• HEALTH CARE
  • Escitalopram-Teva 20mg 28 tablets — Made in Poland — Free Delivery

Escitalopram-Teva 20mg 28 tablets — Made in Poland — Free Delivery

(Escitalopram-Teva)
Escitalopram-Teva 20mg 28 tablets — Made in Poland — Free Delivery
Escitalopram-Teva 20mg 28 tablets — Made in Poland — Free Delivery
Availability: In Stock
TEVA Brand: TEVA
View all products
View more in Good mood
Free Shipping! If your country is on the checkout list, we deliver to you.
Delivery Timeframes:
Europe: 7 to 18 business days
US and the Rest of the World: 9 to 20 business days

Description Escitalopram-Teva 20mg 28 tablets — Made in Poland — Free Delivery

Pharmacological properties

Pharmacodynamics. Escitalopram-teva is an antidepressant, selective serotonin reuptake inhibitor (SSI) (5-nt) with a high affinity for the primary binding site. It also binds to the allosteric site of the serotonin transporter with a 1000-fold lower affinity.
Escitalopram does not have or has a very weak ability to bind to many receptors, including 5-HT1-, 5-HT2-, dopamine D1- and D2-receptors, α1-, α2-, β-adrenergic receptors, histamine H1-, muscarinic, cholinergic , benzodiazepine and opiate receptors.
Suppression of 5-HT serotonin reuptake is only a likely mechanism of action that can explain the pharmacological and clinical effects of escitalopram.
Pharmacokinetics. Absorption is almost complete and does not depend on food intake. The average time to reach Cmax is about 4 hours. The absolute bioavailability of escitalopram is about 80%.
The apparent volume of distribution (Vd, β / F) after oral administration is 12–26 l / kg body weight. The binding of escitalopram and its main metabolites with blood plasma proteins is less than 80%.
Escitalopram is metabolized in the liver to demethylated and didemethylated metabolites. Both are biologically active. Nitrogen can also be oxidized in the form of an N-oxide metabolite. Both the metabolites and the parent compound are partially excreted in the form of glucuronides. After repeated use, the average concentration of demethyl- and didemethylmetabolites is usually 28–31 and 5% of escitalopram, respectively. Biotransformation of escitalopram to a demethylated metabolite occurs mainly by CYP 2C19. Some involvement of CYP 3A4 and CYP 2D6 enzymes is also possible.
T½ after repeated use is about 30 hours. Plasma clearance for oral administration is 0.6 l / min. In the main metabolites of escitalopram, T½ is longer. It is believed that escitalopram and its major metabolites are excreted by the liver (metabolic pathway) and kidneys. Most of it is excreted in the form of metabolites in the urine.
The kinetics of escitalopram is linear. Equilibrium concentration is reached in about 1 week. The average equilibrium concentration of 50 nmol / l (from 20 to 125 nmol / l) is achieved with a daily dose of 10 mg.
Elderly patients (over 65 years old). In the elderly, escitalopram is excreted more slowly than in younger patients. The amount of a substance in the systemic circulation, calculated using the pharmacokinetic index AUC, in elderly people is 50% higher than in young healthy volunteers.
Lack of liver function. In patients with moderate or mild hepatic impairment (according to Child-Pugh criteria A and B), escitalopram T½ increased almost twice, and the exposure was 60% higher than in those with normal liver function.
Weakening of kidney function. In patients with reduced renal function (creatinine clearance 10–53 ml / min), an increase in T½ of racemic citalopram and a slight increase in exposure were noted. The concentration of metabolites in blood plasma has not been investigated, but an increase can be assumed.
With insufficient activity of the isoenzyme CYP 2C19, a double concentration in the blood plasma compared with the normal metabolism of escitalopram was noted.
In case of deficiency of the CYP 2D6 enzyme, no significant changes in exposure were detected.

Indications

Major depressive episodes; panic disorder with / without agoraphobia; social anxiety disorders (social phobia); generalized anxiety disorder; obsessive-compulsive disorder (ocd).

Application

The safe use of doses greater than 20 mg has not been demonstrated.
Escitalopram-Teva is prescribed orally 1 time per day, regardless of food intake.
Major depressive episodes. Usually 10 mg / day is prescribed. Depending on the individual patient's response, the dose can be increased to a maximum of 20 mg / day. The antidepressant effect usually develops 2–4 weeks after starting treatment. After the disappearance of the symptoms of depression, treatment must be continued for at least 6 months to consolidate the achieved effect.
Panic disorder with / without agoraphobia. In the 1st week of treatment, a dose of 5 mg / day is recommended, then it is increased to 10 mg / day. Depending on the patient's individual response, the dose can be further increased to a maximum of 20 mg / day.
The maximum therapeutic effect is achieved in 3 months. The therapy lasts several months.
Social anxiety disorder. Usually prescribed in a dose of 10 mg once a day. A decrease in the severity of symptoms is usually achieved within 2–4 weeks. Depending on the individual patient's response, the dose can be further reduced to 5 mg / day or increased to a maximum of 20 mg / day. Since social anxiety disorder is a chronic disease, the minimum recommended duration of treatment is 12 weeks to consolidate the achieved effect. To prevent recurrence of the disease, the preparation can be prescribed for 6 months, depending on the individual response of patients. It is necessary to regularly check the therapeutic benefits of the treatment.
Social anxiety disorder has a well-defined diagnostic terminology for a specific disease that should not be confused with hypertrophied shyness. Pharmacotherapy is indicated exclusively for a disorder that significantly affects a person's professional and social activity. The effectiveness of this treatment compared to cognitive behavioral therapy has not been investigated. Pharmacotherapy should be part of the overall therapeutic strategy.
Generalized Anxiety Disorder. The recommended starting dose is 10 mg once a day. Depending on the patient's individual response, the dose can be further increased to a maximum of 20 mg / day. It is recommended to continue treatment for 3 months. Long-term administration of the preparation (6 months) at a dose of 20 mg / day is allowed in order to prevent relapses. It is necessary to regularly check the therapeutic benefits of the treatment.
Obsessive-compulsive disorder (OCD). Usually 10 mg is prescribed once a day. Depending on individual sensitivity, the dose may be increased to 20 mg / day. OCD is a chronic condition and treatment should be continued long enough to ensure that symptoms disappear completely, which may be several months or more.
Elderly patients (over 65 years old). The initial dose is 5 mg / day. Depending on the response of a particular patient, the dose can be increased to 10 mg once a day. The minimum effective dose is prescribed.
The effectiveness of Escitalopram-Teva in social anxiety disorder has not been studied in elderly patients.
Impaired renal function. No dose adjustment is required in patients with moderate to weak renal impairment. Patients with severe deterioration of renal function (creatinine clearance 30 ml / min), the preparation should be prescribed with caution.
Liver dysfunction. For patients with moderate and weak hepatic impairment, the recommended initial dose in the first 2 weeks is 5 mg / day. Depending on the patient's individual response, the dose can be further increased to 10 mg / day. In severe hepatic impairment, caution in prescribing and careful titration of the dose is necessary.
Reduced activity of the isoenzyme CYP 2C19. For patients with known weak activity of the isoenzyme CYP 2C19, the recommended initial dose of Escitalopram-Teva in the first 2 weeks is 5 mg / day. Depending on the patient's individual response, the dose can be further increased to 10 mg / day.
Withdrawal symptoms after stopping treatment. Abrupt discontinuation of this preparation should be avoided. The escitalopram dose is gradually tapered at intervals of 1–2 weeks to prevent withdrawal reactions. If, during a gradual reduction in dose, symptoms of intolerance occur, you can restore the previous dose. In the future, the doctor may continue to reduce the dose, but more gradually.

Contraindications

Hypersensitivity to the active substance or any other component of the preparation.
Combined treatment with non-selective irreversible MAO inhibitors due to the risk of developing serotonin syndrome, manifested by agitation, tremors, and hyperthermia.
Combination treatment with escitalopram and reversible MAO type A inhibitors (eg moclobemide) or reversible nonselective MAO inhibitors (linezolid) is also contraindicated due to the risk of serotonin syndrome. If it is known that a patient has a prolongation of the Q-T interval or congenital Q-T lengthening syndrome, the preparation is contraindicated in conjunction with preparations that prolong the Q-T interval. Simultaneous treatment with pimozide.

Side effects

Adverse reactions more often occur in the 1st and 2nd week of treatment and later become less intense, and their frequency decreases with continued treatment.
From the circulatory and lymphatic system: thrombocytopenia.
From the immune system: anaphylactic reactions.
From the endocrine system: violation of the secretion of antidiuretic hormone.
From the side of nutrition and metabolism: decreased or increased appetite, weight gain, weight loss, hyponatremia, anorexia 1.
From the side of the psyche: anxiety, fear, anxiety, dysphoria, abnormal dreams, decreased libido in men and women, anorgasmia in women, teeth grinding during sleep, agitation, nervousness, panic attacks, confusion, aggression, depersonalization, hallucinations, mania, suicidal thoughts, suicidal behavior 2.
From the nervous system: headache, insomnia, drowsiness, dizziness, paresthesia, tremor, taste disturbance, sleep disturbance, fainting, serotonin syndrome, dyskinesia, movement disorders, convulsions, psychomotor anxiety / akathisia 1.
From the side of the organ of vision: mydriasis, blurred vision.
From the side of the organ of hearing: ringing in the ears.
From the side of the cardiovascular system: tachycardia, bradycardia, ventricular arrhythmia, including torsade de pointes arrhythmia, prolongation of the Q – T interval on the ECG, orthostatic hypotension.
Respiratory disorders: sinusitis, yawning, epistaxis.
From the digestive system: nausea, diarrhea, constipation, vomiting, dry mouth, gastrointestinal bleeding (including rectal).
From the liver and biliary tract: hepatitis, changes in liver function tests.
On the part of the skin and subcutaneous tissue: increased sweating, skin rash, baldness, urticaria, itching, bruising, edema.
Musculoskeletal disorders: arthralgia, myalgia.
From the kidneys and urinary tract: urinary retention.
From the reproductive system and mammary glands: galactorrhea; in men: ejaculation disorders, priapism, impotence; in women: metrorrhagia, menorrhagia.
General disorders: fatigue, pyrexia, edema.
1 These adverse reactions have been reported for the therapeutic class of selective serotonin reuptake inhibitor (SSRI) preparations in general.
2 Cases of suicidal thinking or behavior have been reported both during escitalopram therapy and immediately after discontinuation of treatment.
During the post-marketing period, there were cases of prolongation of the Q – T interval, in particular, fusiform arrhythmia, mainly in female patients with hypokalemia or pre-existing lengthening of the Q – T interval or other heart diseases.
Class-specific effects of SSRIs: Epidemiological studies conducted mainly in patients ≥50 years of age have shown an increased risk of bone fractures in patients receiving SSRIs and tricyclic antidepressants. The mechanism of this phenomenon is unknown.
Withdrawal symptoms when you suddenly stop taking. Discontinuation of SSRI treatment (especially sudden discontinuation) usually leads to the development of withdrawal symptoms. Dizziness, sensory disturbances (including paresthesia and sensation of electric shock), sleep disorders (including insomnia and vivid dreams), agitation or anxiety, nausea and / or vomiting, tremors, confusion, increased sweating, headache, diarrhea, tachycardia, emotional lability, irritability and visual disturbances were reported to be the most common reactions. These symptoms are usually mild to moderate and transient, but in some patients they can be severe and / or prolonged. Therefore, it is recommended to gradually stop taking escitalopram by reducing the dose over several weeks or several months, depending on the patient's condition.

Special instructions

The following specific warnings and precautions apply to the entire therapeutic class of siozs.
Paradoxical anxiety. In some patients with panic disorder, an increase in the severity of anxiety symptoms may occur at the beginning of antidepressant treatment. This paradoxical reaction usually disappears within the first 2 weeks of treatment. To reduce the likelihood of an anxiogenic effect, it is recommended to prescribe low initial doses of the preparation.
Convulsive seizures. The use of escitalopram should be discontinued if the patient develops a convulsive seizure for the first time or seizures become more frequent (in patients with an established diagnosis of epilepsy). SSRIs should be avoided in patients with unstable epilepsy, and patients with controlled epilepsy should be closely monitored.
Mania. SSRIs should be used with caution in patients with a history of mania / hypomania. If a patient develops a manic state, SSRIs should be discontinued.
Diabetes. In patients with diabetes mellitus, treatment with SSRIs may affect glycemic control. The dose of insulin and / or oral hypoglycemic agent may require adjustment.
Suicide / suicidal ideation or clinical worsening. Depression is associated with an increased risk of suicide, suicidal thoughts, and self-harm (suicidal behavior). This risk persists until sustained remission is achieved. Since improvement in the condition may not be achieved during the first weeks of treatment or more, patients on antidepressant therapy should be carefully monitored. It is known that the risk of suicide can increase in the early stages of recovery.
Other mental disorders for which Escitalopram-Teva is used may also be associated with an increased risk of suicidal actions. In addition, these conditions can be accompanied by major depressive disorder. A similar precaution must be taken when treating other mental disorders because of the potential for major depressive disorder to develop at the same time.
Due to the high risk of suicidal thoughts and actions during treatment, it is necessary to carefully monitor patients with a history of suicidal thoughts or behavior or with a significant level of suicidal thinking before starting treatment. Medical therapy should be accompanied by careful monitoring of patients, especially those at increased risk, in particular at the beginning of treatment and after dose changes. Patients (and their caregivers) should be warned about the need to monitor the manifestation of such actions and seek emergency help if the corresponding symptoms occur.
Akathisia and psychomotor agitation. The use of SSRIs / SSRIs and norepinephrine has been associated with the development of akathisia, a condition characterized by an unpleasant, debilitating feeling of restlessness and the need to move, often accompanied by an inability to sit or stand still. This situation is most likely to occur during the first few weeks of treatment. Increasing the dose may harm patients who develop these symptoms.
Hyponatremia. During the use of SSRIs, isolated cases of hyponatremia were reported, probably caused by impaired secretion of antidiuretic hormone (SIADH), which usually disappeared after discontinuation of therapy. Particular care is required when treating patients from risk groups (advanced age, the presence of liver cirrhosis, or the simultaneous use of preparations with hyponatremic properties).
Hemorrhage. When taking SSRIs, skin hemorrhages, ecchymosis and purpura are possible. It is necessary to use SSRIs with caution in patients who are simultaneously treated with anticoagulants, preparations that affect platelet function (for example, atypical antipsychotics, phenothiazines, tricyclic antidepressants, acetylsalicylic acid and NSAIDs, ticlopidine and dipyridamole), and in patients with a tendency to bleed.
Electroconvulsive therapy (ECT). Clinical experience with the simultaneous use of SSRIs and ECT is limited, so caution is advised.
Reversible, selective MAO type A inhibitors. Combining escitalopram and type A MAO inhibitors is contraindicated due to the risk of serotonin syndrome.
Serotonin syndrome. Caution is required when using escitalopram with serotonergic agents such as sumatriptan or other triptans, tramadol and tryptophan.
It was reported about the development of serotonin syndrome in isolated cases in patients taking SSRIs simultaneously with serotonergic preparations . Symptoms such as agitation, tremor, myoclonus and hyperthermia can be signs of the onset of this condition. In this case, it is necessary to immediately stop taking escitalopram and begin symptomatic treatment.
St. John's wort. The simultaneous use of SSRIs and herbal preparations containing St. John's wort (Hypericum perforatum) may increase the incidence of side effects.
Coronary heart disease. Due to limited clinical experience, caution is needed when treating patients with coronary heart disease.
Withdrawal symptoms. When treatment is stopped (especially abruptly), withdrawal symptoms usually occur. During clinical trials, side effects associated with discontinuation of treatment were observed in about 25% of patients in the escitalopram group and in 15% of patients in the placebo group.
The risk of withdrawal symptoms depends on several factors, in particular the duration of therapy, the dose and the gradual dose reduction. Dizziness, sensory disturbances (including paresthesias and sensation of electric shock), sleep disorders (including insomnia and vivid dreams), agitation or anxiety, nausea and / or vomiting, tremors, confusion, increased sweating, headache, diarrhea, tachycardia, emotional instability, irritability and visual impairment were noted as the most frequent reactions. These symptoms are usually mild to moderate in severity and transient, but in some patients they can be severe and / or prolonged. Thus, it is recommended to gradually discontinue escitalopram by reducing the dose over several weeks or several months, depending on the patient's condition.
Elongation of the Q – T interval. Established that escitalopram causes a dose-dependent lengthening of the Q – T interval. During the post-marketing period, cases of prolongation of the Q – T interval, in particular fusiform arrhythmia, were reported, mainly in female patients with hypokalemia or pre-existing prolongation of the Q – T interval or other heart diseases.
It is recommended to use with caution in patients with significant bradycardia or recent acute myocardial infarction or uncompensated heart failure.
Electrolyte disturbances such as hypokalemia and hypomagnesemia increase the risk of malignant arrhythmias and should be corrected before starting treatment with escitalopram.
When treating patients with stable heart disease, the ECG should be reviewed before starting treatment.
If signs of cardiac arrhythmia occur during treatment with escitalopram, treatment should be discontinued and an ECG performed.
During treatment with escitalopram, you should not consume alcoholic beverages.
Angle-closure glaucoma. SSRIs, including escitalopram, can affect pupil size, causing mydriasis. In turn, dilation of the pupil can cause narrowing of the angle of the eye and, as a result, increase intraocular pressure and provoke the development of angle-closure glaucoma, especially in patients predisposed to it. Therefore, escitalopram should be used with caution in patients with a history of angle-closure glaucoma or glaucoma.
Use during pregnancy or lactation
Pregnancy. Data on the use of escitalopram during pregnancy are limited. Escitalopram is contraindicated in pregnant women, except in cases where, after careful consideration of all the disadvantages and advantages, the need for prescribing the preparation has been clearly proven. A thorough examination of newborns whose mothers took escitalopram during pregnancy, especially in the third trimester, is recommended.
The use of the preparation during pregnancy should not be stopped suddenly.
Such disorders have been recorded in newborns whose mothers took SSRIs / SSRIs and norepinephrine at the end of pregnancy: respiratory distress syndrome, cyanosis, apnea, convulsions, instability of body temperature, difficulty in sucking, vomiting, hypoglycemia, hypertension, arterial hypotension, hyperreflexes, tremor, nervous agitation, irritability, drowsiness, constant crying, lethargy and difficulty falling asleep. These disorders can be a manifestation of serotonergic effects or withdrawal symptoms. In most cases, complications began immediately or shortly after delivery (24 hours).
It has been reported that the use of SSRIs in pregnant women may increase the risk of persistent pulmonary hypertension in neonates.
Lactation. Since escitalopram passes into breast milk, breastfeeding is not recommended during treatment.
Fertility Animal data have shown that some SSRIs can affect sperm quality. Reports of the use of some SSRIs in humans indicate that the effect on sperm quality is reversible. The effect on human fertility has not yet been noted.
Children. Antidepressants are contraindicated in children. Suicidal behavior (suicidal attempts and thoughts) and hostility (mainly aggression, tendency to confrontation and anger) were more often observed in children and adolescents taking antidepressants than in those taking placebo. If the clinical situation still requires the appointment of such treatment, the patient must be carefully monitored for the timely detection of suicidal symptoms.
In addition, there is no data on further safety for children and adolescents for height, puberty, and cognitive and behavioral development.
The ability to influence the reaction rate when driving vehicles or other mechanisms. Although Escitalopram-Teva has a slight or moderate effect on the ability to drive vehicles, but, as in the case of the use of other psychotropic preparations, patients should be warned of the potential risk of negative effects on the ability to drive vehicles and work with other mechanisms.

Interactions

Pharmacodynamic interactions.
Combinations, the purpose of which is contraindicated.
Elongation of the Q – T interval. Pharmacokinetic and pharmacodynamic studies of escitalopram in combination with other preparations  that prolong the Q – T interval have not been conducted. The general effect of escitalopram and these preparations cannot be ruled out. Therefore, the simultaneous use of escitalopram with preparations that prolong the Q-T interval, such as class IA and III antiarrhythmics, antipsychotics (phenothiazine derivatives, pimozide, haloperidol), tricyclic antidepressants, some antimicrobial preparations (for example, sparfloxacin, erythifloxacin in the introduction, pentamidine, antimalarial preparations, in particular halofantrine), certain antihistamines (astemizole, mizolastine) are contraindicated.
Non-selective MAO inhibitors. Cases of serious reactions have been reported in patients taking SSRIs in combination with non-selective irreversible MAO inhibitors, and in patients who have recently stopped taking SSRIs and switched to therapy with similar MAO inhibitors. Sometimes patients develop serotonin syndrome. The combined use of escitalopram with non-selective irreversible MAO inhibitors is contraindicated. Treatment with escitalopram can be started no earlier than 14 days after the last use of an irreversible MAO inhibitor. In turn, treatment with MAO inhibitors can be started only 7 days after the end of treatment with escitalopram.
The antibiotic linezolid is not recommended for patients receiving escitalopram therapy. If such a combination is extremely necessary, treatment is started at the minimum recommended dose with mandatory careful clinical monitoring.
The simultaneous use of escitalopram with reversible selective MAO-A (moclobemide) is not recommended due to the risk of developing serotonin syndrome. If such a combination is extremely necessary, treatment is started at the minimum recommended dose with mandatory careful clinical monitoring. Treatment with escitalopram can be started no earlier than 1 day after discontinuation of the reversible MAO inhibitor moclobemide.
Due to the risk of developing serotonin syndrome, caution is required when using escitalopram with selegiline (an irreversible type B MAO inhibitor). For simultaneous use with racemic citalopram, doses of seleginine up to 10 mg / day are safe.
Combinations requiring caution
Serotonergic preparations. Concomitant use with serotonergic preparations (for example, sumatriptan, other tryptans, tramadol, oxytriptan and tryptophan) can cause serotonin syndrome.
Medicines that lower the seizure threshold. SSRIs can lower the seizure threshold. Caution is needed when concurrently administering escitalopram with other preparations that can lower this threshold (for example, antidepressants (tricyclic, SSRIs), antipsychotics (phenothiazines, thioxanthenes and butyrophenones), mefloquine, buproprion and tramadol).
Lithium, tryptophan. Since there have been cases of increased serotonergic effects when using SSRIs in combination with lithium or tryptophan, it is recommended to be careful when prescribing escitalopram with these preparations. In this case, it is imperative to carry out regular monitoring of the level of lithium and tryptophan.
St. John's wort. The simultaneous use of escitalopram and herbal preparations containing St. John's wort (Hypericum perforatum) may increase the incidence of adverse reactions. Therefore, you should not simultaneously prescribe escitalopram and preparations containing St. John's wort.
Anticoagulants and preparations that affect blood clotting. Caution is needed when treating patients concomitantly taking anticoagulants, preparations that affect platelet function, in particular NSAIDs, acetylsalicylic acid, dipyridamole, ticlopidine or other preparations (eg atypical antipsychotics, phenothiazines, tricyclic depressants), which may increase the risk of bleeding.
Ethanol. Escitalopram-TEVA does not have a pharmacodynamic or pharmacokinetic interaction with ethanol, but, as in the case of the use of other psychotropic preparations , the simultaneous administration of escitalopram with preparations containing ethanol is not recommended.
Medicines causing hypokalemia / hypomagnesemia. Caution is needed with the simultaneous use of preparations that cause hypokalemia / hypomagnesemia, as this increases the risk of malignant arrhythmias.
The effect of other preparationson the pharmacokinetics of escitalopram. The metabolism of escitalopram occurs mainly with the participation of CYP 2C19, but CYP 3A4 and CYP 2D6 are also involved in the metabolism, although to a lesser extent. The isoenzyme CYP 2D6 is considered to be a partial catalyst for the metabolism of the main metabolite of S-DCT (demethylated escitalopram).
The combined use of escitalopram and omeprazole 30 mg once a day (an inhibitor of CYP 2C19) caused a moderate increase (by about 50%) in the plasma concentration of escitalopram.
The simultaneous use of escitalopram and cimetidine 400 mg 2 times a day (moderate total enzyme inhibitor) causes a moderate increase (by about 70%) in the plasma concentration of escitalopram.
Thus, caution should be exercised when escitalopram is administered concomitantly with cytochrome CYP 2C19 inhibitors (eg omeprazole, esomeprazole, fluvoxamine, lansoprazole, ticlopidine) or cimetidine. When used simultaneously with the above preparations , monitoring of side effects may necessitate a reduction in the dose of escitalopram.
Effect of escitalopram on the pharmacokinetics of other preparations. Escitalopram is an inhibitor of the CYP 2D6 enzyme. Caution is needed when prescribing escitalopram simultaneously with preparations whose metabolism occurs with the participation of this enzyme, as well as preparations that have a low therapeutic index, for example flecainide, propafenone, metoprolol (which is used for heart failure), or with preparations acting on the central nervous system and mainly metabolized with the participation of CYP 2D6, for example, antidepressants - desipramine, clomipramine and nortriptyline; antipsychotic preparations - risperidone, thioridazine, or haloperidol. In these cases, dose adjustment may be required.
Concomitant use with desipramine (the main metabolite of imipramine) or metoprolol leads to a twofold increase in plasma levels of two CYP 2D6 substrates. Escitalopram causes mild inhibition of CYP 2C19. Therefore, caution is recommended in the combined use of preparations , the metabolism of which occurs with the participation of CYP 2C19.

Overdose

Data on escitalopram overdose are limited. in most cases, symptoms were absent or mild. with an overdose of escitalopram, lethal cases have been reported rarely. in most of these cases, concomitant overdose of other preparations was noted. escitalopram doses of 400–800 mg did not cause severe symptoms.
Symptoms reported in escitalopram overdose were generally related to the central nervous system (from dizziness, tremor, agitation to rare cases of serotonin syndrome, seizures and coma), gastrointestinal tract (vomiting, nausea), cardiovascular system (arterial hypotension, tachycardia, lengthening of the interval Q – T and arrhythmia), as well as electrolyte and fluid balance (hypokalemia, hyponatremia).
Treatment. There is no specific antidote. Support and maintenance of airway patency, adequate oxygenation and respiratory function. Gastric lavage, which should be carried out as soon as possible after oral administration of the preparation, and the use of activated charcoal. Continuous monitoring of the functions of the cardiovascular system and the main indicators of the state of the body in combination with general symptomatic supportive measures is recommended.
In case of overdose, ECG monitoring is recommended in patients with congestive heart failure / bradyarrhythmia, in patients concomitantly taking preparations that prolong the Q – T interval, or in patients with metabolic disorders, such as liver failure.

Storage conditions

At a temperature not exceeding 30 ° C in original packaging to protect from light and moisture.

Tags: Escitalopram

Reviews Escitalopram-Teva 20mg 28 tablets — Made in Poland — Free Delivery

There are no reviews for this product.

Write a review

Please login or register to review

Buyers Online

AI Pharmacist • VEV.ICU

Online | Multilingual

v2.24
Hi! I am your AI assistant. Describe your problem, and I'll help you find the right medicine.
You can write to me in any language you prefer.
I don't answer technical questions (prices, delivery, payments).