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DRUGS & SUPPLEMENTS
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Citel
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Citel uses
Pharmacological action
Citel is an antidepressant. This medication selectively inhibits the reuptake of serotonin, increases the concentration of the neurotransmitter in the synaptic cleft, prolongs and enhances the action of serotonin on postsynaptic receptors. Escitalopram practically does not bind to serotonin, dopamine (D1 and D2) receptors, alpha-adrenergic-, m-cholinergic receptors, with benzodiazepine and opioid receptors.
Antidepressant effect of this drug is usually develops within 2-4 weeks after starting treatment. The maximum therapeutic effect of the treatment of panic disorder is reached at about 3 months after starting treatment.
Pharmacokinetics
The absorption of Citel is independent of ingestion. Bioavailability is 80%. Time to Cmax in the plasma is 4 h. The kinetics of escitalopram is linear. Css achieved after 1 week. The apparent Vd is from 12 up to 26 L / kg. The plasma protein binding is 80%. Metabolized in the liver to the active metabolites. The metabolism of escitalopram with the formation of demethylated metabolite occurs mainly with the participation of isoenzymes CYP2C19, CYPZA4 and CYP2D6.
Why is Citel prescribed?
Depression, panic disorder.
Major depressive disorder, generalized anxiety disorder.
Dosage and administration
Citel is taken orally regardless of the meal. Depending on the testimony of a single dose is 10-20 mg / day. The maximum daily dose is 20 mg. The duration of treatment is a few months. Upon the termination of treatment the dose should be gradually reduced over 1-2 weeks in order to avoid withdrawal symptoms.
For elderly patients (65 years) the recommended dose is 5 mg / day, the maximum daily dose is 10 mg.
If abnormal liver function recommended starting dose within the first 2 weeks of treatment is 5 mg / day. Depending on the individual response dose can be increased to 10 mg / day.
For patients with low activity of isoenzyme CYP2C19 the recommended starting dose for the first 2 weeks of treatment is 5 mg / day. Depending on the individual response the dose can be increased to 10 mg / day.
Citel side effects, adverse reactions
CNS and peripheral nervous system: dizziness, fatigue, insomnia or drowsiness, convulsions, tremor, movement disorders, serotonin syndrome, hallucinations, delusions, confusion, agitation, anxiety, depersonalization, panic attacks, irritability, visual disturbances.
Digestive system: nausea, vomiting, dry mucous membranes of the mouth, taste disturbances, loss of appetite, diarrhea, constipation, changes in laboratory parameters of liver function.
Cardiovascular: orthostatic hypotension.
Endocrine: decreased secretion of ADH, galactorrhea.
Reproductive system: decreased libido, impotence, ejaculation disorder, anorgasmia (in females).
Urinary system: urinary retention.
Dermatological reactions: skin rash, itching, ecchymosis, purpura, sweating.
Allergic reaction: angioedema, anaphylactic reactions.
Metabolic: hyponatremia, hyperthermia.
Musculoskeletal system: arthralgia, myalgia.
Other: sinusitis, withdrawal syndrome (dizziness, headaches and nausea).
Citel contraindications
Simultaneous administration of MAO inhibitors, childhood and adolescence to 15 years, pregnancy, lactation, hypersensitivity to escitalopram.
Using during pregnancy and breastfeeding
Do not use Citel during pregnancy and lactation.
Category of the fetus by FDA - C.
Special instructions
With caution Citel should be used in patients with renal insufficiency (creatinine clearance below 30 ml / min), hypomania, mania, pharmacologically uncontrolled epilepsy, depression with suicide attempts, diabetes, in elderly patients, with cirrhosis of the liver, the tendency to bleeding, simultaneously with the admission of drugs that lower the threshold of convulsive readiness, causing hyponatremia, with alcohol, with drugs metabolized with the participation of isoenzymes CYP2C19.
Escitalopram should be prescribed only after 2 weeks after discontinuation of irreversible MAO inhibitors, and 24 h after cessation of treatment reversible inhibitor of MAO.
Non-selective MAO inhibitors may be prescribed no earlier than 7 days after discontinuation of this medication.
Citel should be abolished in the case of epileptic seizures or quickening in pharmacologically uncontrolled epilepsy.
With the development of manic this drug should be abolished.
Escitalopram can increase the concentration of glucose in diabetes, which may require dose adjustment of hypoglycemic medications.
With the development of serotonin syndrome this medicine should be immediately withdrawn and a symptomatic therapy prescribed.
During the treatment, patients should avoid driving vehicles and other activities that require high concentration and speed of psychomotor reactions.
Citel drug interactions
When this drug applied simultaneously with:
- inhibitors increases the risk of serotonin syndrome and serious adverse reactions.
- serotonergic agents may lead to serotonin syndrome.
- drugs to lower the threshold of convulsive readiness, the risk of seizures increases.
Escitalopram increases the effects of tryptophan and lithium drugs, increases the toxicity of preparations based on hypericum, the effects of drugs affecting blood clotting (requires monitoring of indicators of blood coagulation).
Drugs metabolized with the participation of CYP2C19 isoenzyme (including omeprazole), and are potent inhibitors of CYPZA4 and CYP2D6 (including flecainide, propafenone, metoprolol, desipramine, clomipramine, nortriptyline, risperidone, thioridazine, haloperidol), increase concentration of this medication in plasma.
Citel increases the plasma concentrations of desipramine and metoprolol in 2 times.
Citel in case of emergency / overdose
Treatment: achieve and maintain an airway for adequate ventilation and oxygenation, gastric lavage and the use of activated charcoal. It is recommended careful observation and monitoring of vital functions, including cardiac function, symptomatic and supportive therapy. Because of the large volume of distribution of escitalopram is unlikely to efficiency measures such as forced diuresis, dialysis, hemoperfusion and exchange transfusion. There is no specific antidote.
Citel pharmaceutical active ingredients containing related brand and generic drugs:
Citel available forms, composition, doses:
Citel destination | category:
Citel Anatomical Therapeutic Chemical codes:
Citel pharmaceutical companies:
References
- Dailymed."LEXAPRO (ESCITALOPRAM OXALATE) TABLET, FILM COATED [LAKE ERIE MEDICAL DBA QUALITY CARE PRODUCTS LLC]". https://dailymed.nlm.nih.gov/dailym... (accessed August 28, 2018).
- "Escitalopram". https://pubchem.ncbi.nlm.nih.gov/co... (accessed August 28, 2018).
- "Escitalopram". http://www.drugbank.ca/drugs/DB0117... (accessed August 28, 2018).
Frequently asked Questions
Can i drive or operate heavy machine after consuming Citel?Depending on the reaction of the Citel after taken, if you are feeling dizziness, drowsiness or any weakness as a reaction on your body, Then consider Citel not safe to drive or operate heavy machine after consumption. Meaning that, do not drive or operate heavy duty machines after taking the capsule if the capsule has a strange reaction on your body like dizziness, drowsiness. As prescribed by a pharmacist, it is dangerous to take alcohol while taking medicines as it exposed patients to drowsiness and health risk. Please take note of such effect most especially when taking Primosa capsule. It's advisable to consult your doctor on time for a proper recommendation and medical consultations.
Is Citel addictive or habit forming?Medicines are not designed with the mind of creating an addiction or abuse on the health of the users. Addictive Medicine is categorically called Controlled substances by the government. For instance, Schedule H or X in India and schedule II-V in the US are controlled substances.
Please consult the medicine instruction manual on how to use and ensure it is not a controlled substance.In conclusion, self medication is a killer to your health. Consult your doctor for a proper prescription, recommendation, and guidiance.
Review
sdrugs.com conducted a study on Citel, and the result of the survey is set out below. It is noteworthy that the product of the survey is based on the perception and impressions of the visitors of the website as well as the views of Citel consumers. We, as a result of this, advice that you do not base your therapeutic or medical decisions on this result, but rather consult your certified medical experts for their recommendations.Visitor reports
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The information was verified by Dr. Rachana Salvi, MD Pharmacology