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Escitalopram
Overview
What is Escitalopram?
Escitalopram oxalate is an orally administered selective serotonin reuptake inhibitor (SSRI). Escitalopram is the pure S-enantiomer (single isomer) of the racemic bicyclic phthalane derivative citalopram. Escitalopram oxalate is designated S-(+)-1-[3-(dimethyl-amino)propyl]-1-(
-fluorophenyl)-5-phthalancarbonitrile oxalate with the following structural formula:
The molecular formula is C
H
FN
• C
H
O
and the molecular weight is 414.40.
Escitalopram oxalate occurs as a fine, white to slightly-yellow powder and is freely soluble in methanol and dimethyl sulfoxide (DMSO), soluble in isotonic saline solution, sparingly soluble in water and ethanol, slightly soluble in ethyl acetate, and insoluble in heptane.
Escitalopram oxalate is available as tablets.
Escitalopram tablets USP are film-coated, round tablets containing escitalopram oxalate in strengths equivalent to 5 mg, 10 mg, and 20 mg escitalopram base. The 10 and 20 mg tablets are scored. The tablets also contain the following inactive ingredients: croscarmellose sodium, microcrystalline cellulose,hypromellose,colloidal anhydrous silica magnesium stearate and talc. The film coating contains hypromellose, titanium dioxide, and polyethylene glycol.
What does Escitalopram look like?
What are the available doses of Escitalopram?
Escitalopram tablets are film-coated, round tablets containing escitalopram oxalate in strengths equivalent to 5 mg, 10 mg and 20 mg escitalopram base. The 10 and 20 mg tablets are scored. Debossed with either "5", “10”, or “20” on the one side according to their respective strengths and plain on other side.
What should I talk to my health care provider before I take Escitalopram?
Pregnancy: Use only if the potential benefit justifies the potential risk to the fetus (
).
Nursing Mothers: Caution should be exercised when administered to a nursing woman (
)
Pediatric Use: Safety and effectiveness of escitalopram oxalate has not been established in pediatric MDD patients less than 12 years of age (
).
How should I use Escitalopram?
Escitalopram tablet USP is indicated for the acute and maintenance treatment of major depressive disorder in adults and in adolescents 12 to 17 years of age [
].
A major depressive episode (DSM-IV) implies a prominent and relatively persistent (nearly every day for at least 2 weeks) depressed or dysphoric mood that usually interferes with daily functioning, and includes at least five of the following nine symptoms: depressed mood, loss of interest in usual activities, significant change in weight and/or appetite, insomnia or hypersomnia, psychomotor agitation or retardation, increased fatigue, feelings of guilt or worthlessness, slowed thinking or impaired concentration, a suicide attempt or suicidal ideation.
Escitalopram tablets should be administered once daily, in the morning or evening, with or without food.
What interacts with Escitalopram?
Sorry No Records found
What are the warnings of Escitalopram?
Sorry No Records found
What are the precautions of Escitalopram?
Sorry No Records found
What are the side effects of Escitalopram?
Sorry No records found
What should I look out for while using Escitalopram?
Serotonin Syndrome and MAOIs: Do not use MAOIs intended to treat psychiatric disorders with escitalopram tablets or within 14 days of stopping treatment with escitalopram tablets. Do not use escitalopram tablets within 14 days of stopping an MAOI intended to treat psychiatric disorders. In addition, do not start escitalopram tablets in a patient who is being treated with linezolid or intravenous methylene blue (
).
Pimozide: Do not use concomitantly (
).
Known hypersensitivity to escitalopram or citalopram or any of the inactive ingredients (
).
Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults in short-term studies of major depressive disorder (MDD) and other psychiatric disorders. Anyone considering the use of escitalopram oxalate or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24; there was a reduction in risk with antidepressants compared to placebo in adults aged 65 and older. Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide. Patients of all ages who are started on antidepressant therapy should be monitored appropriately and observed closely for clinical worsening, suicidality, or unusual changes in behavior. Families and caregivers should be advised of the need for close observation and communication with the prescriber. Escitalopram oxalate is not approved for use in pediatric patients less than 12 years of age.
What might happen if I take too much Escitalopram?
How should I store and handle Escitalopram?
StorageStore Pantoprazole Sodium Delayed-Release Tablets, USP at 20° to 25°C (68° to 77°F); excursions permitted to 15° to 30°C (59° to 86°F) [ ]. StorageStore Pantoprazole Sodium Delayed-Release Tablets, USP at 20° to 25°C (68° to 77°F); excursions permitted to 15° to 30°C (59° to 86°F) [ ]. 25 mg tablets are peach, round, biconvex, film-coated tablets, debossed with ‘25’ on one side and plain on the other side and are supplied as: Bottles of 30’s with Child Resistant Cap ……………… NDC 47335-902-83 Bottles of 100’s with Child Resistant Cap …………….. NDC 47335-902-88 Bottles of 1000’s with Non Child Resistant Cap …..….. NDC 47335-902-18 Unit-dose blister pack of 100 (10 × 10) tablets ..………. NDC 47335-902-61 50 mg tablets are white, round, biconvex, film-coated tablets, debossed with ‘50’ on one side and plain on the other side and are supplied as: Bottles of 30’s with Child Resistant Cap ……………… NDC 47335-903-83 Bottles of 100’s with Child Resistant Cap …………….. NDC 47335-903-88 Bottles of 1000’s with Non Child Resistant Cap …..….. NDC 47335-903-18 Unit-dose blister pack of 100 (10 × 10) tablets ..………. NDC 47335-903-61 100 mg tablets are yellow, round, biconvex, film-coated tablets, debossed with ‘904’ on one side and plain on the other side and are supplied as: Bottles of 30’s with Child Resistant Cap ……………… NDC 47335-904-83 Bottles of 100’s with Child Resistant Cap …………….. NDC 47335-904-88 Bottles of 1000’s with Non Child Resistant Cap …..….. NDC 47335-904-18 Unit-dose blister pack of 100 (10 × 10) tablets ..………. NDC 47335-904-61 200 mg tablets are white, round, biconvex, film-coated tablets, debossed with ‘905’ on one side and plain on the other side and are supplied as: Bottles of 30’s with Child Resistant Cap ……………… NDC 47335-905-83 Bottles of 100’s with Child Resistant Cap …………….. NDC 47335-905-88 Bottles of 1000’s with Non Child Resistant Cap …..….. NDC 47335-905-18 Unit-dose blister pack of 100 (10 × 10) tablets ..………. NDC 47335-905-61 300 mg tablets are white, capsule-shaped, biconvex, film-coated tablets, debossed with ‘906’ on one side and plain on the other side and are supplied as: Bottles of 30’s with Child Resistant Cap ……………… NDC 47335-906-83 Bottles of 60’s with Child Resistant Cap ……………… NDC 47335-906-86 Bottles of 100’s with Child Resistant Cap …………….. NDC 47335-906-88 Bottles of 1000’s with Non Child Resistant Cap …..….. NDC 47335-906-18 Unit-dose blister pack of 100 (10 × 10) tablets ..………. NDC 47335-906-61 400 mg tablets are yellow, capsule-shaped, biconvex, film-coated tablets, debossed with ‘907’ on one side and plain on the other side and are supplied as: Bottles of 30’s with Child Resistant Cap ……………… NDC 47335-907-83 Bottles of 100’s with Child Resistant Cap …………….. NDC 47335-907-88 Bottles of 1000’s with Non Child Resistant Cap …..….. NDC 47335-907-18 Unit-dose blister pack of 100 (10 × 10) tablets ..………. NDC 47335-907-61 Store at 20° to 25°C (68° to 77°F); excursions permitted between 15° and 30°C (59° and 86°F) [see USP Controlled Room Temperature].
Clinical Information
Chemical Structure
No Image foundClinical Pharmacology
The mechanism of antidepressant action of escitalopram, the S-enantiomer of racemic citalopram, is presumed to be linked to potentiation of serotonergic activity in the central nervous system (CNS) resulting from its inhibition of CNS neuronal reuptake of serotonin (5-HT).
Non-Clinical Toxicology
Serotonin Syndrome and MAOIs: Do not use MAOIs intended to treat psychiatric disorders with escitalopram tablets or within 14 days of stopping treatment with escitalopram tablets. Do not use escitalopram tablets within 14 days of stopping an MAOI intended to treat psychiatric disorders. In addition, do not start escitalopram tablets in a patient who is being treated with linezolid or intravenous methylene blue ( ).Pimozide: Do not use concomitantly ( ).
Known hypersensitivity to escitalopram or citalopram or any of the inactive ingredients ( ).
Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults in short-term studies of major depressive disorder (MDD) and other psychiatric disorders. Anyone considering the use of escitalopram oxalate or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24; there was a reduction in risk with antidepressants compared to placebo in adults aged 65 and older. Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide. Patients of all ages who are started on antidepressant therapy should be monitored appropriately and observed closely for clinical worsening, suicidality, or unusual changes in behavior. Families and caregivers should be advised of the need for close observation and communication with the prescriber. Escitalopram oxalate is not approved for use in pediatric patients less than 12 years of age.
Due to potential for additive effects, caution is warranted in patients receiving diltiazem hydrochloride injection concomitantly with other agent(s) known to affect cardiac contractility and/or SA or AV node conduction (see ).
As with all drugs, care should be exercised when treating patients with multiple medications. Diltiazem hydrochloride undergoes extensive metabolism by the cytochrome P-450 mixed function oxidase system. Although specific pharmacokinetic drug-drug interaction studies have not been conducted with single intravenous injection or constant rate intravenous infusion, coadministration of diltiazem hydrochloride injection with other agents which primarily undergo the same route of biotransformation may result in competitive inhibition of metabolism.
Patients with major depressive disorder (MDD), both adult and pediatric, may experience worsening of their depression and/or the emergence of suicidal ideation and behavior (suicidality) or unusual changes in behavior, whether or not they are taking antidepressant medications, and this risk may persist until significant remission occurs. Suicide is a known risk of depression and certain other psychiatric disorders, and these disorders themselves are the strongest predictors of suicide. There has been a long-standing concern, however, that antidepressants may have a role in inducing worsening of depression and the emergence of suicidality in certain patients during the early phases of treatment. Pooled analyses of short-term placebo-controlled trials of antidepressant drugs (SSRIs and others) showed that these drugs increase the risk of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults (ages 18 to 24) with major depressive disorder (MDD) and other psychiatric disorders. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24; there was a reduction with antidepressants compared to placebo in adults aged 65 and older.
The pooled analyses of placebo-controlled trials in children and adolescents with MDD, obsessive compulsive disorder (OCD), or other psychiatric disorders included a total of 24 short-term trials of 9 antidepressant drugs in over 4400 patients. The pooled analyses of placebo-controlled trials in adults with MDD or other psychiatric disorders included a total of 295 short-term trials (median duration of 2 months) of 11 antidepressant drugs in over 77,000 patients. There was considerable variation in risk of suicidality among drugs, but a tendency toward an increase in the younger patients for almost all drugs studied. There were differences in absolute risk of suicidality across the different indications, with the highest incidence in MDD. The risk differences (drug vs. placebo), however, were relatively stable within age strata and across indications. These risk differences (drug-placebo difference in the number of cases of suicidality per 1000 patients treated) are provided in
No suicides occurred in any of the pediatric trials. There were suicides in the adult trials, but the number was not sufficient to reach any conclusion about drug effect on suicide.
It is unknown whether the suicidality risk extends to longer-term use, i.e., beyond several months. However, there is substantial evidence from placebo-controlled maintenance trials in adults with depression that the use of antidepressants can delay the recurrence of depression.
All patients being treated with antidepressants for any indication should be monitored appropriately and observed closely for clinical worsening, suicidality, and unusual changes in behavior, especially during the initial few months of a course of drug therapy, or at times of dose changes, either increases or decreases.
The following symptoms, anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia (psychomotor restlessness), hypomania, and mania, have been reported in adult and pediatric patients being treated with antidepressants for major depressive disorder as well as for other indications, both psychiatric and nonpsychiatric. Although a causal link between the emergence of such symptoms and either the worsening of depression and/or the emergence of suicidal impulses has not been established, there is concern that such symptoms may represent precursors to emerging suicidality.
Consideration should be given to changing the therapeutic regimen, including possibly discontinuing the medication, in patients whose depression is persistently worse, or who are experiencing emergent suicidality or symptoms that might be precursors to worsening depression or suicidality, especially if these symptoms are severe, abrupt in onset, or were not part of the patient's presenting symptoms.
If the decision has been made to discontinue treatment, medication should be tapered, as rapidly as is feasible, but with recognition that abrupt discontinuation can be associated with certain symptoms [ ].
Families and caregivers of patients being treated with antidepressants for major depressive disorder or other indications, both psychiatric and nonpsychiatric, should be alerted about the need to monitor patients for the emergence of agitation, irritability, unusual changes in behavior, and the other symptoms described above, as well as the emergence of suicidality, and to report such symptoms immediately to health care providers. Such monitoring should include daily observation by families and caregivers [ ]. Prescriptions for escitalopram oxalate should be written for the smallest quantity of tablets consistent with good patient management, in order to reduce the risk of overdose.
Reference
This information is obtained from the National Institute of Health's Standard Packaging Label drug database.
"https://dailymed.nlm.nih.gov/dailymed/"
While we update our database periodically, we cannot guarantee it is always updated to the latest version.
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Clonazepam Description Each single-scored tablet, for oral administration, contains 0.5 mg, 1 mg, or 2 mg Clonazepam, USP, a benzodiazepine. Each tablet also contains corn starch, lactose monohydrate, magnesium stearate, microcrystalline cellulose, and povidone. Clonazepam tablets USP 0.5 mg contain Yellow D&C No. 10 Aluminum Lake. Clonazepam tablets USP 1 mg contain Yellow D&C No. 10 Aluminum Lake, as well as FD&C Blue No. 1 Aluminum Lake. Chemically, Clonazepam, USP is 5-(o-chlorophenyl)-1,3-dihydro-7-nitro-2H-1,4-benzodiazepin-2-one. It is a light yellow crystalline powder. It has the following structural formula: C15H10ClN3O3 M.W. 315.72Tips
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Interactions
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