Citalex
Generic Name
Escitalopram
Manufacturer
Renata Limited
Country
Bangladesh
Loading images...
Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| citalex 10 mg tablet | ৳ 9.00 | ৳ 90.00 |
Description
Overview of the medicine
Citalex 10 mg Tablet contains Escitalopram, an antidepressant belonging to the Selective Serotonin Reuptake Inhibitor (SSRI) class. It is primarily used to treat major depressive disorder and generalized anxiety disorder.
Uses & Indications
Dosage
Adults
Initial dose is 10 mg once daily, which may be increased to 20 mg once daily after at least one week, based on patient response. Maximum recommended dose is 20 mg/day.
Elderly
For elderly patients (over 65 years), an initial dose of 5 mg once daily is recommended, with a maximum of 10 mg/day.
Renal_impairment
No dosage adjustment is generally needed for mild to moderate renal impairment. Use with caution in severe renal impairment (creatinine clearance < 30 mL/min).
How to Take
Take Citalex 10 mg Tablet orally, once daily, with or without food. It is advisable to take it at the same time each day to maintain consistent drug levels.
Mechanism of Action
Escitalopram works by selectively inhibiting the reuptake of serotonin (5-HT) in the central nervous system, thereby increasing the concentration of serotonin in the synaptic cleft. This leads to potentiation of serotonergic activity in the brain.
Pharmacokinetics
Onset
Initial therapeutic effects usually begin to appear within 2-4 weeks of consistent treatment, with full antidepressant effects often observed after 6-8 weeks.
Excretion
Approximately 8% of escitalopram is excreted unchanged in the urine, with the remainder excreted as metabolites via both urine and feces.
Half life
The elimination half-life is approximately 27-32 hours, allowing for once-daily dosing.
Absorption
Well absorbed orally, with peak plasma concentrations typically reached within 4-5 hours after a single dose. Food does not significantly affect absorption.
Metabolism
Extensively metabolized in the liver by CYP2C19, CYP3A4, and CYP2D6 enzymes into inactive and active (demethylated and didemethylated) metabolites. The demethylated metabolite is pharmacologically active.
Side Effects
Contraindications
- Concomitant use with Monoamine Oxidase Inhibitors (MAOIs) or within 14 days of stopping an MAOI
- Hypersensitivity to escitalopram or citalopram
- Concomitant use with pimozide
- Congenital long QT syndrome or acquired long QT interval
Drug Interactions
MAOIs
Concomitant use is contraindicated due to the risk of serotonin syndrome, which can be life-threatening.
Pimozide
Concomitant use is contraindicated due to the risk of QT prolongation.
Warfarin
May increase the anticoagulant effect of warfarin, leading to increased bleeding risk.
NSAIDs/Aspirin
Increased risk of gastrointestinal bleeding.
Triptans (e.g., sumatriptan)
Increased risk of serotonin syndrome when co-administered.
SSRIs/SNRIs and Tricyclic Antidepressants
Increased risk of serotonin syndrome and other adverse effects.
Storage
Store below 30°C in a dry place, away from direct sunlight and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include dizziness, tremor, nausea, vomiting, somnolence, tachycardia, and in more severe cases, seizures, ECG changes (e.g., QT prolongation), and hypotension. Management is supportive and symptomatic; ensure adequate airway, breathing, and circulation. Activated charcoal may be considered. There is no specific antidote.
Pregnancy & Lactation
Pregnancy Category C. Escitalopram should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Neonates exposed to SSRIs late in the third trimester have developed complications requiring prolonged hospitalization, respiratory support, and tube feeding. Escitalopram is excreted in human milk; caution is advised when administered to a nursing mother.
Side Effects
Contraindications
- Concomitant use with Monoamine Oxidase Inhibitors (MAOIs) or within 14 days of stopping an MAOI
- Hypersensitivity to escitalopram or citalopram
- Concomitant use with pimozide
- Congenital long QT syndrome or acquired long QT interval
Drug Interactions
MAOIs
Concomitant use is contraindicated due to the risk of serotonin syndrome, which can be life-threatening.
Pimozide
Concomitant use is contraindicated due to the risk of QT prolongation.
Warfarin
May increase the anticoagulant effect of warfarin, leading to increased bleeding risk.
NSAIDs/Aspirin
Increased risk of gastrointestinal bleeding.
Triptans (e.g., sumatriptan)
Increased risk of serotonin syndrome when co-administered.
SSRIs/SNRIs and Tricyclic Antidepressants
Increased risk of serotonin syndrome and other adverse effects.
Storage
Store below 30°C in a dry place, away from direct sunlight and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include dizziness, tremor, nausea, vomiting, somnolence, tachycardia, and in more severe cases, seizures, ECG changes (e.g., QT prolongation), and hypotension. Management is supportive and symptomatic; ensure adequate airway, breathing, and circulation. Activated charcoal may be considered. There is no specific antidote.
Pregnancy & Lactation
Pregnancy Category C. Escitalopram should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Neonates exposed to SSRIs late in the third trimester have developed complications requiring prolonged hospitalization, respiratory support, and tube feeding. Escitalopram is excreted in human milk; caution is advised when administered to a nursing mother.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24 to 36 months from the manufacturing date. Refer to the specific product packaging for exact expiry details.
Availability
Pharmacies, hospitals
Approval Status
FDA Approved
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have established the efficacy and safety of escitalopram in the treatment of major depressive disorder, generalized anxiety disorder, panic disorder, social anxiety disorder, and obsessive-compulsive disorder. Ongoing post-marketing surveillance continues to monitor its long-term effects and safety profile.
Lab Monitoring
- Monitor for hyponatremia, especially in elderly patients or those on diuretics.
- Liver function tests (LFTs) may be considered if liver impairment is suspected.
- Electrolytes (especially sodium) should be checked periodically.
Doctor Notes
- Emphasize the importance of patient adherence and gradual tapering of the dose upon discontinuation to prevent withdrawal symptoms.
- Regularly assess for suicidal ideation, especially during the initial phase of treatment or following dose adjustments.
- Counsel patients on the delayed onset of action and manage expectations regarding symptom improvement.
Patient Guidelines
- Do not stop taking this medicine suddenly, as it can cause withdrawal symptoms. Consult your doctor for gradual dose reduction.
- It may take several weeks to experience the full therapeutic benefits. Continue taking the medicine as prescribed.
- Report any worsening depression, unusual changes in mood or behavior, or suicidal thoughts to your doctor immediately.
- Avoid alcohol while taking this medication.
Missed Dose Advice
If a dose is missed, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not double the dose to make up for a missed one.
Driving Precautions
Citalex may cause dizziness, drowsiness, or visual disturbances. Patients should exercise caution when driving or operating machinery until they are certain how the medication affects them.
Lifestyle Advice
- Engage in regular physical activity and maintain a balanced diet to support overall well-being.
- Practice stress-reducing techniques such as meditation, yoga, or deep breathing exercises.
- Ensure adequate sleep hygiene and maintain a regular sleep schedule.
- Seek support from friends, family, or support groups.
Alternative Medicines in Bangladesh
Similar medicines available in the market
Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.
Other Medicines in Citalex Brand
Other medicines available under the same brand name
