s87_20990s35s44s45lbl.pdf
  1. Carvalho M, Almeida IF. The Role of Pharmaceutical Compounding in Promoting Medication Adherence. Pharmaceuticals (Basel). 2022 Aug 31;15(9):1091. doi: 10.3390/ph15091091. PMID: 36145312; PMCID: PMC9503326. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9503326/ 
  1. Berti JJ, Lipsky JJ. Transcutaneous drug delivery: a practical review. Mayo Clin Proc. 1995 Jun;70(6):581-6. doi: 10.4065/70.6.581. PMID: 7776720. https://pubmed.ncbi.nlm.nih.gov/7776720/ 

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