Overview
Concomitant use Belexa the drug Belexa desipramine or metoprolol led to a twofold increase in the concentration of these CYP2D6 substrates in plasma.
Research in vitro showed that escitalopram may also be a weak inhibitor of CYP2C19. It is recommended to use the drug with caution along with drugs metabolized by CYP2C19
Special instructions and precautions:
Children's age under 18 is a contraindication for the use of escitalopram, since the effectiveness and safety of its use at this age have not been established.
Due to the possibility of suicidal attempts, in patients with depression it is necessary to carefully monitor patients at the beginning of treatment and to prescribe the minimum effective doses to reduce the risk of overdose. This precaution should also be observed in the treatment of other mental disorders because of the possibility of a simultaneous illness with a depressive episode.
Severe depression is characterized by a risk of suicidal actions, which can persist until significant remission is achieved. In this regard, at the beginning of treatment, constant medical supervision, supervision of patient behavior and the organization of storage and distribution of medicines only by authorized persons are necessary. In the treatment of panic disorders with the appointment of antidepressants and / or benzodiazepines, in some patients, in response to the treatment started, anxiety or anxiety is significantly increased. This condition, called by specialists “pathological disinhibition” or simply “paradoxical anxiety”, is regarded as a rare phenomenon, although this pathological reaction has been repeatedly documented in the scientific literature. This “paradoxical anxiety” usually decreases within the first two weeks after starting treatment. It is recommended that you start with simple low dose to reduce the risk of paradoxical anxiety. In this case, drug withdrawal is recommended if such a paradoxical reaction does not disappear for a long time, and if such complications of therapy exceed the benefit of the treatment.
In children, adolescents and young people (under 24 years old) with depression and other mental disorders, antidepressants, compared with placebo, increase the risk of suicidal thoughts and suicidal behavior. Therefore, when prescribing the drug Escitalopram or any other antidepressants in this category of patients, the risk of suicide and the benefits of their use should be correlated. In short-term studies in people over 24 years of age, the risk of suicide did not increase, while in people over 65 years of age it decreased slightly. During antidepressant Belexa, all patients should be monitored for the early detection of behavioral disorders, as well as suicidal tendencies.
Escitalopram can cause a dose-dependent prolongation of the QT interval on the ECG, which can lead to heart rhythm disturbance.
Hyponatremia develops due to impaired secretion of antidiuretic hormone, especially a high level of risk in older women.
Against the background of taking escitalopram, skin hemorrhages (ecchymosis and purpura) may develop. It is necessary to use the drug with caution in patients at risk of bleeding, as well as taking oral anticoagulants and drugs that affect blood coagulation.
Escitalopram treatment may alter glycemic control in patients with diabetes mellitus. The dose of insulin and / or oral hypoglycemic agents should be adjusted.
It is rarely possible to develop akathisia, characterized by a constant or periodically arising feeling of internal motor anxiety and manifested in the inability to sit quietly in one position for a long time or to remain motionless for a long time. Passes during the first weeks of treatment.
Patients with bipolar disorder or with mania / hypomania have a history of mania. Then treatment with escitalopram should be discontinued.
It is necessary to use Escitalopram with caution in the presence of drug dependence (including a history) and a history of epileptic seizures. In the case of convulsive seizures, as well as in patients with epilepsy with an increase in the frequency of convulsive seizures, the drug Escitalopram, as well as other drugs of the SSRI group, should be discontinued. Not recommended for use in patients with unstable epilepsy.
Escitalopram should not be next in combination with monoamine oxidase inhibitors (MAO).
For mild to moderate impaired renal function, dose adjustment is not required; for severe renal impairment, caution is required. In case of impaired liver function, Noubid drug is limited to the minimum recommended doses. Elderly patients require escitalopram dose reduction.
With the development of a manic state, the drug should be discontinued.
The clinical experience of the simultaneous use of the drug Escitalopram and electroconvulsive therapy is insufficient, therefore caution is required.
At the beginning of treatment, insomnia and feelings of anxiety may occur, which can be solved by adjusting the initial dose.
No interaction of escitalopram with alcohol was detected. However, as is the case with other antidepressants, you should refrain from drinking alcohol during the entire period of treatment with the drug.
Abrupt cessation of escitalopram therapy may lead to withdrawal syndrome. Undesirable reactions such as dizziness, headaches, and nausea may occur. To avoid the occurrence of the "withdrawal" syndrome, a gradual withdrawal of the drug within 1-2 weeks is necessary. The doctor solves this issue individually: for some patients, a period of 2-3 months or follow may be required.
Influence on the ability to drive vehicles and control mechanisms
During the treatment with Escitalopram, patients are not recommended to drive a car or mechanisms. The patient should be informed of the potential danger of the effects of escitalopram on the ability to drive vehicles and mechanisms.
Storage conditions:
In the dark place at a temperature of no higher than 25 ° C. Keep out of the reach of children. Do not use after the expiration date indicated on the package.
Escitalopram 10mg 30 pcs. film-coated tablets
