Why it's used

Escitalopram is used for the treatment and maintenance of depression (major depressive disorder) in adults and children 12-17 years. This medicine works by increasing the level of a natural substance (serotonin) in the brain. Escitalopram is also used to treat severe anxiety (generalized anxiety disorder) in adults, to treat the panic disorder with or without fear of places and situations (agoraphobia), to treat social phobia (also called, social anxiety disorder), and to treat mental illness with uncontrollable thoughts and repetitive behaviours (known as, Obsessive-compulsive disorder).
Selective Serotonin Reuptake inhibitor
Escitalopram is a prescription medicine that belongs to a class of medicines called Selective Serotonin Reuptake inhibitor. Selective serotonin reuptake inhibitors (SSRIs) are a group of medicine used to treat depression and anxiety disorders. Serotonin is the natural chemical that carries signals between brain cells. SSRIs block the re-absorption of serotonin thus making more serotonin available in the brain.

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How to use

Follow directions on the product label, information guide, and provided by your doctor before using Escitalopram. Consume this medicine as per your doctor's instructions.
Escitalopram is consumed with or without food. Escitalopram is consumed morning or evening.

Typical Dosage

The typical adult dose of Escitalopram is 10 mg once daily (not more than 20 mg once daily). The typical dose for children is 10 mg once daily (not more than 20 mg once daily). The maximum dose for adults of Escitalopram is 20 mg per day. This medicine is commonly used for a period of 8 weeks for depression (major depressive disorder). There are no known habit-forming tendencies with this medicine.
Escitalopram is to be used for longer periods of time. Escitalopram may be used for long-term treatment of social anxiety disorder and panic disorder with or without fear of places and situations (agoraphobia). You should continue to use this medicine as directed by the doctor even if you feel well.

Talk to Your Doctor

Tell your doctor if you develop new symptoms. Talk to your doctor if nervousness (agitation), irritability, unusual changes in behavior, and suicidal ideation. If you have issues with the health of your liver, An initial dose of 5 mg/day should be given to the patients with mild to moderate liver dysfunction. According to the patient's response, the dose of Escitalopram is increased to 10 mg/day. Precaution and careful dose adjustment is adviced in patients with reduced liver function. Consult with your doctor before stopping the use of Escitalopram.
To see the impact of Escitalopram on the body, your doctor may recommend a lower initial dose. Please follow your doctor's instructions carefully. A lower dose of Escitalopram may be recommended to reduce the risk of side-effects. Older patients may see an increase in the risk of side-effects. Hence, a lower dose may be recommended.
When stopping this medicine, it is possible that you may experience withdrawal symptoms such as anxiety, irritability, high or low mood, changes in sleep habits, headache, nausea, dizziness, electric shock-like sensations, shaking, confusion, feeling restless, sweating, sensory disturbances, abnormal sensations in the body, insomnia, intense dreams, nervousness (agitation), vomiting, tremor, confusion, diarrhea, palpitations, emotional instability, and vision disturbances. You may need to gradually decrease the dose of this medicine before stopping.

Use in Children

The safety and effectiveness of using this medicine in children has not been established. Escitalopram should not be used in children under the age of 12 years. It can be used only in children aged more than 12 years.

Avoid Alcohol

Avoid drinking alcohol with Escitalopram.

Lab Tests

Your doctor may require that certain tests be performed before using Escitalopram. The doctor may ask you to have Electrocardiogram test. If the patient has a stable heart disease, electrocardiography should be reviewed before starting the treatment with Escitalopram because there are chances of developing a serious heart problem. Your doctor may request Electrolytes test. This test is performed to check the disturbance of electrolytes such as low level of potassium and magnesium. Low electrolytes levels increase the risk of life-threatening heart disease and these levels should be maintained before starting the treatment with Escitalopram.

Storage

Store Escitalopram at 15°C - 30°C (59°F - 86°F). Keep this medicine away from children and pets.
Medicines may be given for uses other than those listed in the medicine guide. Do not use Escitalopram for symptoms for which it was not prescribed. Do not give Escitalopram to others who may have similar symptoms as you. Self-medication can cause harm.

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How to take Escitalopram

The dose and frequency of using Escitalopram will depend on the following factors:
  • patient's health
  • the health of the patient's kidneys
  • response to the medicine

Escitalopram Dosage

Dosage for depression

Adult
  • Recommended: 10 mg once daily
  • Maximum: 20 mg daily
Children (children aged 12-17 years)
  • Recommended: 10 mg once daily
  • Maximum: 20 mg after 3 weeks of recommended dose
Older Adults (more than 65 years)
  • Initial: 5 mg once daily
  • Maximum: 10 mg daily

Dosage for severe anxiety

Adult
  • Recommended: 10 mg once daily
  • Maximum: 20 mg after one week of recommended dose

Dosage for panic disorder

Adult (with or without fear in open public space)
  • Recommended: 10 mg daily after one week of initial dose
  • Initial: 5 mg for the first week
  • Maximum: 20 mg daily

Dosage for social phobia

Adult
  • Recommended: 10 mg once daily, the dose may be decreased to 5 mg or increased to 20 mg daily depending on the patient's response
  • Maximum: 20 mg daily

Dosage for mental illness with repetitive behaviours

Adult (Obsessive-compulsive disorder)
  • Initial: 10 mg once daily
  • Maximum: 20 mg daily

Minimum Age

12 years

Dosage calculation for children

To calculate the dosage for children please use the weight based dose calculator to calculate the appropriate dosage as per the weight of your child.

Forms

Tablet
Strength: 5 mg, 10 mg, 15 mg, and 20 mg
Oral solution
Strength: 1 mg/mL

Special Instructions

Abnormal liver function
10 mg daily dose of Escitalopram is recommended for patients with abnormal liver function.
Abnormal functioning of kidneys
There is no dose adjustment recommended for patients with mild to moderate abnormal functioning of kidneys, but Escitalopram should be taken with caution in patients with the severe abnormal functioning of kidneys.
Poor metabolizers of an enzyme (CYP2C19)
5 mg daily initial dose of Escitalopram is recommended in patients with poor metabolizers of an enzyme (CYP2C19) for two weeks. The dose may be increased to 10 mg daily on the basis of the patient's response to the treatment.

Missed Dose

Take the missed dose as soon as you remember. Skip the missed dose if its time for next dose. Do not take a double dose to make up for the dose that you may have missed.

Overdose

What to do if you overdose on Escitalopram?
In case of overdose, oxygen or artificial respiration should be given for breathing problems. Stomach emptying and use of charcoal, a substance that absorbs poisons from the stomach should be done. Carefully monitor heart and vital signs and also provide supportive care. Escitalopram can be removed from the blood by artificial blood purifying techniques (dialysis and hemoperfusion), and excessive production of urine (diuresis), and patient's blood exchange.
Symptoms of an overdose of Escitalopram
If you use too much of this medicine, it could lead to dangerous levels of the medicine in your body. In such cases, symptoms of an overdose may include:
If you think you have overdosed on Escitalopram, call a poison control center immediately. You can look up the poison control center information from the Poison Center Finder at TabletWise.com.

Precautions while using Escitalopram

Before you use Escitalopram, tell your doctor of your medical and health history including the following:
  • abnormally elevated mood
  • bleeding problems
  • depression
  • drug abuse
  • family history of suicide
  • heart problems
  • high blood pressure
  • kidney problems
  • liver problems
  • low blood sodium levels
  • periods of depression and abnormally elevated mood (bipolar disorder)
  • seizure disorder
  • stroke
Escitalopram does not work against periods of depression and abnormally elevated mood (bipolar disorder).
Before you use Escitalopram, tell your doctor if you are allergic to it or its ingredients. Your doctor may prescribe an alternative medicine and update your medical records to record this information. Tell your doctor if you are allergic to citalopram hydrobromide.
The use of this medicine may change the bilirubin level. The patients may experience an increase in bilirubin level during Escitalopram therapy.
The use of Escitalopram may change Electrocardiogram QT prolongation. The patients may experience prolonged heartbeat during Escitalopram therapy.
The use of this medicine may change liver enzymes. The patients may experience an increase in liver enzymes during Escitalopram therapy.
The use of this medicine may change cholesterol. The patients may experience an increase in blood cholesterol levels during Escitalopram therapy.
The use of Escitalopram may change the ratio of the patient's prothrombin time to control blood sample (international normalized ratio). This medicine may increase the patient's blood clotting time.

Alcohol

Avoid the consumption of alcohol with Escitalopram. Drinking alcohol may cause insomnia, seizures, dizziness, nausea, prolonged heartbeat (QT prolongation), vomiting, low blood pressure, increased heartbeat, drowsiness, abnormal heartbeat (torsade de pointes), and coma.

Use in Pregnancy

Consult with your doctor on the use of Escitalopram during pregnancy. Use of Escitalopram late in the third trimester may cause complications in newborn which includes including breathing problem during sleep (apnea), respiratory distress, seizures, bluish or purplish skin discoloration (cyanosis), temperature instability, muscle weakness (hypotonia), feeding difficulty, muscle rigidity (hypertonia), vomiting, low blood sugar (hypoglycemia), involuntary muscle contraction and relaxation (tremor), overactive response (hyperreflexia), involuntary movements (jitteriness), constant crying, irritability, and persistent high blood pressure due to lung disease in newborn. Escitalopram should only be used during pregnancy if the possible benefit outweighs the potential risk to the fetus.

Use while Breastfeeding

Consult with your doctor on the use of Escitalopram during breastfeeding. Escitalopram may pass into breast milk. This medicine causes excessive drowsiness, weight loss, and decreased feeding in newborn. This medicine should be given with caution in such patients and closely monitor breastfeeding newborn for side effects of Escitalopram.

Impact on Fertility

Consult with your doctor on the use of Escitalopram, if you are trying to conceive.

Seizures

Escitalopram can make you feel sleepy. Be careful while driving, using machinery, or doing any other activity that needs you to be alert. The consumption of alcohol with Escitalopram can make you feel more sleepy. Escitalopram may cause seizures in some people. Discuss with your doctor if you perform activities where a loss of consciousness may cause you or others harm.

Increased Risk

This medicine can cause stomach bleeding. The use of alcohol/tobacco with Escitalopram may increase the risk. Talk to your doctor if you drink alcohol or smoke regularly. This medicine may increase your sensitivity to sunlight. If this happens, limit your time outdoors and prevent sunburns. Cover your skin or use a sunscreen.

Side-effects in Children

Escitalopram may cause an increased risk of side-effects in younger patients. Children using this medicine may see an increased risk of decreased appetite, and weight loss.

Side-effects in Older Patients

Escitalopram may increase side-effects in older patients. Elderly patients may see an increased risk of low blood sodium level.

What precautions should be taken during Pregnancy and Nursing, and administering Escitalopram to Children or the Older Adults?

Pregnant Women

Only When Necessary
Warning: No adequate and well-controlled studies of Escitalopram have been done in pregnant women.

Breastfeeding

Only When Necessary
Warning: Escitalopram may pass into breast milk. Consult with a doctor while taking this medicine if breastfeeding or plan to breastfeed.

Younger Adults Population

Only When Necessary
Warning: The safety and effectiveness of Escitalopram have not been established in depressed children of age younger than 12 years. While using Escitalopram in children, monitor their weight and growth regularly.

Older Adults Population

Possibly safe
Warning: There is no difference in safety and effectiveness of Escitalopram between adult and elder patients. But some elderly patients may have greater sensitivity to this medicine.

Escitalopram Side-effects

The following side-effects may commonly occur when using Escitalopram. If any of these side-effects worsen or last for a long time, you should consult with your doctor:
The following side-effects may commonly occur in older patients on the use of Escitalopram. Discuss with your doctor if any of these side-effects last for a long time or are severe:
The following side-effects may commonly occur in children when using Escitalopram. Discuss with your doctor if any of these side-effects last for a long time or are severe:
  • changes in appetite or weight
Rarely, the use of Escitalopram may cause the following side-effects:
The following severe side-effects may also occur when using Escitalopram:
  • Blood diseases such as low level of red blood cells (anemia), low white blood cell count, decreased production of new blood cells (aplastic anemia), destruction of red blood cells (hemolytic anemia), low level of leukocytes (leukopenia), low level of cells that prevent bleeding
  • Severe allergy (also called, anaphylactic reaction)
    Symptoms: trouble breathing, swelling of the face, swelling of the tongue, swelling of the eyes, swelling of the mouth, skin rash, hives, blisters on the skin, fever joint pain
    The patient should contact the doctor immediately if such symptoms occur.
  • Mental disorders such as abnormally elevated mood (mania)
    Symptoms: significantly increased energy, difficulty in sleeping, racing thoughts, rash behavior, unusually grand ideas, extreme happiness or anger talking more or quicker than usual
    If these symptoms occur then contact your doctor immediately.
  • Eye disorders (visual problems)
    Symptoms: pain in the eye, changes in vision inflammation in or around the eye
    The patients may have an eye examination to estimate the risk of such events. If this happens, the patient should contact the doctor immediately.
  • Heart diseases such as slow heart rate, rapid and irregular heartbeat (atrial fibrillation), heart failure, abnormal heartbeat (torsade de pointes)
  • Stomach and intestinal disorders such as stomach flu (gastroenteritis) or vomiting
  • Liver diseases such as liver failure, liver cell death (liver necrosis), inflammation of the liver (hepatitis)
  • Group of symptoms includes fever, tremor, nervousness, sweating, increased reflexes, diarrhea, and dilated pupils caused by the use of serotonergic drugs (also called, serotonin syndrome) (possibly fatal)
    Symptoms: anxiety, hallucinations, coma, changes in the mental status, coordination problems, muscle twitching, rapid heartbeat, high or low blood pressure, increased sweating, fever, nausea, vomiting, diarrhea muscle rigidity
    If these symptoms occur then contact your doctor immediately.
  • Reproductive system disorders such as disorders of semen discharge from the male reproductory tract (ejaculation disorder), erectile dysfunction (impotence), abnormal uterus bleeding (metrorrhagia)
  • Suicidal thoughts or actions
    Symptoms: attempts to do suicide, acting on dangerous thoughts, acting violent, thoughts about suicide, depression, anxiety or panic attacks, feeling agitated, restless, irritable or angry, problem in sleeping, increase in the activity or talking more than normal, unusual changes in behavior, mood, actions, thoughts or feelings
    If this happens, the patient should contact the doctor immediately.
Your doctor has prescribed this medicine because they judge that the benefit is greater than the risk posed by side-effects. Many people using this medicine do not have serious cases of side-effects. This page does not contain a complete list of all possible side-effects.
If you experience side-effects or notice other side-effects not listed above, contact your doctor for medical advice. You may also report side-effects to your local food and drug administration authority. You can look up the drug authority contact information from the Drug Authority Finder at TabletWise.com.

Side-effects and Allergic Reactions of Escitalopram by Severity and Frequency

Common Side-effects

Following are the common side-effects of this medicine:

Infrequent and Rare Side-effects

Following are the infrequent and rare side-effects of this medicine:

Severe Side-effects

Following are the severe side-effects of this medicine:

Side-effects in Older Adults

Following are the side-effects of this medicine in elderly patients:

Side-effects in Children

Following are the side-effects of this medicine in young patients:
  • changes in appetite or weight

Side-effects differences in men and women

While using Escitalopram in women the common side effect observed is the inability to achieve orgasm (anorgasmia). In men, impotence occurs while using this medicine.

Serious Allergic Reactions

Following are the symptoms of serious allergic reactions to this medicine:
The patient should contact the doctor immediately if such symptoms occur.
If you experience side-effects or notice other side-effects not listed above, contact your doctor for medical advice. You may also report side-effects to your local food and drug administration authority. You can look up the drug authority contact information from the Drug Authority Finder at TabletWise.com.

Warnings

Diabetes

Patients with diabetes are at increased risk when using this medicine. These patients may suffer from abnormal blood glucose level (hypoglycaemia or hyperglycaemia). If this happens, dose adjustment of insulin or oral blood glucose lowering drugs (oral hypoglycemic drugs) is required.

Severe Kidney Dysfunction

Patients with severe kidney dysfunction are at increased risk. Escitalopram should be used with caution in these patients.

Children

The children under the age of 18 years are at increased risk. These patients may develop suicide-related behaviors (for example, suicide attempt and suicidal thoughts), and aggressive behavior (for example aggression, oppositional behavior, and anger). Escitalopram should not be used in patients of age less than 12 years and if it is used, the patient should carefully be monitored for the suicidal symptoms.

Anxiety

Patients with panic disorder are at increased risk when using this medicine. These patients may experience anxiety at the starting of treatment. In these cases, a low starting dose of Escitalopram is advised to reduce the unwanted effect.

Eye Disorder

Patients who use antidepressants are at increased risk. These patients may suffer from an angle closure attack (angle-closure glaucoma). Escitalopram should be used cautiously in patients having a history of eye disorder (angle-closure glaucoma).

Seizures

Patients with a history of the seizure disorder are at increased risk when using this medicine. These patients may suffer from seizures. Escitalopram should be used with care in these patients.

Abnormally Elevated Mood (Activation of Mania/Hypomania)

Patients with a history of abnormally elevated mood are at increased risk when using this medicine. These patients may suffer from hyperactivity (hypomania). Escitalopram should be used with caution in these patients.

Low Blood Sodium Level

Patients using diuretics and patients with older age or long-term liver damage (cirrhosis) are at increased risk when using this medicine. If, the patient use medicines that can cause low sodium levels in combination with Escitalopram are also at increased risk. These patients may suffer from decreased sodium levels. If this happens, discontinue the use of Escitalopram and appropriate treatment should be given to the patient. The patients who are at risk should use caution.

Abnormal Bleeding

Patients who use aspirin, nonsteroidal anti-inflammatory drugs and blood thinners (anticoagulants) are at increased risk when using this medicine. These patients may suffer from stomach and intestinal bleeding. This may include discoloration of the skin (ecchymoses), blood collection outside the blood vessels (hematomas), bleeding from the nose (epistaxis), and red or purple spot on the skin (petechiae) to life-threatening internal bleeding (hemorrhages). Escitalopram should be used with caution in these patients.

Disturbed Mental Action and Movement Performance

Patients using psychoactive drugs are at increased risk. These patients may suffer from disturbed thinking, judgment, or muscle movement (motor) skills. The patients should be cautious about operating heavy machinery until they almost sure that Escitalopram does not affect their ability to work.

Worsening of Depression

Patients with depression are at increased risk when using this medicine. There are increased chances of worsening of depression and suicidal behavior in these patients. If you develop new symptoms including nervousness, irritability, and unusual changes in behavior, contact your doctor immediately.

Periods of Depression and Abnormally Elevated Mood

Patients with periods of depression and abnormally elevated mood (bipolar disorder) are at increased risk when using this medicine. In these patients, the chances of abnormally elevated mood (mixed and manic episodes) are increased. Escitalopram should not be used to treat bipolar disorder and before starting treatment with Escitalopram, the screening for bipolar disorder should be done.

Life-Threatening Condition

Patients using Escitalopram with other drugs that affect the serotonin level (fentanyl, triptans, tricyclic antidepressants, lithium, tryptophan, tramadol, amphetamines, buspirone, and St. John’s Wort) are at increased risk. These patients may suffer from serotonin syndrome. The symptoms of serotonin syndrome include mental status changes (for example, nervousness, hallucinations, mental confusion) and nervous system instability (for example, increased heartbeat, fluctuation in blood pressure, dizziness, sweating, elevated body temperature). The patient may also show muscles related symptoms (for example, tremor, uncontrolled movement of muscles, over-responsiveness, rigidity, incoordination) seizures, and stomach and intestinal symptoms (for example, nausea, vomiting, diarrhea). If this happens, the patient should be monitored for the serotonin syndrome.

Monoamine Oxidase Inhibitors

Patients using monoamine oxidase inhibitors (for example, methylene blue) are at increased risk when using this medicine. These patients may suffer from serotonin syndrome. Escitalopram should not be used in combination with monoamine oxidase inhibitors.

Discontinuation of Treatment with Escitalopram

Patients who discontinue using this medicine immediately, are at increased risk. These patients may develop symptoms including mental discomfort (dysphoric mood), irritability, nervousness (agitation), dizziness, sensory disturbances (for example, electric shock sensations), anxiety, confusion, headache, lack of energy (lethargy), emotional changes (lability), insomnia, and hyperactivity (hypomania). Escitalopram should not be discontinued immediately. Its dose should be gradually decreased.

Interactions with Escitalopram

When two or more medicines are taken together, it can change how the medicines work and increase the risk of side-effects. In medical terms, this is called as a Drug Interaction.
This page does not contain all the possible interactions of Escitalopram. Share a list of all medicines that you use with your doctor and pharmacist. Do not start, stop, or change the dose of any medicines without the approval of your doctor.

Triptans

Escitalopram interacts with triptans, which are used to treat a severe headache. The use of Escitalopram with triptans may lead to a life-threatening condition, called serotonin syndrome. If serotonin syndrome occurs then discontinue the use of triptans with Escitalopram immediately and start a supportive treatment.

Serotonergic Drugs

There may be an interaction of Escitalopram with serotonergic drugs, which are used to treat depression. The use of Escitalopram with serotonergic drugs, for example, triptans, lithium, fentanyl, tramadol, tryptophan, buspirone, amphetamines, sumatriptan, St. John’s Wort, tricyclic antidepressants may lead to a life-threatening condition, called serotonin syndrome. If serotonin syndrome occurs then discontinue the use of serotonergic drugs with Escitalopram immediately and start a supportive treatment.

Monoamine Oxidase Inhibitors

Escitalopram may interact with monoamine oxidase inhibitors, which are used to treat depression. The use of Escitalopram with monoamine oxidase inhibitors, for example, linezolid, methylene blue, or selegiline may lead to a life-threatening condition, called serotonin syndrome. Escitalopram should not be taken with monoamine oxidase inhibitors. If the combination of Escitalopram and monoamine oxidase inhibitors is recommended then start with low dose and close monitoring should be followed. Otherwise, there should be 14 days gap between the use of Escitalopram and monoamine oxidase inhibitors.

Blood Thinners

Your doctor's guidelines may need to be followed while taking this medicine along with blood thinners, which are used to prevent the formation of blood clots. The use of Escitalopram with blood thinners, for example, aspirin, warfarin, or nonsteroidal anti-inflammatory drugs may lead to an increased risk of bleeding. The patients taking warfarin and other blood thinners should be carefully monitored when Escitalopram is started or discontinued.

Central Nervous System Drugs

Special instructions need to be followed while taking this medicine along with central nervous system drugs, which are used to treat abnormal brain function. Escitalopram should be taken with caution while taking in combination with central nervous system drugs.

Metoprolol

Your doctor's guidelines may need to be followed while taking this medicine along with metoprolol, which is used to treat high blood pressure and to prevent chest pain. The use of Escitalopram with metoprolol results in an increase in the amount of Escitalopram in the blood. The increased level of metoprolol in the blood causes a decrease in the effectiveness of metoprolol in the treatment of heart diseases (cardioselectivity). The patients should be cautious while taking Escitalopram with metoprolol. The dose adjustment may also be required in such patients.

Drugs Metabolized by Enzyme

Special instructions need to be followed while taking this medicine along with drugs metabolized by enzyme (cytochrome P4502D6). The patients should be cautious while taking Escitalopram with the drugs that are metabolized by an enzyme (CYP2D6). These medicines mainly include flecainide, propafenone, and metoprolol or antidepressants (for example, clomipramine, desipramine, and nortriptyline) or antipsychotics (for example, haloperidol, thioridazine, and risperidone). The dose adjustment may also be required in such patients.

Carbamazepine

Escitalopram interacts with carbamazepine, which is used to treat seizures. There is a possibility that carbamazepine may increase the clearance of Escitalopram. The patients should be carefully monitored when Escitalopram is taken together with carbamazepine.

Sumatriptan

There may be an interaction of Escitalopram with sumatriptan, which is used to treat migraine headache. There are some reports of weakness, overresponsive reflexes, and lack of coordination after the use of Escitalopram and sumatriptan. In such patients, appropriate observation is advised.

Cimetidine

Escitalopram may interact with cimetidine, which is used to treat excessive stomach acid production. The use of Escitalopram with cimetidine results in an increase in the amount of Escitalopram in the blood. The patients are advised to be cautious while taking Escitalopram with cimetidine. The dose adjustment may be required in such case.

Antiepileptic Drugs

Special instructions need to be followed while taking this medicine along with medicinal products that lower the patient's susceptibility to seizures. This medicine can lower the patient's susceptibility to seizures. Escitalopram should not be used with the medicinal products that also lowers the patient's susceptibility to seizures. These medicines are antidepressants (selective serotonin reuptake inhibitor, tricyclic), neuroleptics (phenothiazines, thioxanthenes and butyrophenones), bupropion, mefloquin and tramadol.

Drug-Induced Heartbeat Prolongation

Escitalopram interacts with medicines that prolong the heartbeat (QT-interval). Escitalopram is not recommended to use with medicines that prolong the heartbeat such as antipsychotics (for example, pimozide, phenotiazine, haloperidol), class IA and III antiarrhythmics, tricyclic antidepressants, certain antihistamines (mizolastine, astemizole), certain antimicrobial agents (for example, moxifloxacin, sparfloxacin, erythromycin IV, halofantrine, pentamidine).

CYP2C19 Inhibitors

There may be an interaction of Escitalopram with enzyme (CYP2C19) inhibitors. The use of Escitalopram with omeprazole cause an increase in the amount of Escitalopram in blood. The patients are advised to be cautious while taking Escitalopram with enzyme (CYP2C19) inhibitors (for example, fluvoxamine, omeprazole, ticlopidine, lansoprazole, esomeprazole). The dose adjustment may be required in the patients based on monitoring of side-effects.

Decrease in Potassium or Magnesium Levels

Escitalopram may interact with medicines causing a decrease in potassium or magnesium levels. The patients are at an increased risk of developing heart disease with an irregular heartbeat. It is advised to be cautious during simultaneous use of Escitalopram with medicines that cause a decrease in potassium or magnesium levels.

Interactions of Escitalopram by Severity

Severe

The following medicines are usually not to be taken together without consulting with your doctor or pharmacist.

Serious

The following medicines may interact when taken together and can cause harmful effects in the body. Please consult with your doctor or pharmacist before taking these medicines together.

Moderate

The following medicines may interact when taken together and can increase your risk of harmful effects. Please consult with your doctor or pharmacist before taking these medicines together.

When should Escitalopram be not used?

Medicines that Prolong the Heartbeat

The use of Escitalopram is not recommended with the medicines that prolong the heartbeat.

Use of Monoamine Oxidase Inhibitors

Monoamine oxidase inhibitors are not recommended in patients who are intended to treat mental disorders with Escitalopram. Also, monoamine oxidase inhibitors should not be used within 14 days of stopping treatment with Escitalopram. When Escitalopram is used with irreversible monoamine oxidase inhibitors, patients have an increased risk of developing a life-threatening condition (called as, Serotonin Syndrome) with agitation, tremor, increased body temperature. When Escitalopram is used with reversible monoamine oxidase inhibitors (moclobemide) the patients have an increased risk of developing serotonin syndrome. These patients may have the following symptoms if they use this medicine:

Use of Linezolid

The patients using linezolid, which is a reversible non-selective monoamine oxidase inhibitor and used for bacterial infections should not be treated with Escitalopram. These patients have an increased risk of developing a life-threatening condition (called as, serotonin syndrome). These patients may have the following symptoms if they use this medicine:

Use of Pimozide

The use of this Escitalopram is not recommended with pimozide, which treat mental health conditions.

Severe Allergy

This medicine is not recommended in patients who are allergic to Escitalopram or citalopram or any other constituents.

Used Methylene Blue

The patients treated with methylene blue (injection in the vein) should not be treated with Escitalopram. These patients have an increased risk of developing a life-threatening condition (called as, serotonin syndrome).

Brands

Following are the top brand names of Escitalopram in countries around the world:

Traveling With Medication

  • Ensure that you carry enough doses of each of your prescription medicines to last the entire trip. The best place to store your medicines is in the carry on baggage. However, while flying, if carrying liquid medicines, make sure you do not go over the limits imposed for carry-on liquids.
  • While traveling overseas, make sure that you can carry each of your prescription medicines legally to your destination country. One way to ensure this is by checking with your destination country's embassy or website.
  • Make sure that you carry each of your medicines in their original packaging, which should typically include your name and address, and the details of the prescribing doctor.
  • If your travel involves crossing time zones, and you are required to take your medicine as per a fixed schedule, make sure that you adjust for the change in time.

Expired Medication

Taking a single dose of expired Escitalopram is unlikely to cause a side-effect. However, please discuss with your doctor or pharmacist, if you feel unwell or sick. An expired medicine may become ineffective in treating your prescribed conditions. To be on the safe side, it is important not to use an expired drug. You are much safer by always keeping a fresh supply of unexpired medicines.

Safe Disposal of Medication

  • If there are disposal instructions on the package, please follow the instructions.
  • If there are medicine take-back programs in your country, you should contact the respective authority to arrange for the disposal of the medicine. For example, in the USA, the Drug Enforcement Administration regularly hosts National Prescription Drug Take-Back events.
  • If there are no take-back programs, mix the medicine with dirt and place them in a sealed plastic bag. Throw the plastic bag in your household trash. Separately, remove all personal information including the prescription label from the medicine packaging and then dispose off the container.
  • If specifically indicated on the medicine package that it needs to be flushed down the toilet when no longer needed, perform the required step.
This page provides information for Escitalopram .
Depression
Anxiety
Panic Disorder
Obsessive-Compulsive Disorder

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