Lexapro
Generic Name
Escitalopram 10 mg tablet
Manufacturer
Lundbeck (Innovator), various generics
Country
Denmark (Innovator), various countries for generics
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| lexapro 10 mg tablet | ৳ 11.00 | ৳ 110.00 |
Description
Overview of the medicine
Lexapro 10 mg tablet contains escitalopram, 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 improve mood and feelings of well-being.
Uses & Indications
Dosage
Adults
Initial 10 mg once daily. May be increased to a maximum of 20 mg once daily after at least one week, based on clinical response and tolerability.
Elderly
Initial 5 mg once daily. Maximum recommended dose is 10 mg once daily.
Renal_impairment
No dosage adjustment needed for mild to moderate renal impairment. Caution advised in severe renal impairment (creatinine clearance < 20 mL/min).
How to Take
Take orally once daily, with or without food. Swallow the tablet whole with water. Do not crush, chew, or break.
Mechanism of Action
Escitalopram is a selective serotonin reuptake inhibitor (SSRI). It potently and selectively blocks the reuptake of serotonin (5-HT) into the presynaptic neuron, thereby increasing the concentration of 5-HT in the synaptic cleft and enhancing serotonergic neurotransmission. It has minimal affinity for other receptors (e.g., adrenergic, dopaminergic, histaminergic).
Pharmacokinetics
Onset
Initial clinical improvement may be seen within 1-2 weeks, but full antidepressant effect typically takes 2-4 weeks or longer.
Excretion
Excreted through both renal (urine) and hepatic (bile) pathways. Approximately 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 orally, peak plasma concentrations reached in about 3-4 hours after multiple doses. Food does not significantly affect absorption.
Metabolism
Primarily metabolized in the liver by CYP2C19, CYP3A4, and CYP2D6 to its active metabolite, S-demethylcitalopram (S-DCT), and inactive S-didesmethylcitalopram (S-DDCT).
Side Effects
Contraindications
- Hypersensitivity to escitalopram or any component of the formulation.
- Concomitant use of monoamine oxidase inhibitors (MAOIs) or within 14 days of discontinuing an MAOI.
- Concomitant use with pimozide.
- Congenital long QT syndrome or acquired long QT interval.
Drug Interactions
MAOIs
Risk of serious, sometimes fatal, serotonin syndrome. Avoid concomitant use and maintain a 14-day washout period.
NSAIDs/Aspirin
Increased risk of gastrointestinal bleeding.
Warfarin and other oral anticoagulants
Increased bleeding risk due to escitalopram's effect on platelet aggregation.
Cimetidine, Omeprazole, Fluoxetine, Fluvoxamine
May increase escitalopram plasma levels.
Other serotonergic drugs (e.g., triptans, tramadol, fentanyl, St. John's Wort)
Increased risk of serotonin syndrome.
Storage
Store at controlled room temperature (20-25°C or 68-77°F), away from moisture and light. Keep out of reach of children.
Overdose
Symptoms of overdose include dizziness, tremor, nausea, vomiting, somnolence, sinus tachycardia, QTc prolongation, and rarely, convulsions or serotonin syndrome. Treatment is supportive and symptomatic, including maintaining an open airway, monitoring cardiac and vital signs, and activated charcoal if appropriate. 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 human 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 of monoamine oxidase inhibitors (MAOIs) or within 14 days of discontinuing an MAOI.
- Concomitant use with pimozide.
- Congenital long QT syndrome or acquired long QT interval.
Drug Interactions
MAOIs
Risk of serious, sometimes fatal, serotonin syndrome. Avoid concomitant use and maintain a 14-day washout period.
NSAIDs/Aspirin
Increased risk of gastrointestinal bleeding.
Warfarin and other oral anticoagulants
Increased bleeding risk due to escitalopram's effect on platelet aggregation.
Cimetidine, Omeprazole, Fluoxetine, Fluvoxamine
May increase escitalopram plasma levels.
Other serotonergic drugs (e.g., triptans, tramadol, fentanyl, St. John's Wort)
Increased risk of serotonin syndrome.
Storage
Store at controlled room temperature (20-25°C or 68-77°F), away from moisture and light. Keep out of reach of children.
Overdose
Symptoms of overdose include dizziness, tremor, nausea, vomiting, somnolence, sinus tachycardia, QTc prolongation, and rarely, convulsions or serotonin syndrome. Treatment is supportive and symptomatic, including maintaining an open airway, monitoring cardiac and vital signs, and activated charcoal if appropriate. 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 human milk; caution should be exercised when administered to a nursing woman.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24-36 months from the date of manufacture, refer to product packaging for exact details.
Availability
Pharmacies, Hospitals
Approval Status
FDA Approved
Patent Status
Generally off-patent, generics available
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have demonstrated escitalopram's efficacy and safety in the treatment of MDD, GAD, PD, SAD, and OCD. Studies have shown superiority over placebo and comparable efficacy to other SSRIs and SNRIs for various indications.
Lab Monitoring
- Monitor electrolytes (especially sodium) in at-risk patients (e.g., elderly, those on diuretics).
- Monitor liver function in patients with hepatic impairment.
Doctor Notes
- Counsel patients on the delayed onset of action and the importance of continued treatment.
- Monitor for emergent suicidality, especially at treatment initiation or dose changes.
- Educate about serotonin syndrome symptoms and drug interactions.
Patient Guidelines
- Take exactly as prescribed by your doctor; do not stop abruptly without medical advice.
- It may take several weeks to feel the full effects of the medication.
- Report any worsening depression, suicidal thoughts, or unusual changes in behavior to your doctor immediately.
- Avoid alcohol while taking this medication.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose to catch up.
Driving Precautions
Lexapro may cause drowsiness, dizziness, or blurred vision. Avoid driving or operating machinery until you know how this medication affects you.
Lifestyle Advice
- Regular exercise and a balanced diet can complement the treatment. Consider stress-reduction techniques.
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