When to take lexapro?

Contents

Lexapro

Brand Names: Lexapro

Generic Name: escitalopram

  • What is escitalopram (Lexapro)?
  • What are the possible side effects of escitalopram (Lexapro)?
  • What is the most important information I should know about escitalopram (Lexapro)?
  • What should I discuss with my healthcare provider before taking escitalopram (Lexapro)?
  • How should I take escitalopram (Lexapro)?
  • What happens if I miss a dose (Lexapro)?
  • What happens if I overdose (Lexapro)?
  • What should I avoid while taking escitalopram (Lexapro)?
  • What other drugs will affect escitalopram (Lexapro)?
  • Where can I get more information (Lexapro)?

What is escitalopram (Lexapro)?

Escitalopram is an antidepressant in a group of drugs called selective serotonin reuptake inhibitors (SSRIs). Escitalopram affects chemicals in the brain that may be unbalanced in people with depression or anxiety.

Escitalopram is used to treat anxiety in adults. Escitalopram is also used to treat major depressive disorder in adults and adolescents who are at least 12 years old.

Escitalopram may also be used for purposes not listed in this medication guide.

What are the possible side effects of escitalopram (Lexapro)?

Get emergency medical help if you have signs of an allergic reaction: skin rash or hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have:

  • blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights;
  • racing thoughts, unusual risk-taking behavior, feelings of extreme happiness or sadness;
  • low levels of sodium in the body–headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady; or
  • severe nervous system reaction–very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, feeling like you might pass out.

Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.

Common side effects may include:

  • dizziness, drowsiness, weakness;
  • sweating, feeling shaky or anxious;
  • sleep problems (insomnia);
  • dry mouth, loss of appetite;
  • nausea, constipation;
  • yawning;
  • weight changes; or
  • decreased sex drive, impotence, or difficulty having an orgasm.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What is the most important information I should know about escitalopram (Lexapro)?

You should not use this medicine you also take pimozide (Orap) or citalopram (Celexa).

Do not use escitalopram within 14 days before or 14 days after you have used an MAO inhibitor, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine.

Some young people have thoughts about suicide when first taking an antidepressant. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor.

Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.

Do not give this medicine to anyone under 12 years.

Missed escitalopram dose and side effects.
June 9, 2014 11:47 AM   Subscribe

Mmm, it could definitely be physiological. In fact, it probably is. Lexapro isn’t the same starting as it is ending, which is to say, just because it has a long-ish amp up period doesn’t mean it has a symmetrical ramp down period.
Because Lexapro inhibits the reuptake of serotonin, it creates more serotonin in the synaptic cleft, i.e. more serotonin gets ‘left behind’ after some synapse. But this serotonin can’t really be transmitted any further in the brain until the neuron on the post-synaptic cleft grows more receptors for 5-HT. So it takes some weeks for the increased serotonin to actually be available to the brain, so to speak.
But the receptors don’t need to disappear when you stop taking Lexapro for the amount of serotonin to drop, as once you stop the Lexapro the reuptake transporters will no longer be bound to the lexapro and will start reuptaking the serotonin back to the pre-synaptic cleft. Since Lexapro has a half-life of somewhere in the 30 hour range, it’s completely possible that you would notice an effect from having missed a day’s dose of Lexapro.
Anecdotally, this is confirmed by lots of people, including myself, who have noticed discontinuation effects ranging from being mildly groggy to being pretty blue from having missed a day or two of their SSRI.
posted by Lutoslawski at 1:23 PM on June 9, 2014

Escitalopram

Before taking escitalopram,

  • tell your doctor or pharmacist if you are allergic to escitalopram, citalopram (Celexa), or any other medications.
  • tell your doctor if you are taking pimozide (Orap) or a monoamine oxidase (MAO) inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate), or if you have stopped taking an MAO inhibitor within the past 14 days. Your doctor will probably tell you not to take escitalopram. If you stop taking escitalopram, you should wait at least 14 days before you start to take an MAO inhibitor.
  • you should know that escitalopram is very similar to another SSRI, citalopram (Celexa). You should not take these two medications together.
  • tell your doctor or pharmacist what prescription and nonprescription medications and vitamins you are taking or plan to take. Be sure to mention any of the following: anticoagulants (‘blood thinners’) such as warfarin (Coumadin); antihistamines; aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn); carbamazepine (Tegretol); cimetidine (Tagamet); ketoconazole (Sporanox); lithium (Eskalith, Lithobid, Lithotabs); linezolid (Zyvox); medications for anxiety, mental illness, or seizures; medications for migraine headaches such as almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt), sumatriptan (Imitrex), and zolmitriptan (Zomig); metoprolol (Lopressor, Toprol XL); other antidepressants such as desipramine (Norpramin); sedatives; sibutramine (Meridia); sleeping pills; tramadol; methylene blue; and tranquilizers. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
  • tell your doctor what nutritional supplements and herbal products you are taking, especially products containing St. John’s wort or tryptophan.
  • tell your doctor if you have recently had a heart attack and if you have or have ever had seizures or liver, kidney, thyroid, or heart disease.
  • tell your doctor if you are pregnant, especially if you are in the last few months of your pregnancy, or if you plan to become pregnant or are breast-feeding. If you become pregnant while taking escitalopram, call your doctor. Escitalopram may cause problems in newborns following delivery if it is taken during the last months of pregnancy.
  • if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking escitalopram.
  • you should know that escitalopram may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you.
  • remember that alcohol can add to the drowsiness caused by this medication.
  • you should know that escitalopram may cause angle-closure glaucoma (a condition where the fluid is suddenly blocked and unable to flow out of the eye causing a quick, severe increase in eye pressure which may lead to a loss of vision). Talk to your doctor about having an eye examination before you start taking this medication. If you have nausea, eye pain, changes in vision, such as seeing colored rings around lights, and swelling or redness in or around the eye, call your doctor or get emergency medical treatment right away.

What is escitalopram?

Escitalopram oxalate is a type of antidepressant called a selective serotonin reuptake inhibitor (SSRI).

Escitalopram is a generic medicine, available as tablets (5mg,10mg, 20mg) or drops.

Cipralex is the brand name for escitalopram in the UK.

In the US escitalopram is available under the brand name Lexapro.

What is escitalopram used for?

Escitalopram is used to treat the following conditions in adults aged 18 years and over:

  • Depression.
  • Generalised anxiety disorder.
  • Obsessive-compulsive disorder (OCD).
  • Panic disorder with or without agoraphobia.
  • Social phobia or social anxiety disorder.

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How does escitalopram work?

Escitalopram oxalate is a type of antidepressant called a selective serotonin reuptake inhibitor (SSRI). It works by enhancing the activity of a neurotransmitter called serotonin in the brain.

Neurotransmitters are natural body chemicals that act as chemical messengers between the nerve cells. Serotonin is a neurotransmitter known to be involved in regulating emotions, mood and behaviour, among other things. In depression and anxiety disorders there is a decreased amount of serotonin released from nerve cells in the brain.

Escitalopram works by stopping the serotonin that has been released from being reabsorbed back into the nerve cells in the brain. This helps to prolong its effects and over time this helps to lighten mood and relieve depression. Antidepressants like escitalopram have also been found to be effective in relieving symptoms of anxiety, such as panic and fear.

Escitalopram won’t change your personality or make you feel instantly happy and relaxed. It works over time to correct the chemical changes in your brain that have made you become depressed or anxious, and gets you back to feeling like your old self.

How long does escitalopram take to work?

▪️ It can take between two to four weeks of taking escitalopram before it starts to work, so it’s very important that you keep taking it, even if it doesn’t seem to make much difference at first. You’ll usually need to keep taking escitalopram every day for several months, and for at least six months after you feel better. You should keep taking it for as long as your doctor asks you to.

▪️ If you feel your depression or anxiety has got worse, or if you have any distressing thoughts, or feelings about suicide or harming yourself in the first few weeks, or indeed at any point during treatment or after stopping treatment, then it is very important to talk to your doctor. It’s a good idea to tell a relative or close friend that you’ve started taking escitalopram so they can support you and let you know if they think your depression or anxiety has got worse, or they notice any changes in your behaviour.

Escitalopram: dosage instructions

  • Escitalopram should be taken once a day. You can take your dose at any time of day, but try to always stick to the same time – this will also help you remember to take it.
  • Always follow the instructions given by your doctor regarding the dose you should take. Remember that it takes a while for escitalopram to start working, so keep taking it as prescribed even if it doesn’t seem to make much difference at first.
  • Escitalopram tablets can be taken either with or without food, on a full or empty stomach. If you’re taking escitalopram as Cipralex drops your dose can be mixed with water, apple juice or orange juice.
  • Missed dose: If you forget to take a dose of escitalopram at your usual time, take it as soon as you remember that day. If you don’t remember until the following day, just leave out the missed dose and take your next dose as usual. Do not take a double dose to make up for a missed dose.
  • You should keep taking escitalopram every day for as long as your doctor asks you to. It’s normal for your doctor to ask you to keep taking it for several months after you feel better (at least six months for depression and at least a year for generalised anxiety disorder), as this has been shown to reduce the risk of your depression or anxiety coming back.

What should I know about taking escitalopram?

▪️ Selective serotonin re-uptake inhibitor (SSRI) antidepressants like escitalopram have sometimes been associated with unpleasant or distressing restlessness and feeling as though you need to move, often accompanied by an inability to sit or stand still. This is most likely to occur within the first few weeks of treatment if it’s going to affect you. If you experience these symptoms you should consult your doctor.

▪️ Do not suddenly stop taking escitalopram unless your doctor tells you to, as this can cause withdrawal symptoms such as dizziness, sleep disturbances (including intense dreams), headache, feeling sick or weak, sweating, pins and needles, burning or electric shock sensations and feeling anxious. Withdrawal symptoms are temporary and are not due to addiction or dependence on the medicine. They can usually be avoided by stopping the medicine gradually, usually over a period of weeks or months, depending on your individual situation. Follow the instructions given by your doctor when it’s time to stop treatment with this medicine. On very rare occasions some people have experienced withdrawal symptoms after accidentally missing a dose of escitalopram.

▪️ It is OK to drink alcohol in moderation while taking escitalopram. However, it’s usually recommended that you avoid drinking alcohol while taking antidepressants because alcohol can make depression worse.

▪️ Escitalopram may reduce your ability to drive, operate machinery, ride a bike or play sport safely, as it may make you feel tired and dizzy. You should avoid driving or operating machinery until you know how this medicine affects you and you are sure it won’t affect your performance.

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Escitalopram should be used with caution for:

  • Elderly people.
  • People with a history of mania or hypomania.
  • People also receiving electroconvulsive therapy (ECT).
  • People with kidney or liver problems.
  • People with diabetes. Escitalopram may alter the control of your blood sugar. As a result, you may need an adjustment in your dose of insulin or antidiabetic tablets. Discuss this with your doctor.
  • People with epilepsy. Tell your doctor if you experience more seizures than normal after starting escitalopram.
  • People with raised pressure in the eye or glaucoma.
  • People with heart disease such as heart failure, a recent heart attack or a slow or irregular heartbeat (your doctor may want you to have an electrocardiogram (ECG) to monitor your heartbeat before treatment is started because this medicine can potentially affect your heart rhythm).
  • People with a low level of potassium or magnesium in their blood.
  • People with a history of bleeding disorders and people taking medicine that affects blood clotting.

Who should not take escitalopram?

  • Children and adolescents under 18 years of age.
  • People in a manic episode of bipolar affective disorder.
  • People with uncontrolled epilepsy.
  • People with an abnormal heart rhythm seen on a heart monitoring trace (ECG) as a ‘prolonged QT interval’ and people taking other medicines that can cause this problem (your doctor will know, but see the end of this page for some examples).
  • People who have taken the MAOI medicines phenelzine, tranylcypromine, isocarboxazid, selegiline or rasagiline in the last two weeks, or moclobemide or linezolid in the last few days.

Is it safe to take escitalopram if pregnant?

It may be necessary for some women to take escitalopram during their pregnancy in order for them to remain well during the pregnancy and be able to care for their baby. But, it is important to talk to your doctor about the risks and benefits of taking escitalopram during the pregnancy compared with stopping treatment or using other treatments.

This is particularly important in the first and third trimesters, where escitalopram could potentially have harmful effects on the baby. For example, SSRI antidepressants may carry a slightly increased risk of causing heart defects if taken in the first trimester, and symptoms that resemble side effects or withdrawal symptoms of escitalopram have been seen in new-born babies whose mothers took citalopram in the third trimester.

It is important to get medical advice from your doctor if you think you could be pregnant or want to plan a pregnancy while taking escitalopram.

If you decide to stop taking escitalopram your doctor will advise you how to do this. Don’t suddenly stop taking escitalopram, as this can cause withdrawal symptoms.

Read more about taking escitalopram during pregnancy here

Is it safe to take escitalopram if breastfeeding?

Escitalopram passes into breast milk in small amounts and may affect your baby. You should get advice from your doctor if you want to breastfeed while taking escitalopram. Various factors need to be taken into consideration, for example whether you were taking escitalopram during the pregnancy and if the baby was born prematurely. In some cases, it’s OK to breastfeed while continuing to take escitalopram, as long as the baby is monitored for any potential problems. Always get advice from your doctor.

What are the possible side effects of escitalopram?

Medicines and possible side-effects can affect individual people in different ways. The following are some of the side-effects which may be associated with this medicine. Just because a side-effect is listed here, this does not mean that everyone who uses this medicine will experience it, or any side-effect. If you are concerned about side-effects or experience an adverse reaction from your medicine, consult your doctor.

Very common (affect more than 1 in 10 people)

  • Feeling sick.
  • Headache.

Common (affect between 1 in 10 and 1 in 100 people)

  • Decreased or increased appetite and weight gain.
  • Feeling anxious or restless.
  • Difficulty sleeping (insomnia).
  • Feeling sleepy or tired.
  • Abnormal dreams.
  • Yawning.
  • Feeling dizzy or shaky.
  • Increased sweating.
  • Pins and needles sensations.
  • Inflammation of the sinuses (sinusitis).
  • Disturbances of the gut such as diarrhoea, constipation, vomiting.
  • Dry mouth.
  • Aching muscles or joints.
  • Sexual problems such as decreased sex drive, difficulty achieving orgasm, erectile dysfunction or problems with ejaculation in men.

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Uncommon (affect between 1 in 100 and 1 in 1000 people)

  • Weight loss.
  • Teeth grinding.
  • Feeling nervous or agitated.
  • Confusion.
  • Change in the way things taste.
  • Fast heartbeat.
  • Dilated pupils and visual disturbances.
  • Sensation of ringing or other noise in the ears (tinnitus).
  • Bleeding, eg nosebleeds or bleeding in the gut.
  • Rash, itching or hives.
  • Hair loss.
  • Heavy periods in women.
  • Fluid retention.

Frequency not known

  • Difficulty passing urine.
  • Decrease in the number of platelets in the blood (thrombocytopenia).
  • Irregular heartbeat or abnormal heart rhythm seen as a ‘prolonged QT interval’ on an ECG.
  • Low level of sodium in the blood. This can cause symptoms such as drowsiness, confusion, muscle twitching or convulsions. Elderly people may be particularly susceptible to this effect. Consult your doctor if you develop any of these symptoms while taking escitalopram, so that your blood sodium level can be checked if necessary.
  • Seizures.
  • Mania.
  • Inflammation of the liver (hepatitis).
  • Persistent painful erection of the penis (priapism).
  • Bruising under the skin causing red patches (ecchymosis).

You should read the patient information leaflet that is supplied with your medication for more information about side effects associated with escitalopram. You can find a copy of this here

If you think you have experienced side effects from this medicine you can report them using the yellow card scheme.

Can I take other medicines with escitalopram?

Always check with your doctor or pharmacist before taking any new medicines while taking escitalopram, to make sure that the combination is safe.

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Escitalopram with painkillers

It is fine to take painkillers such as paracetamol, co-codamol or codeine with escitalopram. However, it is best to avoid non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, diclofenac, naproxen (unless you have been prescribed them by your doctor, as these may increase the risk of bleeding.

Herbal remedies with escitalopram

Avoid taking the herbal remedy St John’s wort (Hypericum perforatum), as it can increase the risk of getting side effects from escitalopram.

MAOIs and escitalopram

Escitalopram must not be taken at the same time as monoamine oxidase inhibitor antidepressants (MAOIs) such as phenelzine, isocarboxazid or tranylcypromine, or with selegiline, rasagiline or safinamide, which are MAOIs used to treat Parkinson’s disease. If you have been taking one of these MAOIs you should not start treatment with escitalopram until at least 14 days after stopping the MAOI. Treatment with these MAOIs, or with the related antidepressant moclobemide, should not be started until at least five weeks after escitalopram has been stopped.

Escitalopram with medicines that lower potassium levels

The medicines below can sometimes cause the amount of potassium in the blood to drop too low. If this happens in someone taking escitalopram it could increase the risk of irregular heartbeats. acetazolamide

  • aminophylline
  • amphotericin
  • beta 2 agonists, such as salbutamol or terbutaline
  • corticosteroids, such as hydrocortisone or prednisolone
  • diuretics, such as bendroflumethazide
  • reboxetine
  • stimulant laxatives such as senna
  • theophylline.

If you’re taking any of these with escitalopram your doctor may want to regularly check your blood potassium level.

Medicines that can increase the risk of bleeding with escitalopram

You may be more likely to have problems with bleeding if you take other medicines that affect blood clotting with escitalopram such as the following:

  • anticoagulant medicines such as warfarin, phenindione, dabigatran, rivaroxaban, apixaban, heparin.
  • other ‘blood-thinning’ (antiplatelet) medicines such as low-dose aspirin, dipyridamole or clopidogrel.
  • glycoprotein IIb/IIIa inhibitors, such as abciximab, eptifibatide, tirofiban
  • medicines that break down blood clots (thrombolytics), such as alteplase, streptokinase
  • duloxetine
  • ginko biloba (an herbal remedy)
  • iloprost
  • laropiprant
  • non-steroidal anti-inflammatory drugs (NSAIDs), such as naproxen, ibuprofen, diclofenac
  • Other SSRI antidepressants such as fluoxetine.
  • venlafaxine.

Other medicine interactions with escitalopram

There may be an increased risk of developing an abnormal heart rhythm if medicines that can cause an abnormal heart rhythm (seen as a prolonged QT interval on an ECG), such as the following, are taken with escitalopram:

  • antiarrhythmics (medicines to treat abnormal heart beats), such as amiodarone, procainamide, disopyramide, sotalol, dronedarone
  • the antihistamines astemizole, mizolastine or terfenadine
  • antidepressants clomipramine
  • certain antimalarials, such as halofantrine, chloroquine, quinine, mefloquine
  • certain antimicrobials, such as erythromycin given by injection, clarithromycin, moxifloxacin, voriconazole or pentamidine
  • certain antipsychotics, such as thioridazine, haloperidol, sertindole, pimozide
  • cisapride
  • droperidol
  • methadone.
  • sildenafil
  • tolterodine
  • vardenafil.

If you take other medicines or drugs that enhance serotonin activity in the brain while you’re taking escitalopram, you’re more at risk of getting a side effect called ‘serotonin syndrome’, with symptoms such as agitation, tremor, shivering, increased heart rate and diarrhoea. Other medicines that increase serotonin activity include the following:

  • dexamfetamine
  • duloxetine
  • fentanyl
  • illegal drugs such as cocaine, amphetamine (speed) and ecstasy (MDMA)
  • lithium
  • SSRI, tricyclic or related antidepressants, eg paroxetine, amitriptyline, mirtazapine
  • tramadol
  • triptans for migraine, such as sumatriptan
  • tryptophan.

The following medicines may increase the blood level of escitalopram and could increase the risk of its side effects:

  • cimetidine
  • esomeprazole
  • omeprazole.

Read more detailed information about medicines that may interact with escitalopram here

Last updated 02.10.2019

Rita Ghelani (BPharm, MRPharmS) Pharmacist A UK registered practising pharmacist with over 20 years’ experience, Rita is a member of the medical journalists’ association (MJA) and has a wealth of experience in community pharmacy.

What Pain Medication Can You Take With Lexapro

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  • 1.Celexa (citalopram hydrobromide) US prescribing information. Forest Laboratories Inc. January, 2019.
  • 2.Lexapro (escitalopram oxalate) US prescribing information. Forest Pharmaceuticals Inc. January, 2019.
  • 3.Prozac (fluoxetine hydrochloride) US prescribing information. Eli Lilly and Company October, 2014.
  • 4.Paxil (paroxetine hydrochloride) US prescribing information. Apotex Technologies January, 2017.
  • 5.Pexeva (paroxetine mesylate) US prescribing information. Noven Therapeutics, LLC December, 2012.
  • 6.Zoloft (sertraline) US prescribing information. Pfizer Inc. December, 2017.
  • 7.Luvox (fluvoxamine maleate) US prescribing information. Jazz Pharmaceuticals, Inc. January, 2017.
  • 8.Pristiq (desvenlafaxine succinate) US prescribing information. Wyeth Pharmaceuticals, Inc. February 8, 2018.
  • 9.Effexor (venlafaxine hydrochloride) US prescribing information. Wyeth Pharmaceuticals December, 2012.
  • 10.Cymbalta (duloxetine hydrochloride) US prescribing information. Eli Lilly and Company October, 2019.
  • 11.Dalton SO, Johansen C, Mellemkjaer L, Norgard B, Sorensen HT, Olsen JH. Use of selective serotonin reuptake inhibitors and risk of upper gastrointestinal tract bleeding: a population-based cohort study. Arch Intern Med 2003 Jan 13;163(1):59-64.
  • 12.de Abajo FJ, Rodriguez LA, Montero D. Association between selective serotonin reuptake inhibitors and upper gastrointestinal bleeding: population based case-control study. BMJ 1999 Oct 23;319(7217):1106-9.
  • 13.Trintellix (vortioxetine) US prescribing information. Takeda Pharmaceuticals America, Inc. July, 2019.
  • 14.Russo NW, Petrucci G, Rocca B. Aspirin, stroke and drug-drug interactions. Vascul Pharmacol 2016 Dec;87:14-22.
  • 15.Iwagami M, Tomlinson LA, Mansfield KE, Douglas IJ, Smeeth L, Nitsch D. Gastrointestinal bleeding risk of selective serotonin reuptake inhibitors by level of kidney function: A population-based cohort study. Br J Clin Pharmacol 2018 Sep;84(9):2142-2151.

Can You Overdose on Antidepressants?

The lethal dosage of an antidepressant depends on many factors, including:

  • the type of antidepressant
  • how your body metabolizes the medication
  • your weight
  • your age
  • if you have any preexisting conditions, like a heart, kidney, or liver condition
  • if you took the antidepressant with alcohol or other drugs (including other antidepressants)

TCAs

When compared to other types of antidepressants, tricyclic antidepressants (TCAs) result in the highest number of fatal overdoses.

The typical daily dose of the TCA amitriptyline is between 40 and 100 milligrams (mg). The typical dose of imipramine is between 75 and 150 mg per day. According to one 2007 review of U.S. poison center data, life-threatening symptoms are typically seen with doses greater than 1,000 mg. In one clinical trial, the lowest fatal dose of imipramine was just 200 mg.

The researchers recommended emergency treatment for anyone who’s taken a dose of desipramine, nortriptyline, or trimipramine greater than 2.5 mg per kilogram (kg) of weight. For a person who weighs 70 kg (about 154 pounds), this translates to about 175 mg. For all other TCAs, emergency treatment is recommended for doses greater than 5 mg/kg. For a person who weighs 70 kg, this translates to about 350 mg.

SSRIs

Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed antidepressants because they tend to have fewer side effects. If taken alone, an SSRI overdose is rarely fatal.

The typical dosage of the SSRI fluoxetine (Prozac) is between 20 and 80 mg per day. A dose as low as 520 mg of fluoxetine has been associated with a lethal outcome, but there’s record of someone taking 8 grams of fluoxetine and recovering.

The risk of toxicity and death is much higher when a high dose of an SSRI is taken with alcohol or other drugs.

SNRIs

Serotonin-norepinephrine reuptake inhibitors (SNRIs) are considered less toxic than TCAs, but more toxic than SSRIs.

A typical dose of the SNRI venlafaxine is between 75 and 225 mg per day, taken in two or three divided doses. Lethal outcomes have been seen at doses as low as 2,000 mg (2 g).

Still, the majority of SNRI overdoses aren’t fatal, even at higher doses. Most cases of fatal overdoses involve more than one drug.

MAOIs

Monoamine oxidase inhibitors (MAOIs) are an older class of antidepressants and aren’t used as widely anymore. Most cases of MAOI toxicity happen when large doses are taken along with alcohol or other drugs.

Severe symptoms of an overdose can occur if you take more than 2 mg per kg of your body weight. Death from an MAOI overdose is rare, but this is likely because they aren’t widely prescribed anymore due to their many interactions.

Suicide prevention

  • If you think someone is at immediate risk of self-harm or hurting another person:
  • •  Call 911 or your local emergency number.
  • •  Stay with the person until help arrives.
  • •  Remove any guns, knives, medications, or other things that may cause harm.
  • •  Listen, but don’t judge, argue, threaten, or yell.
  • If you or someone you know is considering suicide, get help from a crisis or suicide prevention hotline. Try the National Suicide Prevention Lifeline at 800-273-8255.

APO-Escitalopram

Contains the active ingredient, escitalopram (as escitalopram oxalate)

Consumer Medicine Information

For a copy of a large print leaflet, Ph: 1800 195 055

What is in this leaflet

Read this leaflet carefully before taking your medicine. This leaflet answers some common questions about escitalopram.

It does not contain all the available information. It does not take the place of talking to your doctor or pharmacist.

The information in this leaflet was last updated on the date listed on the last page. More recent information on this medicine may be available.

Ask your doctor or pharmacist:

  • if there is anything you do not understand in this leaflet,
  • if you are worried about taking your medicine, or
  • to obtain the most up-to-date information.

You can also download the most up to date leaflet from www.apotex.com.au.

All medicines have risks and benefits. Your doctor has weighed the risks of you using this medicine against the benefits they expect it will have for you.

Pharmaceutical companies cannot give you medical advice or an individual diagnosis.

Keep this leaflet with your medicine. You may want to read it again.

What this medicine is used for

The name of your medicine is APO-Escitalopram. It contains the active ingredient, escitalopram (as escitalopram oxalate).

It is used to treat

  • depression
  • obsessive-compulsive disorder.

Ask your doctor if you have any questions about why this medicine has been prescribed for you. Your doctor may have prescribed this medicine for another reason.

This medicine is available only with a doctor’s prescription.

How it works

Escitalopram belongs to a group of medicines called Selective Serotonin Reuptake Inhibitors (SSRIs). Escitalopram and other SSRIs are thought to help by increasing the amount of serotonin in your brain.

Depression is longer lasting or more severe than the “low moods” everyone has from time to time due to the stress of everyday life. It is thought to be caused by a chemical imbalance in parts of the brain. This imbalance affects your whole body and can cause emotional and physical symptoms such as feeling low in spirit, loss of interest in activities, being unable to enjoy life, poor appetite or overeating, disturbed sleep, often waking up early, loss of sex drive, lack of energy and feeling guilty over nothing.

Escitalopram corrects this chemical imbalance and may help relieve the symptoms of depression.

There is no evidence that escitalopram is addictive. However, if you suddenly stop taking it, you may get side effects.

Tell your doctor if you get any side effects after stopping escitalopram.

Use in children

Do not give this medicine to a child or adolescent. There is no experience with its use in children and adolescents under 18 years of age.

Before you take this medicine

When you must not take it

Do not take this medicine if:

  • You are taking the following other medicines:
    – pimozide, used to treat disorders which affect the way you think, feel or act
    – monoamine oxidase inhibitors (MAOIs), used to treat depression (phenelzine, tranylcypromine, moclobemide), Parkinson’s Disease (selegiline) or infections (linezolid).
    Do not take escitalopram until 14 days after stopping most MAOIs. The exception is the MAOI, moclobemide, where you may take escitalopram one whole day after finishing taking moclobemide. Similarly, do not take any MAOI until at least 14 days after stopping taking escitalopram.
    Taking escitalopram with MAOIs may cause a serious reaction with signs such as a sudden increase in body temperature, very high blood pressure, rigid muscles, nausea/vomiting and/or fits (convulsions). Your doctor will know when it is safe to start escitalopram after the MAOI has been stopped.
  • The expiry date (EXP) printed on the pack has passed.
  • The packaging is torn, shows signs of tampering or it does not look quite right.
  • You have had an allergic reaction to escitalopram, citalopram or any of the ingredients listed at the end of this leaflet.
    Symptoms of an allergic reaction may include cough, shortness of breath, wheezing or difficulty breathing; swelling of the face, lips, tongue, throat or other parts of the body; rash, itching or hives on the skin; fainting or hayfever-like symptoms.
    If you think you are having an allergic reaction do not take any more of the medicine and contact your doctor immediately or go to the Accident and Emergency department at the nearest hospital.

Before you start to take it

Before you start taking this medicine, tell your doctor if:

  1. You have allergies to:
  • any other medicines
  • any other substances such as foods, preservatives, lactose or dyes.
  1. You have or have had any medical conditions, especially the following:
  • mania, hypomania, bipolar disorder or any other conditions which affect the way you think, feel or act
  • epilepsy or convulsions, fits or seizures (you should avoid taking escitalopram if your epilepsy is not properly controlled; if it is properly controlled your doctor will wish to watch you carefully if you take escitalopram)
  • heart problems
  • liver problems
  • kidney problems
  • problems with blood clotting or abnormal bleeding, i.e. a tendency to bleed or bruise easily
  • thoughts or actions relating to self-harm or suicide
  • diabetes
  • a decreased level of sodium in your blood
  • restlessness and/or a need to move often (akathisia)
  1. You are currently pregnant or you plan to become pregnant.
    There have been reports that babies exposed to certain antidepressants during the third trimester of pregnancy may develop complications after birth.
    Do not take this medicine whilst pregnant until you and your doctor have discussed the risks and benefits involved.
  2. You are currently breast-feeding or you plan to breast-feed.
    It is not recommended that you breast-feed while taking this medicine because escitalopram passes into breast milk and may affect your baby.
    Do not take this medicine whilst breast-feeding until you and your doctor have discussed the risks and benefits involved.
  3. You are receiving electroconvulsive therapy (ECT).
  4. You are planning to have, or have very recently had, surgery or an anaesthetic.
  5. You are currently receiving or are planning to receive dental treatment.
  6. You are taking or are planning to take any other medicines
    This includes vitamins and supplements that are available from your pharmacy, supermarket or health food shop.

Some combinations of medicines may increase the risk of serious side effects and are potentially life-threatening.

Therefore some medicines MUST NOT be taken with escitalopram. These include:

  • monoamine oxidase inhibitors, such as moclobemide, phenelzine, tranylcypromine, selegiline and linezolid
  • pimozide

(see also “When you must not take it”).

Some other medicines may interact with escitalopram.

These include:

  • tryptophan, contained in some multivitamin and herbal preparations
  • sumatriptan, used to treat migraines
  • tramadol, a strong pain killer
  • sumatriptan and similar medicines used to treat migraines and cluster headaches
  • St John’s Wort (Hypericum perforatum), a herbal remedy
  • other medicines used to treat depression, including SSRIs, imipramine, clomipramine, nortriptyline and desipramine
  • lithium, used to treat mood swings and some types of depression
  • any other medicines used to treat anxiety, obsessive-compulsive disorder or pre-menstrual dysphoric disorder.
  • antipsychotics, medicines used to treat psychoses, schizophrenia and other conditions which affect the way you think, feel or act (e.g. risperidone, thioridazine and haloperidol)
  • any other medicines affecting the chemicals in the brain
  • prochlorperazine, used to prevent or treat severe nausea and vomiting
  • bupropion, a medicine helping to treat nicotine dependence
  • mefloquine, an anti-malaria medicine
  • some heart or blood pressure medications, e.g. dipyridamole, flecainide, propafenone, metoprolol
  • medicines known to prolong bleeding e.g. aspirin or other non-steroidal anti-inflammatory drugs (NSAIDs) and anti-coagulants (such as warfarin and ticlopidine), which are used to prevent blood clots
  • medicines used to treat reflux and ulcers, such as cimetidine, omeprazole, esomeprazole and lansoprazole
  • imipramine and desipramine types of antidepressants.

If you are taking any of these you may need a different dose or you may need to take different medicines.

Other medicines not listed above may also interact with escitalopram.

How to take this medicine

Follow carefully all directions given to you by your doctor. Their instructions may be different to the information in this leaflet.

How much to take

Your doctor will tell you how much of this medicine you should take. This will depend on your condition and whether you are taking any other medicines.

The standard dose for this medicine is 10 mg per day. Your doctor may increase your dose to 20 mg per day depending on how you respond to this medicine.

Elderly people may need smaller doses. The maximum dose for elderly people is 10 mg per day.

Patients with liver disease or with a lack of certain liver enzymes may receive a lower initial dose of 5 mg daily for the first two weeks. Your doctor may increase the dose to 10 mg daily.

Do not stop taking your medicine or change your dosage without first checking with your doctor.

How to take it

Swallow the tablets whole with a full glass of water.

Do not chew them.

When to take it

Take escitalopram as a single dose, either in the morning or in the evening.

Take this medicine at the same time each day.

Taking it at the same time each day will have the best effect and will also help you remember when to take it.

It does not matter if you take it before, with or after food.

How long to take it for

Continue taking your medicine for as long as your doctor tells you, even if it takes some time before you feel any improvement in your condition.

Make sure you have enough to last over weekends and holidays.

As with other medicines for the treatment of these conditions, it may take a few weeks before you feel any improvement.

Individuals will vary greatly in their response to escitalopram.

Your doctor will check your progress at regular intervals.

The length of treatment may vary for each individual, but is usually at least 6 months.

In some cases, your doctor may decide that longer treatment is necessary.

Occasionally the symptoms of depression or other psychiatric conditions may include thoughts of harming yourself or committing suicide. It is possible that these symptoms may continue or increase until the full anti-depressant effect of your medicine becomes apparent.

You or anyone close to you or caring for you should watch for these symptoms and tell your doctor immediately or go to the nearest hospital if you have any distressing thoughts or experiences during this initial period or at any other time. Also contact your doctor if you experience any worsening of your depression or other symptoms at any time during your treatment.

Stopping Treatment

Do not stop taking this medicine even if you begin to feel better.

Your doctor may decide that you should continue to take it for some time, even when you have overcome your problem. For best effect, this medicine must be taken regularly.

The underlying illness may persist for a long time and if you stop your treatment too soon, your symptoms may return.

Do not stop taking this medicine suddenly. If you suddenly stop taking your medicine, you may experience mild, but usually temporary, symptoms such as dizziness, pins and needles, electric shock sensations, sleeping problems (vivid dreams, nightmares, inability to sleep), feeling anxious, restless or agitated, headaches, feeling sick (nausea), vomiting, sweating, tremor (shaking), feeling confused, feeling emotional or irritable, diarrhoea, visual disturbances, or fast or irregular heartbeats.

When you have completed your course of treatment, the dose of escitalopram is gradually reduced over a couple of weeks rather than stopped abruptly.

Your doctor will tell you how to reduce the dosage so that you help avoid getting side effects.

If you forget to take it

If you missed a dose and remember in less than 12 hours, take it straight away, and then go back to taking it as you would normally.

Otherwise, if you are more than 12 hours late, skip the dose you missed and take the next dose when you are meant to.

Do not take a double dose to make up for missed doses. This may increase the chance of you experiencing side effects.

If you have trouble remembering to take your medicine, ask your pharmacist for some hints to help you remember.

If you take too much (overdose)

If you think that you or anyone else may have taken too much of this medicine, immediately telephone your doctor or the Poisons Information Centre (Tel: 13 11 26 in Australia) for advice. Alternatively go to the Accident and Emergency Department at your nearest hospital.

Do this even if there are no signs of discomfort or poisoning. You may need urgent medical attention.

If you take too much escitalopram, you may get symptoms of drowsiness, sleepiness, dizziness, high or low blood pressure, nausea (feeling sick), vomiting, agitation or tremor (shaking), fast or slow heart beat or change in heart rhythm, dilated pupils or, rarely, temporary paralysis or weakness of muscles, convulsions or coma.

A condition called serotonin syndrome may occur, with high fever, agitation, confusion, trembling and abrupt contraction of muscles.

While you are taking this medicine

Things you must do

People taking escitalopram may be more likely to think about killing themselves or actually trying to do so, especially when escitalopram is first started or the dose is changed. Tell your doctor immediately if you have thoughts about killing yourself or if you are close to or care for someone using escitalopram who talks about or shows signs of killing him or herself.

All mentions of suicide or violence must be taken seriously.

Occasionally, the symptoms of depression may include thoughts of suicide or self-harm. It is possible that these symptoms continue or get worse until the full antidepressant effect of the medicine becomes apparent. This is more likely to occur if you are a young adult, i.e. 18 to 24 years of age, and you have not used antidepressant medicines before.

If you or someone you know or care for demonstrates any of the following warning signs of suicide-related behaviour while taking escitalopram, contact a doctor immediately, or even to go to the nearest hospital for treatment:

  • thoughts or talk of death or suicide
  • thoughts or talk of self-harm or harm to others
  • any recent attempts of self-harm
  • increase in aggressive behaviour, irritability or agitation
  • worsening of depression.

Follow your doctor’s instructions. Do not stop taking this medicine or change the dose without consulting your doctor, even if you experience increased anxiety at the beginning of treatment.

At the beginning of treatment, some patients may experience increased anxiety, which will disappear during continued treatment.

Tell your doctor immediately if you experience symptoms such as restlessness or difficulty sitting or standing still. These symptoms can also occur during the first weeks of treatment.

Contact your doctor as soon as possible if you suddenly experience an episode of mania.

Some people with bipolar disorder (manic depression) may enter into a manic phase. Symptoms of mania include lots of rapidly changing thoughts or ideas, exaggerated gaiety, being much more physically active and much more restless.

Sometimes you may not know that you are manic, so it may be helpful to have a friend or relative watch over you for any possible signs of change in your behaviour.

Visit your doctor regularly so they can check on your progress.

Tell your doctor immediately if you become pregnant. If you are a woman of child-bearing age, you should avoid becoming pregnant while taking escitalopram.

Make sure your midwife and/or doctor know you are taking escitalopram. When taken during pregnancy, particularly in the last 3 months of pregnancy, medicines like escitalopram may increase the risk of a serious condition in babies, called persistent pulmonary hypertension of the newborn (PPHN), making the baby breathe faster and appear bluish. These symptoms usually begin during the first 24 hours after the baby is born. If this happens to your baby you should contact your midwife and/or doctor immediately.

Low Sodium
Some people (especially older people or those taking diuretics/water tablets) may experience a lack of sodium in the blood when taking this medicine. Tell your doctor if you get a headache or start to feel sick, restless, irritated, confused or fatigued or if you vomit or have fits, muscle weakness or spasms.

Tell your doctor that you are taking this medicine if:

  • you are about to be started on any new medicine
  • you are breast-feeding or are planning to breastfeed
  • you are about to have any blood tests
  • you are going to have surgery or an anaesthetic or are going into hospital.

Your doctor may occasionally do tests to make sure the medicine is working and to prevent side effects.

Go to your doctor regularly for a check-up.

Tell any other doctors, dentists and pharmacists who are treating you that you take this medicine.

Tell your doctor if, for any reason, you have not taken your medicine exactly as prescribed. Otherwise your doctor may think that it was not effective and change your treatment unnecessarily.

Tell your doctor if you feel this medicine is not helping your condition.

If you are being treated for depression, be sure to discuss with your doctor any problems you may have and how you feel, especially any feelings of severe sadness, thoughts of suicide, bursts of unusual energy, anger or aggression, or if you become particularly agitated or restless.

Tell your doctor immediately if you have any suicidal thoughts or other mental/mood changes.

Make sure you have enough tablets to last over weekends and holidays.

Things you must not do

Do not:

  • Give this medicine to anyone else, even if their symptoms seem similar to yours.
  • Take your medicine to treat any other condition unless your doctor or pharmacist tells you to.
  • Stop taking your medicine, or change the dosage, without first checking with your doctor.

Do not let yourself run out of medicine over the weekend or on holidays.

Suddenly stopping escitalopram may cause unwanted discontinuation symptoms, such as dizziness, headache and nausea. Your doctor will tell you when and how escitalopram should be discontinued. You doctor will gradually reduce the amount you are using, usually over a period of one to two weeks, before stopping completely.

Things to be careful of

Be careful when driving or operating machinery until you know how this medicine affects you.

This medicine may cause nausea, fatigue, drowsiness, sight problems or dizziness in some people, especially early in the treatment. If you have any of these symptoms, do not drive, operate machinery, or do anything else that could be dangerous.

Avoid alcohol while you are taking this medicine. It is best not to drink alcohol while you are being treated for depression.

You should be aware that people over 50 years of age who take antidepressants have an increased risk of having a bone fracture.

Possible side effects

Tell your doctor as soon as possible if you do not feel well while you are taking escitalopram or if you have any questions or concerns.

Do not be alarmed by the following lists of side effects. You may not experience any of them. All medicines can have side effects. Sometimes they are serious, but most of the time, they are not.

Tell your doctor if you notice any of the following:

  • feeling tired and weak (fatigued), hot flushes, fever, feeling unwell, shaking or tremors, migraine, headache, or giddiness
  • muscle, back, bone, nerve or joint pain, stiffness, weakness or cramps, decrease or loss of touch or other senses
  • increased or decreased sensitivity to outside stimuli
  • feeling or being sick, reflux, diarrhoea or loose bowel motions, constipation, indigestion, stomach pain or discomfort, wind, burping, hiccups, problems swallowing, sore mouth, tongue or throat, haemorrhoids (piles)
  • dry mouth, feeling thirsty increased saliva, taste disturbance
  • fatigue, sleepiness or drowsiness, yawning, sleeping difficulties, strange or terrifying dreams
  • teeth grinding or clenching
  • increased or decreased appetite, weight loss
  • excessive and/or abnormal movements
  • increased muscle tension, muscle twitching
  • sexual problems, painful erection, prostate problems
  • symptoms of hyperglycaemia (high blood sugar): feeling hungry, thirsty and/or frequent or excessive urination;
  • problems with eyes or eyesight
  • dizziness when you stand up suddenly, due to low blood pressure
  • unable to tolerate alcohol
  • menstrual irregularities, period pain, breast pain, unusual vaginal bleeding
  • loss of bladder control unusual hair loss or thinning
  • tingling or numbness of the hands or feet
  • breast enlargement or unusual secretion of breast milk in men or women
  • mild rash, or itching or prickling of the skin
  • acne, eczema, dermatitis, dry skin, psoriasis or other skin problem
  • pain of any type
  • ringing or other persistent noise in the ears, problems hearing or earache
  • increased or decreased sweating
  • bruises
  • osteoporosis
  • tooth or jaw problems
  • flu-like symptoms, runny or blocked nose, sneezing, facial pressure or pain, coughing or sore throat

Tell your doctor as soon as possible if you notice any of the following.

These may be serious side effects. You may need medical attention.

  • becoming nervous, confused, forgetful, unable to concentrate, agitated, confused, panicky or anxious
  • feeling restless or unable to sit still
  • stomach pain with nausea and vomiting of blood, or blood in the bowel movements
  • aggression, worsening of depression
  • general swelling or swollen hands, ankles, feet or face or eye area due to fluid build-up
  • problems speaking
  • feelings of not being part of your body, or in a daze
  • feeling sick or unwell with weak muscles or feeling confused (these symptoms may be signs of a rare condition as a result of low levels of sodium in the blood, which may be caused by antidepressants and occurs especially in elderly women) increased tendency to bleed, develop bruises or broken bones
  • passing more or less urine than normal, or problems when urinating, or bladder infection
  • abnormal liver function tests (increased amount of liver enzymes)
  • flushing, varicose veins
  • infection in any part of your body
  • dizziness
  • agitation, anxiety, feeling tense and restless, tired, drowsy, lack of energy, irritable, problems sleeping, headache, nausea and tingling or numbness of the hands and feet after stopping escitalopram.

If you experience any of the following, stop taking your medicine and contact your doctor immediately or go to the Accident and Emergency department at your nearest hospital.

These are very serious side effects. You may need urgent medical attention or hospitalisation.

  • seizures, tremors, movement disorders (involuntary movements of the muscles or being unco-ordinated).
  • coma (unconsciousness)
  • a collection of symptoms including weight gain (despite loss of appetite), feeling and being sick, muscle weakness and irritability
  • severe rash, with blisters and/ or excessive peeling of skin and also possibly severe blisters and bleeding in the lips, eyes, mouth, nose and genitals
  • a sudden increase in body temperature, very high blood pressure, rigid muscles, nausea/vomiting and/or fits (convulsions). These symptoms may be signs of a rare condition called Serotonin Syndrome.
  • Neuroleptic Malignant Syndrome (a serious reaction to some medicines with a sudden increase in body temperature, extremely high blood pressure and severe convulsions)
  • fast, slow or irregular heartbeat, high blood pressure
  • palpitations, fainting or chest pain or tightness
  • abnormal bleeding
  • kidney pain, difficulty in passing urine, dark coloured urine or blood in the urine
  • a collection of symptoms including fever, sore throat, swollen glands, mouth ulcers, unusual bleeding or bruising under the skin
  • mania (mood of excitement, over-activity and uninhibited behaviour or aggression), hallucinations (hearing, seeing or feeling things that are not there)
  • jaundice (yellowing of the skin and/or eyes), with or without other signs of hepatitis or liver problems (loss of appetite, tiredness, feeling or being sick, dark urine, stomach pain or swelling, confusion, unconsciousness).
  • feeling paranoid, panicky, or “high” or having mood swings or feeling more depressed or in a trance
  • thoughts of suicide or attempting suicide or self-harm
  • sudden, severe breathing problems
  • sudden weakness or numbness of the face, arms or legs, especially on one side, slurred speech

Other side effects not listed above may also occur in some people.

Allergic reactions

If you think you are having an allergic reaction to escitalopram, do not take any more of this medicine and tell your doctor immediately or go to the Accident and Emergency department at your nearest hospital.

Symptoms of an allergic reaction may include some or all of the following:

  • cough, shortness of breath, wheezing or difficulty breathing
  • swelling of the face, lips, tongue, throat or other parts of the body
  • rash, itching or hives on the skin
  • fainting
  • hayfever-like symptoms

Storage and disposal

Storage

Keep your medicine in its original packaging until it is time to take it. If you take your medicine out of its original packaging, it may not keep well.

Keep your medicine in a cool dry place where the temperature will stay below 30°C. Do not store your medicine, or any other medicine, in the bathroom, or near a sink.

Do not leave it on a window-sill or in the car. Heat and dampness can destroy some medicines.

Keep this medicine where children cannot reach it. A locked cupboard at least one-and-a-half metres above the ground is a good place to store medicines.

Disposal

If your doctor tells you to stop taking this medicine, or it has passed its expiry date, your pharmacist can dispose of the remaining medicine safely.

Product description

What APO-Escitalopram looks like

APO-Escitalopram tablets are available in the following strengths:

  • 10 mg tablets: white to off – white, oval, biconvex, film-coated tablets with “C4” embossed on one side and a notch break-line on the other side.
  • 20 mg tablets: white to off – white, oval, biconvex, film-coated tablets with “C3” embossed on one side and a notch break-line on the other side.

Blister packs of 28 tablets.

* Not all strengths may be available.

Ingredients

Each tablet contains 10 mg, or 20 mg of escitalopram (as oxalate) as the active ingredient.

It also contains the following inactive ingredients:

  • microcrystalline cellulose
  • colloidal anhydrous silica
  • hypromellose
  • magnesium stearate
  • croscarmellose sodium
  • purified talc
  • macrogol 400
  • titanium dioxide.

This medicine is gluten-free, lactose free, sucrose-free, tartrazine-free and free of other azo dyes.

Australian Registration Numbers

APO-Escitalopram 10 mg tablets (blister pack): AUST R 213721.

APO-Escitalopram 20 mg tablets (blister pack): AUST R 213722.

Apotex Pty Ltd
16 Giffnock Avenue
Macquarie Park NSW 2113

APO and APOTEX are registered trade marks of Apotex Inc.

This leaflet was last updated in:
January 2017.

Published by MIMS April 2017

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