Escitalopram


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult: PO Depression; Generalised anxiety disorder; Obsessive compulsive disorder 10 mg once daily, may be increased after at least 1 week to Max of 20 mg once daily. Social anxiety disorder 10 mg once daily, may be decreased to 5 mg or increased to Max of 20 mg once daily after at least 1 week depending on patient response. Panic disorder with or without agoraphobia Initial: 5 mg once daily for the 1st week then increased to 10 mg once daily; may further increase dose up to Max of 20 mg daily depending on patient response.
Administration
May be taken with or without food.
Contraindications
Known QT interval prolongation or congenital long QT syndrome, unstable epilepsy. Concomitant use of QT interval prolonging agents (e.g. pimozide) and MAOIs (or within 14 days of use).
Special Precautions
Patient with history of seizure disorder or conditions predisposing to seizures (e.g. brain damage, alcoholism); history of mania/hypomania, suicide-related events, suicidal ideation; diabetes, bleeding tendencies, bradycardia, recent MI, decompensated heart failure, electrolyte disturbances (e.g. hypokalaemia), metabolic disease. CYP2C19 ultrarapid or poor metabolisers. Hepatic and severe renal impairment. Elderly. Pregnancy and lactation. Avoid abrupt withdrawal. Concomitant electroconvulsive therapy. Patient Counselling This drug may impair cognitive or motor performance, if affected, do not drive or operate machinery. Monitoring Parameters Re-evaluate treatment periodically. Monitor for clinical worsening, suicidal behaviour or ideation and unusual changes in behaviour. Monitor electrolytes (e.g. K, Mg, Na), liver and renal function at baseline and as clinically indicated; signs of serotonin syndrome (e.g. mental status changes, autonomic instability, seizures) during treatment and withdrawal syndrome (e.g. dizziness, sensory disturbances, agitation, sleep disturbances) upon discontinuation.
Adverse Reactions
Significant: Withdrawal syndrome, anxiety, suicide-related events, worsening of depressive symptoms, hypomania or mania, bleeding abnormalities (e.g. ecchymoses, purpura, haematoma, epistaxis), akathisia, QT interval prolongation, ventricular arrhythmia, torsade de pointes, mydriasis, narrow-angle glaucoma, bone fractures, sexual dysfunction. Rarely, hyponatraemia. Gastrointestinal disorders: Nausea, diarrhoea, vomiting, constipation, dry mouth. General disorders and administration site conditions: Fatigue, pyrexia. Metabolism and nutrition disorders: Decreased or increased appetite, increased weight. Musculoskeletal and connective tissue disorders: Arthralgia, myalgia. Nervous system disorders: Headache, dizziness, paraesthesia, tremor. Psychiatric disorders: Restlessness, abnormal dreams, insomnia, somnolence. Reproductive system and breast disorders: Decreased libido, anorgasmia, ejaculation disorder, impotence. Respiratory, thoracic and mediastinal disorders: Sinusitis, yawning. Skin and subcutaneous tissue disorders: Increased sweating.
Potentially Fatal: Serotonin syndrome, suicidal ideation or behaviour, haemorrhage.
Drug Interactions
Increased risk of bleeding tendencies with oral anticoagulants (e.g. warfarin), antiplatelet agents (e.g. ticlopidine, aspirin, dipyridamole), antipsychotics, and NSAIDs. Enhanced effect with concomitant use of other serotonergic agents (e.g. TCA, sumatriptan, tramadol, tryptophan, lithium, buspirone, fentanyl). Increased risk of lowering seizure threshold with other antidepressants (e.g. other SSRIs), neuroleptics (e.g. phenothiazines, thioxanthenes, butyrophenones), mefloquine, and bupropion. Increased serum concentration with CYP2C19 inhibitors (e.g. omeprazole, fluconazole, fluvoxamine) or cimetidine. Increases the plasma concentrations of CYP2D6 substrates (e.g. metoprolol, desipramine). Enhanced hypoglycaemic effect of antidiabetic agents.
CIMS Class
ATC Classification
N06AB10 - escitalopram ; Belongs to the class of selective serotonin reuptake inhibitors. Used in the management of depression.
Disclaimer: This information is independently developed by CIMS based on escitalopram from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to CIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, CIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2021 CIMS. All rights reserved. Powered by CIMSAsia.com
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