Escitalopram 10mg Tablets

Escitalopram is a selective serotonin reuptake inhibitor (SSRI). It potently and selectively inhibits the reuptake of serotonin (5-HT) into the presynaptic neuron, leading to an increase in the concentration of 5-HT in the synaptic cleft and enhanced serotonergic neurotransmission. It has minimal effects on norepinephrine and dopamine neuronal reuptake.

Urgent Side Effects: Seek Medical Help Right Away

Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor immediately or seek emergency medical attention:

Signs of an allergic reaction, such as:
+ Rash or hives
+ Itching or red, swollen, blistered, or peeling skin (with or without fever)
+ Wheezing or tightness in the chest or throat
+ Difficulty breathing, swallowing, or talking
+ Unusual hoarseness or swelling of the mouth, face, lips, tongue, or throat
Signs of low sodium levels, including:
+ Headache
+ Trouble focusing or memory problems
+ Feeling confused or weak
+ Seizures or changes in balance
Signs of bleeding, such as:
+ Vomiting or coughing up blood
+ Vomit that resembles coffee grounds
+ Blood in the urine
+ Black, red, or tarry stools
+ Bleeding from the gums
+ Abnormal vaginal bleeding
+ Unexplained bruises or bruises that enlarge
+ Uncontrollable bleeding
Seizures
Fever or chills
Painful erection (priapism) or an erection lasting longer than 4 hours
Sex problems, including:
+ Decreased interest in sex
+ Difficulty having an orgasm
+ Ejaculation problems
+ Trouble getting or maintaining an erection

Some individuals may be at a higher risk of developing eye problems while taking this medication. Your doctor may recommend an eye exam to assess this risk. If you experience any of the following eye-related symptoms, contact your doctor immediately:

Eye pain
Changes in vision
Swelling or redness in or around the eye

A rare but potentially life-threatening condition called serotonin syndrome may occur, especially if you are taking certain other medications. Seek medical help right away if you experience:

Agitation
Changes in balance
Confusion
Hallucinations
Fever
Rapid or abnormal heartbeat
Flushing
Muscle twitching or stiffness
Seizures
Shivering or shaking
Excessive sweating
Severe diarrhea, nausea, or vomiting
Severe headache

Other Possible Side Effects

Most people do not experience significant side effects, but some may occur. If you notice any of the following symptoms or if they persist or bother you, contact your doctor:

Dizziness, drowsiness, fatigue, or weakness
Upset stomach
Diarrhea or constipation
Dry mouth
Difficulty sleeping
Excessive sweating
Flu-like symptoms
Runny nose
Headache
* Yawning

This is not an exhaustive list of possible side effects. If you have questions or concerns about side effects, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.

Before Taking This Medication: Important Information to Share with Your Doctor

It is essential to inform your doctor about the following:

Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction you experienced.
If you are currently taking linezolid or methylene blue, as these medications can interact with this drug.
If you are taking citalopram or pimozide, as concomitant use with this medication is not recommended.
If you have taken any medications for depression or Parkinson's disease within the last 14 days, including isocarboxazid, phenelzine, tranylcypromine, selegiline, or rasagiline, as this may increase the risk of very high blood pressure.

Please note that this is not an exhaustive list of all potential drug interactions or health concerns. Therefore, it is crucial to discuss all of your medications (prescription, over-the-counter, natural products, and vitamins) and health problems with your doctor and pharmacist to ensure safe use. Do not initiate, discontinue, or modify the dosage of any medication without first consulting your doctor.

It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication.

Before operating a vehicle or engaging in activities that require your full attention, wait until you understand how this medication affects you.

To minimize the risk of side effects, do not abruptly stop taking this medication without first consulting your doctor. If you need to discontinue use, your doctor will provide guidance on how to gradually taper off the medication.

While taking this medication, it is recommended that you avoid consuming alcohol. Additionally, consult with your doctor before using marijuana, cannabis, or any prescription or over-the-counter medications that may cause drowsiness or impair your reactions.

In patients with depression, improvements in sleep and appetite may be observed soon after initiating treatment. However, other symptoms of depression may take up to 4 weeks to show significant improvement.

This medication may increase the risk of bleeding, which can be life-threatening in some cases. Discuss this risk with your doctor.

Furthermore, this medication can cause low sodium levels, which can be life-threatening and lead to seizures, loss of consciousness, respiratory difficulties, or death.

If you are 65 years or older, use this medication with caution, as you may be more susceptible to side effects.

In children and adolescents, this medication may affect growth in some cases. Regular growth checks may be necessary, and you should discuss this with your doctor.

If you are pregnant, planning to become pregnant, or may be pregnant, inform your doctor. You will need to discuss the potential benefits and risks of taking this medication to both you and your baby. Taking this medication during the third trimester of pregnancy may increase your risk of postpartum bleeding and potentially cause health problems in the newborn.

If you are breastfeeding, consult with your doctor to discuss any potential risks to your baby.

• Monoamine Oxidase Inhibitors (MAOIs) (risk of serotonin syndrome)
• Pimozide (risk of QT prolongation)

• Other serotonergic drugs (e.g., triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, tryptophan, buspirone, St. John's Wort) - increased risk of serotonin syndrome.
• Drugs that prolong the QT interval (e.g., Class IA and III antiarrhythmics, antipsychotics, macrolide antibiotics, fluoroquinolone antibiotics, certain antihistamines) - increased risk of QT prolongation and Torsade de Pointes.
• Anticoagulants (e.g., warfarin) and antiplatelet agents (e.g., aspirin, NSAIDs) - increased risk of bleeding.
• Alcohol (potentiates CNS depressant effects).

• CYP2C19 inhibitors (e.g., omeprazole, esomeprazole, fluoxetine, fluvoxamine, ticlopidine) - may increase escitalopram levels.
• CYP3A4 inhibitors (e.g., ketoconazole, itraconazole, clarithromycin, ritonavir) - may increase escitalopram levels.
• Drugs metabolized by CYP2D6 (e.g., flecainide, propafenone, metoprolol, desipramine, clomipramine, nortriptyline, risperidone, thioridazine) - escitalopram is a weak inhibitor of CYP2D6, potentially increasing levels of these drugs.
• Cimetidine, lansoprazole, omeprazole - may increase escitalopram levels.

• Not available

• Serotonin Syndrome: agitation, hallucinations, delirium, coma, tachycardia, labile blood pressure, dizziness, diaphoresis, flushing, hyperthermia, tremor, rigidity, myoclonus, hyperreflexia, incoordination, GI symptoms (nausea, vomiting, diarrhea).
• Suicidal Ideation/Behavior: new or worsening depression, anxiety, agitation, panic attacks, insomnia, irritability, hostility, impulsivity, akathisia (psychomotor restlessness), hypomania, mania, or thoughts of self-harm.
• Hyponatremia: headache, difficulty concentrating, memory impairment, confusion, weakness, unsteadiness, falls, severe cases: hallucinations, syncope, seizures, coma, respiratory arrest.
• Withdrawal Symptoms (SSRI Discontinuation Syndrome): dizziness, sensory disturbances (e.g., paresthesias, electric shock sensations), sleep disturbances (insomnia, vivid dreams), agitation, anxiety, nausea, vomiting, tremor, confusion, headache, sweating, fatigue.

Use during pregnancy should be carefully considered, balancing potential risks and benefits. Untreated depression can also pose risks to both mother and fetus. Escitalopram is generally considered a Category C drug, meaning animal studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.

Escitalopram is excreted into breast milk. The decision to breastfeed while taking escitalopram should weigh the benefits of breastfeeding against the potential risks of infant exposure. Monitor the infant for adverse effects.

Escitalopram is approved for Major Depressive Disorder in adolescents aged 12-17 years. A black box warning exists regarding increased risk of suicidal thoughts and behavior in children, adolescents, and young adults (up to age 24) taking antidepressants. Close monitoring is essential.

Lower starting dose (5 mg once daily) and slower titration are recommended due to increased sensitivity to side effects and potential for hyponatremia. Max dose typically 10 mg/day. Elderly patients may have reduced clearance and increased plasma concentrations. Increased risk of falls and hyponatremia.

• Escitalopram is the S-enantiomer of citalopram and is generally considered to have a more favorable side effect profile and less potential for drug interactions compared to racemic citalopram.
• It is often a first-line choice for MDD and GAD due to its efficacy and relatively good tolerability.
• Patients should be advised that it may take several weeks to experience the full therapeutic effects.
• Discontinuation syndrome can occur if escitalopram is stopped abruptly; gradual tapering is crucial.
• Monitor for signs of serotonin syndrome, especially when co-administered with other serotonergic agents.
• Be mindful of the QT prolongation risk, particularly in patients with pre-existing cardiac conditions or those on other QT-prolonging medications.

• Other SSRIs (e.g., sertraline, fluoxetine, paroxetine, citalopram, fluvoxamine)
• Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) (e.g., venlafaxine, duloxetine, desvenlafaxine)
• Atypical Antidepressants (e.g., bupropion, mirtazapine, vortioxetine, vilazodone)
• Tricyclic Antidepressants (TCAs) (e.g., amitriptyline, nortriptyline)
• Monoamine Oxidase Inhibitors (MAOIs) (e.g., phenelzine, tranylcypromine, selegiline)
• Psychotherapy (e.g., Cognitive Behavioral Therapy - CBT)
• Electroconvulsive Therapy (ECT) for severe, refractory depression.

If your symptoms or health issues persist or worsen, it's essential to contact your doctor for further guidance. To ensure your safety, never share your medication with others or take someone else's medication.

This medication is accompanied by a Medication Guide, which provides crucial information about its use. Please read this guide carefully and review it again whenever you receive a refill. If you have any questions or concerns about this medication, don't hesitate to discuss them with your doctor, pharmacist, or other healthcare provider.

In the event of a suspected overdose, immediately call your local poison control center or seek emergency medical attention. Be prepared to provide detailed information about the overdose, including the medication taken, the amount, and the time it occurred.