Zigrow
Generic Name
Escitalopram Oxalate
Manufacturer
MediTop Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| zigrow 20 mg tablet | ৳ 3.00 | N/A |
Description
Overview of the medicine
Zigrow 20 mg Tablet is an antidepressant medicine containing Escitalopram Oxalate, primarily used to treat major depressive disorder and generalized anxiety disorder. It works by increasing the level of serotonin in the brain, a natural substance that helps maintain mental balance.
Uses & Indications
Dosage
Adults
Initial dose 10 mg once daily, may be increased to 20 mg once daily after at least one week. Maximum 20 mg daily.
Elderly
Initial dose 5 mg once daily, may be increased to 10 mg once daily. Maximum 10 mg daily.
Renal_impairment
Mild to moderate renal impairment: no dosage adjustment needed. Severe renal impairment: caution advised, dosage reduction may be considered.
How to Take
Take orally once daily, with or without food. Swallow the tablet whole with water. Do not chew or crush.
Mechanism of Action
Escitalopram selectively inhibits the reuptake of serotonin (5-HT) in the central nervous system, thereby potentiating the effects of serotonin in the brain. It has minimal effect on noradrenaline and dopamine neuronal reuptake.
Pharmacokinetics
Onset
Initial effects may be seen within 1-2 weeks; full therapeutic effect typically observed after 2-4 weeks of treatment.
Excretion
Excreted renally and hepatically. Approximately 8% as unchanged drug in urine.
Half life
Approximately 27-32 hours.
Absorption
Well absorbed from the gastrointestinal tract, unaffected by food. Peak plasma concentration reached in approximately 4-5 hours.
Metabolism
Extensively metabolized in the liver, primarily by CYP3A4, CYP2C19, and CYP2D6 to its primary and secondary metabolites.
Side Effects
Contraindications
- Hypersensitivity to escitalopram or any excipient
- Concomitant use with MAOIs (Monoamine Oxidase Inhibitors) or within 14 days of discontinuing MAOIs
- Concomitant use with pimozide
- Congenital long QT syndrome or acquired QT prolongation
Drug Interactions
MAOIs
Risk of serotonin syndrome (hyperthermia, rigidity, myoclonus, autonomic instability, mental status changes).
Pimozide
Increased pimozide levels, risk of QT prolongation and cardiac arrhythmias.
Warfarin
May increase anticoagulant effect.
NSAIDs/Aspirin
Increased risk of bleeding.
Tricyclic Antidepressants (TCAs)
May increase plasma levels of TCAs.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms include dizziness, tremor, agitation, somnolence, seizures, tachycardia, QT prolongation, and coma. Treatment is symptomatic and supportive, including gastric lavage, activated charcoal, and monitoring of vital signs and ECG.
Pregnancy & Lactation
Pregnancy Category C. Use only if potential benefit justifies potential risk to the fetus. Not recommended during breastfeeding as escitalopram is excreted into breast milk.
Side Effects
Contraindications
- Hypersensitivity to escitalopram or any excipient
- Concomitant use with MAOIs (Monoamine Oxidase Inhibitors) or within 14 days of discontinuing MAOIs
- Concomitant use with pimozide
- Congenital long QT syndrome or acquired QT prolongation
Drug Interactions
MAOIs
Risk of serotonin syndrome (hyperthermia, rigidity, myoclonus, autonomic instability, mental status changes).
Pimozide
Increased pimozide levels, risk of QT prolongation and cardiac arrhythmias.
Warfarin
May increase anticoagulant effect.
NSAIDs/Aspirin
Increased risk of bleeding.
Tricyclic Antidepressants (TCAs)
May increase plasma levels of TCAs.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms include dizziness, tremor, agitation, somnolence, seizures, tachycardia, QT prolongation, and coma. Treatment is symptomatic and supportive, including gastric lavage, activated charcoal, and monitoring of vital signs and ECG.
Pregnancy & Lactation
Pregnancy Category C. Use only if potential benefit justifies potential risk to the fetus. Not recommended during breastfeeding as escitalopram is excreted into breast milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 months
Availability
Available in pharmacies nationwide
Approval Status
Approved by DGDA
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have demonstrated efficacy in MDD and GAD. Ongoing post-marketing surveillance for long-term safety and efficacy.
Lab Monitoring
- Electrolyte levels (especially sodium in elderly patients)
- Liver function tests (periodically)
- ECG (in patients with cardiac risk factors or concomitant medications prolonging QT interval)
Doctor Notes
- Gradual tapering is crucial upon discontinuation to prevent withdrawal symptoms.
- Monitor for worsening depression or emergence of suicidality, especially at initiation or dose changes.
- Consider ECG monitoring in patients with cardiovascular risk factors.
Patient Guidelines
- Do not stop taking this medicine abruptly, as it may cause withdrawal symptoms.
- Report any suicidal thoughts or unusual behavior changes to your doctor immediately.
- Avoid alcohol while taking this medication.
- It may take several weeks to feel the full benefits of this medicine.
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 dose.
Driving Precautions
This medicine may cause drowsiness, dizziness, or blurred vision. Avoid driving or operating machinery until you know how it affects you.
Lifestyle Advice
- Maintain a healthy lifestyle with regular exercise and a balanced diet.
- Practice stress management techniques such as meditation or yoga.
- Ensure adequate sleep.
- Discuss any concerns with your healthcare provider.
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Global Brand Names
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