Generic Medicines
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GENERIC NAME: escitalopram
DRUG CLASS AND MECHANISM
Escitalopram is an oral drug that is used for treating depression and
generalized anxiety disorder. Chemically, escitalopram is similar to
citalopram (Celexa). Both are in the class of drugs called selective
serotonin reuptake inhibitors (SSRIs), a class that also includes
fluoxetine (Prozac), paroxetine (Paxil) and sertraline (Zoloft). SSRIs
work by affecting neurotransmitters in the brain, the chemical messengers
that nerves use to communicate with one another. Neurotransmitters are
made and released by nerves and then travel to other nearby nerves where
they attach to receptors on the nerves. Some neurotransmitters that are
released do not bind to receptors and are taken up by the nerves that
produced them. This is referred to as "reuptake." Many experts believe
that an imbalance of neurotransmitters is the cause of depression.
Escitalopram prevents the reuptake of one neurotransmitter, serotonin, by
nerves, an action which results in more serotonin in the brain to attach
to receptors. The FDA approved escitalopram in August 2002.
PRESCRIPTION: Yes
GENERIC AVAILABLE: No
PREPARATIONS: Tablets: 5, 10, and 20 mg. Solution: 1 mg/ml
PRESCRIBED FOR
Escitalopram is approved for the treatment of depression and
generalized anxiety disorder. Drugs in the SSRI class also have been
studied in persons with obsessive compulsive disorders and panic
disorders, but escitalopram is not approved for this purpose.
DOSING
The usual starting dose of escitalopram is 10 mg once daily in the
morning or evening. The dose may be increased to 20 mg once daily after 1
week. Benefit may not be seen until treatment has been given for up to 4
weeks. A daily dose of 20 mg may not be anymore effective than 10 mg daily
for treatment of depression. Escitalopram can be taken with or without
food.
DRUG INTERACTIONS
All SSRIs, including escitalopram, should not be combined with drugs
in the monoamine oxidase (MAO) inhibitor class of antidepressants such as
isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate),
selegiline (Eldepryl) and procarbazine (Matulane). Such combinations may
lead to confusion, high blood pressure, high fevers, tremor or muscle
rigidity, and increased activity. At least 14 days should elapse after
discontinuing escitalopram before starting an MAO inhibitor. Conversely,
at least 14 days should elapse after discontinuing an MAO inhibitor before
starting escitalopram.
Tryptophan can cause headaches, nausea, sweating, and dizziness when taken
with any SSRI.
Use of selective serotonin inhibitors may increase the risk of
gastrointestinal bleeding in patients taking aspirin, nonsteroidal
antiinflammatory drugs, and other drugs that cause bleeding.
USES
Escitalopram is a selective serotonin reuptake inhibitor (SSRI) used to
treat depression and generalized anxiety disorder (GAD). It works by
helping to restore the balance of certain natural chemicals in the brain
(neurotransmitters).
HOW TO USE
Take this medication by mouth usually once daily with or without food;
or as directed by your doctor. You should take your dosage at the same
time each day, either in the morning or in the evening. The dosage is
based on your medical condition and response to therapy. It is important
to continue taking this medication as prescribed even if you feel well. Do
not stop taking this medication without consulting your doctor. Some
conditions may become worse when the drug is suddenly stopped. Your dose
may need to be gradually decreased. It may take up to several weeks before
the full benefit of this drug takes effect.
SIDE EFFECTS
Nausea, diarrhea, constipation, loss of appetite, stomach pain,
dizziness, drowsiness, trouble sleeping, fatigue, increased sweating, or
dry mouth may occur. If any of these effects persist or worsen, notify
your doctor promptly. Tell your doctor immediately if any of these serious
side effects occur: changes in sexual ability/interest, unusual or severe
mental/mood changes. Tell your doctor immediately if any of these unlikely
but serious side effects occur: black stools, "coffee ground" vomit, easy
bruising/bleeding. Males - If you experience a painful and prolonged
erection, stop using this drug and seek immediate medical attention. An
allergic reaction to this drug is unlikely, but seek immediate medical
attention if it occurs. Symptoms of an allergic reaction include: rash,
itching, swelling, severe dizziness, trouble breathing. If you notice
other effects not listed above, contact your doctor or pharmacist.
PRECAUTIONS
Tell your doctor your medical history, especially of: liver problems,
kidney problems, seizures, heart problems, other mental/mood disorders
(e.g., bipolar disorder), thyroid problems, mineral (electrolyte) problems
(e.g., hyponatremia, SIADH), any allergies. This drug may make you dizzy
or drowsy; use caution engaging in activities requiring alertness such as
driving or using machinery. Limit alcoholic beverages. Though uncommon,
depression can lead to thoughts or attempts of suicide. Tell your doctor
immediately if you have any suicidal thoughts, worsening depression, or
any other mental/mood changes (including new or worsening anxiety,
agitation, panic attacks, trouble sleeping, irritability, hostile/angry
feelings, impulsive actions, severe restlessness, rapid speech). Keep all
medical appointments so your healthcare professional can monitor your
progress closely and adjust/change your medication if needed. Caution is
advised when using this drug in the elderly because they may be more
sensitive to the effects of the drug. This medication should be used only
when clearly needed during pregnancy. Discuss the risks and benefits with
your doctor. If this medication is used during the last 3 months of
pregnancy, infrequently your newborn may develop symptoms including
feeding or breathing difficulties, seizures, muscle stiffness,
jitteriness, or constant crying. However, do not stop taking this
medication unless your doctor directs you to do so. Report any such
symptoms to your doctor promptly. This drug passes into breast milk.
Because of the potential risk to the infant, breast-feeding while using
this drug is not recommended. Consult your doctor before breast-feeding.
OVERDOSE
If overdose is suspected, contact your local poison control center or
emergency room immediately. US residents can call the US national poison
hotline at 1-800-222-1222. Canadian residents should call their local
poison control center directly. Symptoms of overdose may include:
irregular heartbeat, fainting, severe dizziness or lightheadedness,
seizures.
MISSED DOSE
If you miss a dose, use it as soon as you remember. If it is near the
time of the next dose, skip the missed dose and resume your usual dosing
schedule. Do not double the dose to catch up.
STORAGE
Store at room temperature (77 degrees F or 25 degrees C) away from
light and moisture. Brief storage between 59 and 86 degrees F (15 and 30
degrees C) is permitted. Do not store in the bathroom.
Note : This product information is intended only for residents of the India. Taj Pharmaceuticals Limited, medicines help to treat and prevent a range of conditions—from the most common to the most challenging—for people around the world.