Milk of Magnesia Plus Uses, Dosage, Side Effects and more
Milk of Magnesia Plus has potent and selective inhibitory action on CNS neuronal reuptake of 5-HT resulting in increased 5-HT concentrations at the synaptic clefts, leading to facilitation of its sustained activity at the postsynaptic receptor sites. It ultimately results in an improvement of depression. Reduction of Serotonin turnover in brain by Milk of Magnesia Plus is also another contributing fact implicated in its action. Its prolonged elimination half-life offers a benefit of once daily administration.
Milk of Magnesia Plus improves or relieves the symptoms of depression, OCD, post-traumatic stress disorder, obsessive-compulsive disorder, panic disorder, and premenstrual dysphoric disorder via the inhibition of serotonin reuptake. Clinical studies have shown that it improves cognition in depressed patients. It has less sedative, anticholinergic, and cardiovascular effects than the tricyclic antidepressant drugs because it does not exert significant anticholinergic, antihistamine, or adrenergic (alpha1, alpha2, beta) blocking activity. The onset of action and beneficial effects are usually noticed after 4-6 weeks, for reasons that are not fully understood and currently under investigation.
| Attribute | Details |
|---|---|
| Trade Name | Milk of Magnesia Plus |
| Availability | Prescription only |
| Generic | Sertraline |
| Sertraline Other Names | Sertralina, Sertraline, Sertralinum |
| Related Drugs | Rexulti, trazodone, fluoxetine, alprazolam, clonazepam, Lexapro, amitriptyline, venlafaxine, Zoloft, citalopram |
| Type | |
| Formula | C17H17Cl2N |
| Weight | Average: 306.23 Monoisotopic: 305.073804963 |
| Protein binding | Sertraline is highly bound to serum proteins, at about 98%-99%. |
| Groups | Approved |
| Therapeutic Class | SSRIs & related anti-depressant drugs |
| Manufacturer | ACME Laboratories Ltd. |
| Available Country | Bangladesh |
| Last Updated: | July 13, 2025 at 3:05 am |
Uses
Milk of Magnesia Plus is used for Depressive illness, Obsessive-compulsive disorder, Post-traumatic stress disorder, Panic disorder
Milk of Magnesia Plus is also used to associated treatment for these conditions: Binge Eating Disorder (BED), Bulimia Nervosa, Generalized Anxiety Disorder (GAD), Major Depressive Disorder (MDD), Obsessive Compulsive Disorder (OCD), Panic Disorder, Post Traumatic Stress Disorder (PTSD), Premenstrual Dysphoric Disorder, Social Anxiety Disorder (SAD)
How Milk of Magnesia Plus works
Milk of Magnesia Plus selectively inhibits the reuptake of serotonin (5-HT) at the presynaptic neuronal membrane, thereby increasing serotonergic activity. This results in an increased synaptic concentration of serotonin in the CNS, which leads to numerous functional changes associated with enhanced serotonergic neurotransmission. These changes are believed to be responsible for the antidepressant action and beneficial effects in obsessive-compulsive (and other anxiety related disorders). It has been hypothesized that obsessive-compulsive disorder, like depression, is also caused by the disregulation of serotonin.
In animal studies, chronic administration of sertraline results in down-regulation of brain norepinephrine receptors. Milk of Magnesia Plus displays affinity for sigma-1 and 2 receptor binding sites, but binds with stronger affinity to sigma-1 binding sites. In vitro, sertraline shows little to no affinity for GABA, dopaminergic, serotonergic (5HT1A, 5HT1B, 5HT2), or benzodiazepine receptors. It exerts weak inhibitory actions on the neuronal uptake of norepinephrine and dopamine and exhibits no inhibitory effects on the monoamine oxidase enzyme.
Dosage
Depressive illness:
- Adult: Initially 50 mg daily, increased if necessary by increments of 50 mg over several weeks to maximum 200 mg daily. Usual maintenance dose is 50 mg daily.
- Child and adolescent less than 18 years:Not recommended.
Obsessive-compulsive disorder:
- Adult and adolescent over 13 years: Initially 50 mg daily, increased if necessary in steps of 50 mg over several weeks. Usual dose range is 50-200 mg daily.
- Child (6-12 years): Initially 25 mg daily, increased to 50 mg daily after 1 week, further increased if necessary in steps of 50 mg at intervals of at least 1 week (maximum 200 mg daily).
Post-traumatic stress disorder:
- Adult: Initially 25 mg daily, increased after 1 week to 50 mg daily; if response is partial and if drug is tolerated, dose can be increased in steps of 50 mg over several weeks to maximum 200 mg daily.
- Child and adolescent less than 18 years: Not recommended.
How Long Does It Take to Work?
How Long Does It Take to Work? see here Milk of Magnesia Plus
Side Effects
Milk of Magnesia Plus may cause side effects like upset stomach, diarrhoea, constipation, vomiting, dry mouth, loss of appetite, weight changes, drowsiness, dizziness, headache, pain, burning or tingling in the hands or feet, excitement, sore throat etc.
Toxicity
The LD50 of sertraline is >2000 mg/kg in rats according to the FDA label. One other references indicates an oral LD50 of in mice and rats of 419 - 548 mg/kg and 1327 - 1591mg/kg, respectively.
The most common signs and symptoms associated with a non-fatal sertraline overdose are somnolence, vomiting, tachycardia, nausea, dizziness, agitation, and tremor. No cases of fatal overdose with only sertraline have been reported. Most fatal cases are associated with the ingestion of sertraline with other drugs. Consequences of a sertraline overdose may include serotonin syndrome, hypertension, hypotension, syncope, stupor, coma, bradycardia, bundle branch block, QT-prolongation, torsade de pointes, delirium, hallucinations, and pancreatitis.
Precaution
Precaution should be taken in case of liver problems, kidney diseases, seizures, heart problems and any allergies. This drug may cause dizziness or drowsiness. Caution should be taken in activities requiring alertness such as driving or using machinery. Caution is advised while using this product in the elderly because they may be more sensitive to the effects of the drug. Do not take this drug if you have taken monoamine oxidase inhibitor in the last five weeks.
Interaction
Potential effects of co-administration of drugs that are highly bound to plasma proteins- As Milk of Magnesia Plus is tightly bound to plasma protein, the administration of Milk of Magnesia Plus to a patient taking another drug which is tightly bound to protein, (e.g. warfarin, digitoxin) may cause a shift in plasma concentrations potentially resulting in an adverse effect. Conversely adverse effects may result from displacement of protein bound Milk of Magnesia Plus by other tightly bound drugs. Milk of Magnesia Plus may interact with other drugs such as Cimetidine, CNS active drugs like Diazepam, Hypoglycemic drugs, Atenolol etc.
Food Interaction
- Avoid St. John's Wort.
- Take with or without food.
[Moderate] GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of sertraline.
Use in combination may result in additive central nervous system depression and In addition, limited clinical data suggest that consumption of grapefruit juice during treatment with sertraline may result in increased plasma concentrations of sertraline. The proposed mechanism is inhibition of CYP450 3A4-mediated metabolism by certain compounds present in grapefruit. An in-vitro study demonstrated that grapefruit juice dose-dependently inhibits the conversion of sertraline to its metabolite, desmethylsertraline. In a study with eight Japanese subjects, mean plasma levels of sertraline increased by approximately 100% and maximum plasma concentrations increased by 66% after the ingestion of three 250 mL glasses of grapefruit juice per day for 5 days and administration of a single dose of sertraline 75 mg on the sixth day. In another small study with 5 patients, mean sertraline trough levels increased by 47% after taking sertraline for at least 6 weeks, then taking sertraline with 240 mL grapefruit juice daily for 1 week. The clinical significance is unknown; however, pharmacokinetic alterations associated with interactions involving grapefruit juice are often subject to a high degree of interpatient variability. The possibility of significant interaction in some patients should be considered. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how sertraline affects them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities. Some authorities recommend that consumption of grapefruit juice should be avoided during sertraline therapy. Major: amphetamine / dextroamphetamineModerate: aspirin, aspirin, diphenhydramine, pregabalin, metoprolol, metoprolol, albuterol, cetirizineMinor: alprazolamUnknown: rosuvastatin, omega-3 polyunsaturated fatty acids, atorvastatin, esomeprazole, levothyroxine, acetaminophen, cyanocobalamin, ascorbic acid, ergocalciferol, cholecalciferol Major: depressionModerate: hyponatremia, glaucoma, liver disease, mania, platelet function, seizure disorders, SIADHMinor: renal dysfunction, weight loss Milk of Magnesia Plus is widely distributed, and its volume of distribution is estimated to be more than 20L/kg. Post-mortem studies in humans have measured liver tissue concentrations of 3.9–20 mg/kg for sertraline and between 1.4 to 11 mg/kg for its active metabolite, N-desmethyl-sertraline (DMS). Studies have also determined sertraline distributes into the brain, plasma, and serum. Following once-daily administration of 50 to 200 mg for two weeks, the mean peak plasma concentrations (Cmax) of sertraline occurred between 4.5 to 8.4 hours after administration, and measured at 20 to 55 μg/L. Steady-state concentrations are reached after 1 week following once-daily administration, and vary greatly depending on the patient. Bioavailability has been estimated to be above 44%. The area under the curve in healthy volunteers after a 100mg dose of sertraline was 456 μg × h/mL in one study. Effects of food on absorption The effects of food on the bioavailability of the sertraline tablet and oral concentrate were studied in subjects given a single dose with and without food. For the tablet, AUC was slightly increased when sertraline was administered with food, the Cmax was 25% greater, and the time to peak plasma concentration was shortened by about 2.5 hours. For the oral concentrate preparation of sertraline, peak concentration was prolonged by approximately 1 hour with the ingestion of food. The elimination half-life of sertraline is approximately 26 hours. One reference mentions an elimination half-life ranging from 22-36 hours. In pharmacokinetic studies, the clearance of a 200mg dose of sertraline in studies of both young and elderly patients ranged between 1.09 ± 0.38 L/h/kg - 1.35 ± 0.67 L/h/kg. Since sertraline is extensively metabolized, excretion of unchanged drug in the urine is a minor route of elimination, with 12-14% of unchanged sertraline excreted in the feces. Pregnancy: Although animal studies did not provide any evidence of teratogenicity, the safety of Milk of Magnesia Plus during human pregnancy has not been established. Lactation: Milk of Magnesia Plus is known to be excreted in breast milk. Its effects on the nursing infant have not yet been established. If treatment with Milk of Magnesia Plus is considered necessary, discontinuation of breast-feeding should be considered. Milk of Magnesia Plus is contraindicated in patients with a known hypersensitivity to Milk of Magnesia Plus or any of the excipients of drug. Store at 25° C.
Milk of Magnesia Plus
contains
Sertraline
see full prescribing information from innovator
Monograph,
MSDS,
FDA label
Milk of Magnesia Plus may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.
Milk of Magnesia Plus (sertraline) is a good and safe antidepressant that is also used to treat other psychiatric disorders such as panic disorder, post-traumatic stress disorder and obsessive compulsive disorder.
A study in The Lancet Psychiatry found that taking Milk of Magnesia Plus leads to an early reduction in anxiety symptoms, commonly found in depression, several weeks before any improvement in depressive symptoms.
Milk of Magnesia Plus will not change your personality or make you feel euphorically happy. It'll simply help you feel like yourself again. Do not expect to feel better overnight, though. Some people feel worse during the first few weeks of treatment before they begin to feel better.
Milk of Magnesia Plus is designed for use once per day. It's safe to take it at any time of day, with or without food. Many people who experience nausea and other side effects from Milk of Magnesia Plus opt to take it at night in order to limit these side effects.
Some products that may interact with this drug are: pimozide, other drugs that can cause bleeding/bruising (including antiplatelet drugs such as clopidogrel, NSAIDs such as ibuprofen/naproxen, "blood thinners" such as warfarin/dabigatran).
One potential theory is that antidepressants like Milk of Magnesia Plus can make you feel hungrier than normal. People who use Milk of Magnesia Plus might also feel less satisfied after eating food, resulting in them eating bigger portions that contain a larger amount of calories.
Fatigue and tiredness are two of the most common side effects of Milk of Magnesia Plus, as well as several other SSRIs. If you're using Milk of Magnesia Plus to treat depression, fatigue and tiredness from the medication can also be compounded by the effects of depression on your mood.
Milk of Magnesia Plus should help you feel calm and relaxed. It could take some time for Milk of Magnesia Plus to have its full effect. This effect should reduce your behavior problem.
Milk of Magnesia Plus doesn't work immediately, so don't stop taking Milk of Magnesia Plus if your symptoms don't improve right away. It takes two to six weeks to start reducing anxiety symptoms. Some people may feel a reduction in their anxiety symptoms within the first week of taking Milk of Magnesia Plus, but this shouldn't be expected for everyone.
You should not mix alcohol with Milk of Magnesia Plus. Combining the two can make you feel very drowsy, which can be dangerous. The combination can also raise your risk of other dangerous or unpleasant side effects from Milk of Magnesia Plus. Even if you don't take Milk of Magnesia Plus, you shouldn't drink alcohol if you have depression.
Since Milk of Magnesia Plus is a long-term antidepressant, it is not considered an addictive or narcotic substance. The potential for abuse is low according to psychiatrists, even though it is a mind-altering substance. Taken properly and as prescribed, Milk of Magnesia Plus carries very little risk for abuse or addiction.
It can improve sleep quality, appetite, energy levels, restore interest in daily life, and reduce unwanted thoughts and panic attacks. Milk of Magnesia Plus is available in tablet form in dosage strengths of 25 mg, 50 mg, or 100 mg.
Milk of Magnesia Plus last 5.4 days in our body and half life is about 26 hours.
You can feel drowsy in the first few days of taking Milk of Magnesia Plus. This should get better after the first week or two. If it makes you feel drowsy, try taking it just before you go to bed. You could also, strangely, get insomnia (difficulty getting to sleep), and disturbing dreams or nightmares.
It is OK to take Paracetamol with Milk of Magnesia Plus, but if you are taking other kinds of medication every day you need to let your doctor know, as they may interact with Milk of Magnesia Plus and change its effect on your body.
After one day, the level is reduced to 50 percent of the original level, after two days to 25 percent, after three days to 12.5 percent, and so on. Because Milk of Magnesia Plus leaves your body so quickly, stopping it too abruptly can cause discontinuation syndrome to develop.
Talk to your doctor about any other medications you may be taking. You should never take two doses of Milk of Magnesia Plus at the same time, as it can lead to an accidental overdose.
No interactions were found between caffeine and Milk of Magnesia Plus. This does not necessarily mean no interactions exist. Always consult your healthcare provider.
When serotonin levels increase under the influence of SSRIs, they stimulate serotonin receptors in the GI tract as well as the brain. The combined stimulatory effect—on both the GI tract and CNS—can trigger such side effects as: Diarrhea. Loss of appetite (anorexia)
If you feel like your antidepressant has stopped working, you're not alone. It's common for a medication that once worked wonders to become ineffective, especially if you've been taking it for a long time. Symptoms return for up to 33% of people using antidepressants — it's called breakthrough depression.
Milk of Magnesia Plus are powerful prescription medications used to treat depression and other issues. They're both Milk of Magnesia Plus-name drugs. The generic version of Milk of Magnesia Plus is fluoxetine, while the generic version of Milk of Magnesia Plus is sertraline hydrochloride. Both drugs are selective serotonin reuptake inhibitors (SSRIs).
Most common side effects are agitation, hallucinations, fever, overactive reflexes, tremors; nausea, vomiting, loss of appetite, feeling unsteady, loss of coordination; trouble concentrating, memory problems, weakness, fainting, seizure, shallow breathing, or breathing that stops.
Studies show that Milk of Magnesia Plus is an effective treatment for social anxiety disorder. In a 2006 study, researchers found that Milk of Magnesia Plus performed significantly better than a non-therapeutic placebo in reducing social anxiety symptoms.
Stopping Milk of Magnesia Plus abruptly may result in one or more of the following withdrawal symptoms: irritability, nausea, feeling dizzy, vomiting, nightmares, headache, and/or paresthesias (prickling, tingling sensation on the skin). Depression is also a part of bipolar illness.
Consider these strategies:
Generally, these antidepressants are an option during pregnancy: Certain selective serotonin reuptake inhibitors (SSRIs). SSRIs are generally considered an option during pregnancy, including citalopram (Celexa) and sertraline (Milk of Magnesia Plus). Potential complications include maternal weight changes and premature birth.
Antidepressants are a common medication that can lead to night sweats with as many as 22% of people taking antidepressants reporting night sweats as a side effect (especially Milk of Magnesia Plus and venlafaxine).
Milk of Magnesia Plus is a type of antidepressant known as a selective serotonin reuptake inhibitor (SSRI). It's often used to treat depression, and also sometimes panic attacks, obsessive compulsive disorder (OCD) and post-traumatic stress disorder (PTSD).
Many people who experience nausea and other side effects from Milk of Magnesia Plus opt to take it at night in order to limit these side effects. Since Milk of Magnesia Plus can interfere with sleep in a small percentage of users, many people also opt to take Milk of Magnesia Plus in the morning.
Possible side effects include:
MANAGEMENT: Patients receiving sertraline should be advised to avoid or limit consumption of alcohol.Drug Interaction
Disease Interaction
Volume of Distribution
Elimination Route
Half Life
Clearance
Elimination Route
Pregnancy & Breastfeeding use
Contraindication
Storage Condition
Innovators Monograph
FAQ
What are the side effects for Milk of Magnesia Plus?
What should I do if I forget to take Milk of Magnesia Plus?
Is Milk of Magnesia Plus a strong antidepressant?
Is Milk of Magnesia Plus good for anxiety?
Does Milk of Magnesia Plus make you happy?
Can I take Milk of Magnesia Plus at night?
What can't I take with Milk of Magnesia Plus?
Why does Milk of Magnesia Plus make gain weight?
Why is Milk of Magnesia Plus making me so tired?
Will Milk of Magnesia Plus calm me down?
Can Milk of Magnesia Plus work immediately?
What happens if I drink alcohol with sertraline?
Is Milk of Magnesia Plus a addictive?
Does Milk of Magnesia Plus give me energy?
How long does Milk of Magnesia Plus last in my body?
Does Milk of Magnesia Plus make me sleepy?
Can I take paracetamol with Milk of Magnesia Plus?
Can I stop Milk of Magnesia Plus after 2 days?
Can I take 2 50mg Milk of Magnesia Plus?
Can I drink coffee with Milk of Magnesia Plus?
Why is Milk of Magnesia Plus making me sick?
Can Milk of Magnesia Plus become ineffective?
Is Milk of Magnesia Plus a powerful drug?
Can Milk of Magnesia Plus cause memory loss?
Does Milk of Magnesia Plus really work?
What happens if I suddenly stop taking sertraline?
How can I reduce the side effects of Milk of Magnesia Plus?
Can I take Milk of Magnesia Plus during pregnancy?
Can Milk of Magnesia Plus give me night sweats?
What does Milk of Magnesia Plus treat?
Why should not take Milk of Magnesia Plus on a night?
What are long term side effects of Milk of Magnesia Plus?
