Medicine Information

Exilok

Name: Exilok
Brand: Exilok

Tablet20 mgAntidepressant (SSRI)ATC: N06AB10

Generic Name

Escitalopram

Manufacturer

Incepta Pharmaceuticals Ltd.

Country

Bangladesh

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Price Details

Current market pricing information

Variant	Unit Price	Strip Price
exilok 20 mg tablet	৳ 7.00	৳ 70.00

Description

Overview of the medicine

Exilok 20 mg Tablet contains Escitalopram, which is a selective serotonin reuptake inhibitor (SSRI) used to treat major depressive disorder and generalized anxiety disorder. It works by restoring the balance of serotonin, a natural substance in the brain, which helps to improve mood and feelings of well-being.

Uses & Indications

Major Depressive Disorder (MDD)

Generalized Anxiety Disorder (GAD)

Social Anxiety Disorder (SAD)

Panic Disorder (PD) with or without agoraphobia

Obsessive-Compulsive Disorder (OCD)

Dosage

Adults

For MDD and GAD, usually 10 mg once daily, may be increased to a maximum of 20 mg daily after at least one week. For SAD, PD, OCD, usually 10 mg once daily.

Elderly

A starting dose of 5 mg once daily is recommended. Maximum recommended dose is 10 mg daily.

Renal_impairment

No dosage adjustment is generally needed for mild to moderate renal impairment. Caution is advised in severe renal impairment (creatinine clearance <20 mL/min).

How to Take

Take Exilok 20 mg Tablet orally once daily, with or without food. Swallow the tablet whole with water. Do not crush or chew.

Mechanism of Action

Escitalopram selectively inhibits the reuptake of serotonin (5-HT) in the presynaptic neuron, thereby increasing the concentration of serotonin in the synaptic cleft. This leads to enhanced serotonin neurotransmission, which is believed to be responsible for its antidepressant and anxiolytic effects.

Pharmacokinetics

Onset

Initial effects may be observed within 1-2 weeks, but full antidepressant effect typically takes 2-4 weeks. Anxiolytic effects may be seen earlier.

Excretion

Excreted renally (via urine) and fecally. About 8% of the dose is excreted as unchanged escitalopram in urine.

Half life

Approximately 27-32 hours, allowing for once-daily dosing.

Absorption

Well absorbed from the gastrointestinal tract, not significantly affected by food. Peak plasma concentrations are reached in approximately 4-5 hours.

Metabolism

Extensively metabolized in the liver, primarily by CYP2C19, CYP3A4, and CYP2D6 enzymes, to inactive or weakly active metabolites.

Side Effects

Contraindications

Hypersensitivity to escitalopram or any component of the formulation.
Concomitant use with Monoamine Oxidase Inhibitors (MAOIs) or within 14 days of discontinuing MAOI treatment.
Concomitant use with pimozide.
Congenital long QT syndrome or acquired QTc prolongation.

Drug Interactions

Alcohol

Enhances the sedative effects of alcohol. Avoid concomitant use.

Pimozide

Increased pimozide levels and QTc prolongation. Contraindicated.

Warfarin

Potentiation of anticoagulant effects, increased risk of bleeding. Monitor INR.

Metoprolol

Escitalopram can increase metoprolol plasma levels. Dosage adjustment may be needed.

St. John's wort

Increased risk of serotonin syndrome. Avoid concomitant use.

NSAIDs (e.g., ibuprofen)

Increased risk of gastrointestinal bleeding.

Triptans (e.g., sumatriptan)

Increased risk of serotonin syndrome.

MAOIs (e.g., phenelzine, selegiline)

Risk of serotonin syndrome (fatal interaction). Avoid concomitant use.

Storage

Store in a cool and dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.

Overdose

Symptoms of overdose include dizziness, tremor, nausea, vomiting, somnolence, tachycardia, and rarely seizures. Management involves maintaining a clear airway, monitoring cardiac rhythm and vital signs, and providing symptomatic and supportive care. Gastric lavage and activated charcoal may be considered.

Pregnancy & Lactation

Pregnancy Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Escitalopram is excreted into breast milk; therefore, caution should be exercised when Exilok is administered to a nursing woman. Consult your doctor.

Side Effects

Contraindications

Hypersensitivity to escitalopram or any component of the formulation.
Concomitant use with Monoamine Oxidase Inhibitors (MAOIs) or within 14 days of discontinuing MAOI treatment.
Concomitant use with pimozide.
Congenital long QT syndrome or acquired QTc prolongation.

Drug Interactions

Alcohol

Enhances the sedative effects of alcohol. Avoid concomitant use.

Pimozide

Increased pimozide levels and QTc prolongation. Contraindicated.

Warfarin

Potentiation of anticoagulant effects, increased risk of bleeding. Monitor INR.

Metoprolol

Escitalopram can increase metoprolol plasma levels. Dosage adjustment may be needed.

St. John's wort

Increased risk of serotonin syndrome. Avoid concomitant use.

NSAIDs (e.g., ibuprofen)

Increased risk of gastrointestinal bleeding.

Triptans (e.g., sumatriptan)

Increased risk of serotonin syndrome.

MAOIs (e.g., phenelzine, selegiline)

Risk of serotonin syndrome (fatal interaction). Avoid concomitant use.

Storage

Store in a cool and dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.

Overdose

Pregnancy & Lactation

Frequently Asked Questions

Common questions about this medicine

Pack Sizes

Blister pack of 10 tabletsBlister pack of 30 tablets

Shelf Life

Typically 24 to 36 months from the date of manufacture.

Availability

Available in pharmacies and hospitals

Approval Status

Approved by FDA (USA), DGDA (Bangladesh)

Patent Status

Generic available, original patent expired

WHO Essential Medicine

Yes

Clinical Trials

Escitalopram has undergone extensive clinical trials demonstrating its efficacy and safety for approved indications, with studies comparing it to placebo and other antidepressants.

Lab Monitoring

No specific routine laboratory monitoring is required for escitalopram. However, electrolytes (especially sodium) may be monitored in patients at risk of hyponatremia.

Doctor Notes

Educate patients about the delayed onset of therapeutic effects and the importance of adherence.
Monitor for emergent suicidality, especially in young adults, during initiation and dose changes.
Advise patients against abrupt discontinuation due to withdrawal syndrome risk.
Assess for drug interactions, especially with MAOIs, pimozide, and other serotonergic agents.
Consider starting with a lower dose in elderly patients or those with hepatic impairment.

Patient Guidelines

Take this medicine exactly as prescribed by your doctor.
Do not stop taking Exilok abruptly, as this can lead to withdrawal symptoms. Consult your doctor for gradual dose reduction.
Inform your doctor about all other medications you are taking, including over-the-counter drugs and herbal supplements.
Report any worsening depression, unusual changes in behavior, or suicidal thoughts to your doctor immediately.
Avoid alcohol while taking this medicine.

Missed Dose Advice

If you miss a dose, take it as soon as you remember, unless it is almost time for your next dose. In that case, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.

Driving Precautions

Exilok may cause dizziness, somnolence, or blurred vision. Patients should be cautioned about operating hazardous machinery, including automobiles, until they are reasonably certain that Exilok therapy does not adversely affect their ability to engage in such activities.