Cipramil 20mg 28 tablets — Made in Denmark — Free Delivery
(Cipramil )
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Description Cipramil 20mg 28 tablets — Made in Denmark — Free Delivery
Product description
Tablets "Cipramil" are used for the following indications:
- treatment of depression of various etiologies and various types, prevention of relapses;
- treatment of panic disorders, with or without agoraphobia;
- obsessive-compulsive disorder (OCD).
Compound
The active substance is citalopram (one tablet contains citalopram hydrobromide equivalent to 20 mg citalopram).
Excipients: corn starch; lactose, monohydrate; copovidone; glycerin (85%); cellulose microcrystalline; croscarmellose sodium; magnesium stearate; shell: hypromellose, macrogol 400, titanium dioxide (E 171).
Contraindications
- hypersensitivity to the active substance or to any excipients;
- combined use of monoamine oxidase inhibitors (MAOIs);
- citalopram should not be used in patients receiving monoamine oxidase inhibitors (MAOIs, including selegiline) at a daily dose exceeding 10 mg/day;
- contraindicated in the first two weeks after discontinuation of an irreversible MAOI (after discontinuation of reversible MAOIs, such as moclobemide, citalopram should not be prescribed for the time specified in the instructions for use of a reversible MAOI; MAOI treatment should be started no earlier than 7 days after stopping citalopram );
- Citalopram is contraindicated in combination with linezolid unless the means to closely control blood pressure are available;
- contraindicated in combination with pimozide;
- citalopram is contraindicated in patients with established long QT interval or congenital long QT syndrome;
- Citalopram is contraindicated for use with preparations known to prolong the QT interval.
Mode of application
Adults take citalopram once a day, morning or evening. The film-coated tablets can be taken with or without food, but with sufficient liquid.
If a dosage of 10 mg is recommended, the 20 mg tablets should be divided in half along the dividing line.
Treatment for depression
At the beginning of treatment, adults should take 20 mg orally once a day. Depending on the individual sensitivity of the patient, the dose can be increased to a maximum of 40 mg per day. The antidepressant effect usually occurs within 2-4 weeks. Treatment of depression is symptomatic and therefore long-term and should usually continue for another 6 months after recovery to prevent relapse. In patients with recurrent (unipolar) depression, maintenance therapy may be continued for several years to prevent new episodes.
Panic Disorders
The maximum efficacy of citalopram in the treatment of panic disorder is achieved after 3 months of continuous treatment and is maintained through long-term treatment.
Depending on the individual response of the patient, treatment can be continued for a month. Data from clinical studies of efficacy exceeding 6 months is not enough.
Treatment for OCD
The therapeutic effect in the treatment of OCD occurs after 2-4 weeks and increases with time. Because OCD is a chronic disease, patients should be treated for a period long enough to ensure that they are symptom-free. The recommended starting dose is 20 mg. Depending on the individual sensitivity of the patient, the dose can be increased to a maximum of 40 mg per day.
Application features
pregnant
Based on data from reproductive toxicity studies (Phase I, II and III), there is no cause for special concern for the use of citalopram in women of reproductive age.
Citalopram should not be used in pregnant women unless, after careful consideration of all the disadvantages and advantages, the need for the preparation has been clearly demonstrated.
Citalopram passes into breast milk. The dose that an infant receives with milk is approximately 5% of the maternal daily dose of citalopram, calculated by body weight (mg / kg). No or minor effects were observed in neonates. However, the available data are insufficient to assess the risk to the child. Caution is advised.
Animal studies have shown that citalopram may affect sperm quality. Experience with some SSRIs in men suggests that the effect on sperm quality is reversible. So far, no effect on human fertility has been observed.
Children
Antidepressants should not be used in children and adolescents (under 18 years of age). Suicidal behavior (suicidal attempts and suicidal thoughts) and hostility (predominantly aggression, oppositional behavior and anger) were observed more frequently in clinical studies in children and adolescents taking antidepressants compared to those taking placebo. If, for clinical reasons, the decision to prescribe is nevertheless made, it is necessary to carefully monitor the appearance of suicidal symptoms in the patient. In addition, there are no long-term data on the safety of children and adolescents regarding growth, maturation, cognitive and behavioral development.
Drivers
Citalopram has a mild to moderate effect on the ability to drive or use machines. Patients who are prescribed psychotropic preparations should be warned about some decrease in general attention and concentration and about the effect of preparations on the ability to drive a car or use other mechanisms.
Overdose
Toxicity
Comprehensive clinical data on overdose of citalopram are limited and in many cases are combined with overdose of other preparations or alcohol. Fatal cases have been reported following an overdose with citalopram alone; however, most deaths are associated with overdose of concomitant medicinal products.
Symptoms
Convulsions, tachycardia, drowsiness, QT interval prolongation, coma, vomiting, tremor, arterial hypotension, cardiac arrest, nausea, serotonin syndrome, anxiety, bradycardia, dizziness, heart block, QRS prolongation, arterial hypertension, mydriasis, torsades de pointes, stupor, increased sweating, cyanosis, hyperventilation, atrial and ventricular arrhythmia.
Treatment
There is no specific antidote. Treatment is symptomatic and supportive. Gastric lavage, activated charcoal, osmotic laxative (such as sodium sulfate) should be taken. If consciousness is impaired, the patient should be intubated. Monitoring of ECG and vital signs is recommended.
Side effects
The side effects of citalopram are transient and minor. More often they are observed during the 1st or 2nd week of treatment and gradually disappear.
A dose-dependence of such symptoms has been established: increased sweating, dry mouth, insomnia, drowsiness, diarrhea, nausea and fatigue.
Metabolic disorders: often (≥ 1/100 to < 1/10) - loss of appetite, weight loss.
Mental disorders: often (≥ 1/100 to < 1/10) - anxiety, decreased libido, anxiety, nervousness, confusion, anorgasmia (women), abnormal dreams.
From the nervous system: very often (≥ 1/10) - insomnia, drowsiness; often (≥ 1/100 to < 1/10) - tremor, paresthesia, dizziness, impaired attention.
On the part of the hearing organs: often (≥ 1/100 to < 1/10) - ringing in the ears.
From the side of the heart: often (≥ 1/100 to < 1/10) - tachycardia.
Respiratory disorders: often (≥ 1/100 to < 1/10) - yawning.
From the gastrointestinal tract: very often (≥ 1/10) - dry mouth, nausea; often (≥ 1/100 to < 1/10) - diarrhea, vomiting, constipation.
From the skin and subcutaneous tissue: very often (≥ 1/10) - increased sweating; often (≥ 1/100 to < 1/10) - itching.
From the musculoskeletal system: often (≥ 1/100 to < 1/10) - arthralgia, myalgia.
From the reproductive system and mammary glands: often (≥ 1/100 to < 1/10) - ejaculation disorders, lack of ejaculation, impotence.
Storage conditions
Store in the original packaging at a temperature not exceeding 25°C, out of the reach of children.
Shelf life - 5 years.
Tags: Cipramil
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