Expres
Generic Name
Escitalopram
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| expres 10 mg tablet | ৳ 12.00 | ৳ 120.00 |
Description
Overview of the medicine
Expres 10 mg Tablet contains Escitalopram, a selective serotonin reuptake inhibitor (SSRI) used to treat major depressive disorder, generalized anxiety disorder, panic disorder, social anxiety disorder, and obsessive-compulsive disorder.
Uses & Indications
Dosage
Adults
Initial dose 10 mg once daily, may be increased to a maximum of 20 mg once daily after at least one week. For panic disorder, initial dose 5 mg once daily for the first week, then 10 mg once daily.
Elderly
Generally, a lower initial dose and maximum dose are recommended (e.g., 5 mg once daily, max 10 mg once daily).
Renal_impairment
No dosage adjustment needed for mild to moderate impairment. Use with caution in severe renal impairment (CrCl <20 mL/min).
How to Take
Take 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 brain, thereby increasing the concentration of serotonin in the synaptic cleft. This leads to enhanced serotonergic neurotransmission, which is believed to be responsible for its antidepressant and anxiolytic effects.
Pharmacokinetics
Onset
Initial therapeutic effects may be seen within 2-4 weeks, with full effect in 4-6 weeks.
Excretion
Excreted mainly in the urine and feces.
Half life
Approximately 27-32 hours.
Absorption
Well absorbed from the gastrointestinal tract, with peak plasma concentrations reached in approximately 4-5 hours.
Metabolism
Primarily metabolized in the liver via CYP2C19, CYP3A4, and CYP2D6 to its active (S-desmethylcitalopram) and inactive 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 an MAOI.
- Concomitant use with pimozide.
Drug Interactions
MAOIs
Risk of serotonin syndrome. Avoid concomitant use.
Pimozide
Increased QT interval prolongation. Contraindicated.
Linezolid, Methylene Blue
Risk of serotonin syndrome.
Warfarin and other anticoagulants
Increased risk of bleeding.
Tricyclic Antidepressants (TCAs), Lithium, Triptans
Increased risk of serotonin syndrome.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include dizziness, tremor, agitation, somnolence, nausea, vomiting, tachycardia, and rarely, seizures or serotonin syndrome. Treatment is supportive and symptomatic, including maintaining an airway, monitoring cardiac and vital signs. Activated charcoal may be considered. There is no specific antidote.
Pregnancy & Lactation
Pregnancy Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Escitalopram is excreted in breast milk; caution should be exercised when administered to a nursing woman.
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 an MAOI.
- Concomitant use with pimozide.
Drug Interactions
MAOIs
Risk of serotonin syndrome. Avoid concomitant use.
Pimozide
Increased QT interval prolongation. Contraindicated.
Linezolid, Methylene Blue
Risk of serotonin syndrome.
Warfarin and other anticoagulants
Increased risk of bleeding.
Tricyclic Antidepressants (TCAs), Lithium, Triptans
Increased risk of serotonin syndrome.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include dizziness, tremor, agitation, somnolence, nausea, vomiting, tachycardia, and rarely, seizures or serotonin syndrome. Treatment is supportive and symptomatic, including maintaining an airway, monitoring cardiac and vital signs. Activated charcoal may be considered. There is no specific antidote.
Pregnancy & Lactation
Pregnancy Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Escitalopram is excreted in breast milk; caution should be exercised when administered to a nursing woman.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24 to 36 months from the date of manufacture.
Availability
Pharmacies nationwide
Approval Status
Approved by regulatory authorities (e.g., DGDA)
Patent Status
Generic available
Clinical Trials
Escitalopram has been extensively studied in numerous randomized, double-blind, placebo-controlled clinical trials demonstrating its efficacy and safety in the treatment of major depressive disorder and various anxiety disorders.
Lab Monitoring
- Liver function tests (baseline and periodically)
- Renal function tests (baseline and periodically)
- Electrolytes (especially sodium) if hyponatremia is suspected
- ECG if cardiac risk factors are present or with concomitant QT-prolonging drugs
Doctor Notes
- Educate patients about the delayed onset of action and the importance of adherence.
- Monitor for suicidal ideation, especially in the initial weeks of treatment or during dose adjustments.
- Assess for potential drug interactions, particularly with other serotonergic agents.
- Advise patients on gradual discontinuation to minimize withdrawal symptoms.
Patient Guidelines
- Do not stop taking this medicine abruptly without consulting your doctor, as it may lead to withdrawal symptoms.
- It may take several weeks to feel the full benefits of this medicine.
- Avoid alcohol while taking this medication.
- Report any worsening depression or suicidal thoughts to your doctor immediately.
Missed Dose Advice
If a dose is missed, take it as soon as you remember. If it is close to the time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not take two doses at the same time.
Driving Precautions
This medicine may cause dizziness, drowsiness, or blurred vision. Avoid driving or operating machinery until you know how it affects you.
Lifestyle Advice
- Engage in regular physical activity.
- Maintain a balanced diet.
- Ensure adequate sleep.
- Practice stress-reduction techniques like meditation or yoga.
- Avoid illicit drugs and excessive caffeine.
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