Prescribing Details
Description
Citalam is a preparation of Escitalopram Oxalate which is an orally administered selective serotonin reuptake inhibitor (SSRI).
Mechanism of action: Escitalopram is an oral drug that is used for treating depression and generalized anxiety disorder. It works by affecting neurotransmitters in the brain. Escitalopram prevents the reuptake of serotonin by nerves, an action which results in more serotonin in the brain to attach to receptors. Chemically, Escitalopram is very similar to citalopram. Both are in the class of drugs called selective serotonin reuptake inhibitors (SSRIs).
Uses
No Data
Indications
Citalam is indicated for the-
- Major depressive disorder
- Generalized anxiety disorder
- Obsessive-compulsive disorder
- Panic disorder
- Social anxiety disorder
Dosage and administration
Route of administration: Citalam should be taken orally.
It should generally be administered once daily, morning or evening, with or without food.
| Indication | Dosage guideline |
|---|---|
| Major depressive episodes, generalised anxiety disorder, obsessive-compulsive disorder | Initial: 10 mg once daily Maximum: 20 mg once daily |
| Panic disorder | Initial: 5 mg once daily Maximum: 20 mg once daily |
| Social anxiety disorder (social phobia) | Initial: 10 mg once daily (may be decreased up to 5 mg) Maximum: 20 mg once daily |
If the dose is increased to 20 mg, this should occur after a minimum of one week.
Patients with renal and hepatic impairment: 10 mg/day is the recommended dose for most elderly patients and patients with hepatic impairment. No dosage adjustment is required for patients with mild or moderate renal impairment. However, it should be used with caution in patients with severe renal and hepatic impairment.
Use in pregnancy & lactation
Pregnany: Use only if the potential benefit justifies the potential risk to the fetus.
Lactation: Caution should be exercised when administered to a nursing woman.
Use in children and adolescents
Safety and effectiveness in children below the age of 12 years have not been established.
Geriatric use
Precautions
Clinical worsening, suicidality & unusual change in behavior should be monitor, during the initial few months of therapy or at times of dose changes. Escitalopram should be prescribe with care in patients with a history of mania & seizure disorder.
Side effects
Most common side effects of escitalopram are insomnia, ejaculation disorder (primarily ejaculatory delay), nausea, sweating increased, fatigue and somnolence, decreased libido.
Contraindications
Escitalopram is contraindicated in patients with a known hypersensitivity to escitalopram or citalopram or any of the inactive ingredients. Concomitant use in patients taking monoamine oxidase inhibitors (MAOIs) is contraindicated. Concomitant use in patients taking pimozide is contraindicated.
Drug interactions
Drug interaction with medications: All SSRIs, including escitalopram, should not be taken together with any drugs of the MAOI (monoamine oxidase inhibitor) class of antidepressants. For example: isocarboxazid, phenelzine, tranylcypromine and procarbazine. Such combinations may lead to confusion, high blood pressure, high fever, tremor or muscle rigidity. This same type of interaction also may occur with selegiline, fenfluramine and dexfenfluramine. Tryptophan can cause headache, nausea, sweating, and dizziness when taken with any SSRI. At least 14 days should elapse after discontinuing escitalopram before starting a MAOI.
Drug interaction with food and others: Not applicable.
Overdose
Symptoms most often accompanying escitalopram overdose, alone or in combination with other drugs or alcohol include convulsions, coma, dizziness, hypotension, insomnia, nausea, vomiting, sinus tachycardia, somnolence and ECG changes (including QT prolongation). There are no specific antidotes for escitalopram. Establishment and maintenance an airway to ensure adequate ventilation and oxygenation is necessary. Gastric evacuation by lavage and use of activated charcoal should be considered. Careful observation and cardiac & vital sign monitoring are recommended, along with general symptomatic and supportive care.
Preparation
No Data
Pharmaceutical precautions
Store in a cool & dry place. Protect from light. Keep out of the reach of children.
Presentation
Citalam 5 tablet: Each coated tablet contains Escitalopram 5 mg as Oxalate USP.
Citalam 10 tablet: Each coated tablet contains Escitalopram 10 mg as Oxalate USP.
Package quantities
Storage
Store in a cool (below 30°C) and dry place protected from light. Keep out of the reach of children.
Packing
Citalam 5 tablet: Carton of 50 tablets in blister pack.
Citalam 10 tablet: Carton of 50 tablets in blister pack.
