ESCITIL 10 mg. 28 tablets
Escitil comprises escitalopram (escitalopram) and is used to treat depression (major depressive disorder) and anxiety disorders (such as panic disorder with or without agoraphobia, i.e. fear of places where it can not help, social anxiety disorder, generalized anxiety disorder and obsessive compulsive disorder).
Escitalopram belongs to the group of antidepressants, known as selective inhibitors of serotonin reuptake inhibitors (SSRIs). These drugs act on the serotonin system in the brain by increasing serotonin levels. Violations in the serotonin system are considered an important factor in development of depression and related diseases.
2. What you need to know before taking Escitil
Do not take Escitil
if you are allergic to escitalopram or any of the other ingredients of this medicine (listed in section 6);
if you take other medicines that belong to a group called MAO inhibitors, including selegiline (used in the treatment of Parkinson's disease), moclobemide (used to treat depression) and linezolid (an antibiotic);
if born have or have had episodes of irregular heartbeat (identified through ECG study for assessing heart function);
if you are taking medicines for heart rhythm problems or that may affect heart rhythm (see. t. 2, "Other medicines and Escitil ").
Warnings and Precautions
Talk to your doctor before taking Escitil
Please tell your doctor if you suffer from another condition or disease, as may be necessary for your doctor to take this into account.
In particular, tell your doctor:
if you suffer from seizures for the first time in your life or you have epilepsy and seizure frequency increase Escitil treatment should be discontinued (see., and so on. 4 "Possible Side Effects");
if you suffer from impaired liver or kidney function. It may be necessary, your doctor may adjust your dose;
if you have diabetes. Treatment with Escitil may alter glycemic control. It may be necessary to adjust the dose of insulin and / or oral hypoglycemic drugs;
if you have a decreased level of sodium in the blood;
If you are susceptible to easy bleeding or bruising;
if you are receiving electroconvulsive treatment;
if have coronary heart disease;
if you have or have had heart problems or have recently had a heart attack;
if you have a low heart rate measured at rest and / or know that you have salt deficiency due to prolonged severe diarrhea or vomiting (feeling sick), or use of diuretics (water tablets);
if you feel that your heart rate quickened or become irregular if you get sick, collapse or dizziness on standing up which may indicate abnormal functioning of the heart rhythm;
if have an increased pressure in the anterior chamber of the eye due to sudden (acute) or slowly progressive (chronic) blockage of normal circulation of the fluid in the eye.
Please, have in mind
As with other drugs used to treat depression or related diseases, the improvement is not achieved immediately. Following the initiation of treatment with Estsitil may take several weeks before you feel better. In the treatment of panic disorder improvement is usually seen after about 2-4 weeks. At the beginning of treatment, some patients may experience increased anxiety, which will disappear with prolonged treatment. It is therefore important to carefully follow your doctor's instructions and do not stop treatment or change the dose without consulting him.
Thoughts of suicide and worsening of your depression or anxiety disorder
If you are depressed and / or have anxiety disorders can sometimes have thoughts of harming or killing themselves. These may be increased when first starting antidepressants, since these medicines all take time to start running - usually about two weeks but sometimes longer.
You may be more likely to think this way:
If you have previously had thoughts of suicide or self-harm;
If you are a young person. Data from clinical studies suggest an increased risk of behavior associated with suicide in young people under 25 years with psychiatric conditions who were treated with an antidepressant.
If at any time there you have thoughts of harming or killing yourself, contact your doctor or go to hospital.
It may find it helpful to tell a relative or close friend that you are depressed or have an anxiety disorder, and ask them to read this leaflet. You might ask them to tell you if they think your depression or anxiety is getting worse, or are worried about changes in your behavior.
Some patients with manic depressive illness may enter into a manic phase. It is characterized by unusual and rapidly changing ideas, inappropriate happiness and excessive physical activity. If you experience any of these, contact your doctor.
Symptoms such as restlessness or difficulty to sit or stand still can also occur during the first weeks of treatment. Tell your doctor immediately if you experience such symptoms.
Sometimes you may not be aware of the above symptoms and therefore you may be helpful to ask a friend or relative to help you monitor for possible signs of change in your behavior.
Tell your doctor immediately or contact the nearest hospital if you have distressing thoughts or experiences, or if any of the above symptoms occur during treatment.
Children and adolescents
Usually Escitil should not be used in children and adolescents under 18 years. You should also know that patients under 18 have an increased risk of side effects such as suicide attempts, suicidal thoughts and hostility (predominantly aggression, oppositional behavior and anger) when they take this class of drugs. However, your doctor may prescribe Estsitil patients under 18 years old when he decided that it is in their interest. If your doctor has prescribed Estsitil a patient under 18 and you want to discuss this, please go back to your doctor. You should tell your doctor if any of the above symptoms occur or worsen when patients under 18 are taking Estsitil. Also, long-term safety consequences on growth, maturation and cognitive and behavioral development of Escitil in this age group have not yet been established.
Other medicines and Escitil
Tell your doctor or pharmacist if you are taking, you have recently taken or might take any other medicines.
Tell your doctor if you are taking any of the following medications:
"Non-selective monoamine oxidase inhibitors (MAOIs)", containing phenelzine, iproniazid, isocarboxazid, nialamide and tranylcypromine as active ingredients. If you have taken any of these drugs, you have to wait 14 days before you start taking Estsitil. After stopping Estsitil must pass seven days before taking any of these medicines;
"Reversible selective MAO-A inhibitors", containing moclobemide (used in the treatment of depression);
"Irreversible MAO-B inhibitors", containing selegiline (used in the treatment of Parkinson's disease). They increase the risk of side effects;
Lithium (used in the treatment of manic depressive disorder) and tryptophan;
Imipramine and desipramine (both used to treat depression);
Sumatriptan and similar medicines (used to treat migraine) and tramadol (used against severe pain). They increase the risk of side effects;
Cimetidine and omeprazole (used to treat stomach ulcers), fluvoxamine (antidepressant) and ticlopidine (used to reduce the risk of stroke). These may cause increased blood levels of Estsitil;
St. John's wort (Hypericum perforatum) - herbal medicinal product used for depression;
Aspirin and non-steroidal anti-inflammatory drugs (medicines used for pain relief or to thin the blood, so called anticoagulants). They may increase the tendency to bleed;
Warfarin, dipyridamole, and phenprocoumon (medicines used to thin the blood, so called anticoagulants). Your doctor will probably check the coagulation time of your blood when starting and discontinuation of Estsitil to verify that your dose of anticoagulant is still sufficient;
Mefloquine (used to treat malaria), bupropion (used to treat depression) and tramadol (used to treat severe pain) due to the possible risk of lowering seizure threshold;
Neuroleptics (medicines to treat schizophrenia, psychosis) due to the potential risk of lowering the seizure threshold, and antidepressants;
Flecainide, propafenone and metoprolol (used in cardiovascular diseases), desipramine, nortriptyline and clomipramine (antidepressants) and risperidone, thioridazine and haloperidol (antipsychotics). It may need a dose adjustment Estsitil;
DO NOT TAKE ETSSITIL if you are taking medicines for heart rhythm problems or that may affect heart rhythm, such as antiarrhythmics class IA and III, antipsychotics (eg. Derivatives of phenothiazines, pimozide, haloperidol), tricyclic antidepressants, certain antimicrobial products (e. sparfloxacin, moxifloxacin, intravenous erythromycin, pentamidine, antimalarials, particularly halofantrine), some antihistamines (astemizole, mizolastine). If you have any further questions regarding the above, you should consult your doctor.
Estsitil with food, drink and alcohol
Estsitil can be taken with or without food (see. T. 3 "How to take Estsitil"). As with many medicines, combining Estsitil alcohol is not recommended, although not expected Estsitil interact with alcohol.
Pregnancy, lactation and fertility
If you are pregnant or breast-feeding, you think you may be pregnant or planning to become pregnant, talk to your doctor before taking this medicine. Make sure your midwife and / or doctor knows you are taking treatment Estsitil. Applied during pregnancy, especially in the last three months thereof, as Estsitil drugs may increase the risk of serious neonatal condition called persistent pulmonary hypertension, which causes shortness of breath and blueness of the baby. These symptoms usually occur within the first 24 hours after birth. If this happens with your baby, immediately contact your midwife and / or doctor.
If you take Estsitil in the last three months of your pregnancy, you should know that the newborn may occur following consequences: difficulty breathing, bluish skin, fits, body temperature changes, feeding difficulty, vomiting, low blood sugar, stiff or floppy muscles, vivid reflexes, tremor, jitteriness, irritability, lethargy, constant crying, sleepiness and difficulty sleeping. If your newborn baby has any of these symptoms, please contact their doctor immediately.
If used during pregnancy, Estsitil should never be discontinued suddenly.
If you are breastfeeding, do not take Estsitil unless you have discussed the risks and benefits with your doctor.
For citalopram, a drug similar to escitalopram has been found to impair sperm that in animal studies. In theory, this can affect fertility, but the effect on human fertility has not been observed so far.
Ask your doctor or pharmacist before taking any medicine.
Driving and using machines
It is advisable not to drive or operate machinery until you know how you affect Estsitil.
3. How to take Escitil
Always take this medicine exactly as your doctor has told you. If you're not sure, ask your doctor or pharmacist.
The usual recommended dose is 10 mg Estsitil day taken once. Your doctor may increase the dose to a maximum of 20 mg per day.
Escitil starting dose is 5 mg daily, administered once a week before the first dose be increased to 10 mg daily. Your doctor may further increase the dose to a maximum of 20 mg daily.
Social Anxiety Disorder
The usual recommended dose is 10 mg Estsitil day taken once. Your doctor may reduce your dose to 5 mg daily or increase it to a maximum of 20 mg daily, depending on how you react to the drug.
Generalised Anxiety Disorder
The usual recommended dose Estsitil is 10 mg, taken once daily. Your doctor may increase the dose to a maximum of 20 mg daily.
Obsessive Compulsive Disorder
The usual recommended dose Estsitil is 10 mg, taken once daily. Your doctor may increase the dose to a maximum of 20 mg daily.
Elderly (over 65 years)
The usual recommended starting dose is 5 mg Estsitil day taken once your doctor may increase the dose to 10 mg daily.
Use in children and adolescents (under 18 years)
Usually Escitil should not be used in children and adolescents. For additional information, please see section. 2 "What you should know before taking Estsitil."
You can take Estsitil with or without food. Swallow the tablet with some water. Do not chew, as has a bitter taste.
If necessary, you can split the tablet as you put it on a flat surface with the score facing upwards. Then you can break it by pressing with the index down from both sides.
Duration of treatment
It may take several weeks before you feel better. Keep taking Estsitil even take some time before you feel any improvement in your condition.
Do not change the dose of your medicine before talking to your doctor. Keep taking Estsitil as long as your doctor recommends. If you stop treatment too soon, your symptoms may reappear. It is recommended to continue treatment for at least 6 months after you feel well again.
If you take more dose Escitil
If you take more than the prescribed dose Estsitil, immediately contact your doctor or nearest hospital for emergency care. Do this even if there are no signs of discomfort. Some of the signs of overdose may be dizziness, tremors, excitability, convulsions, coma, nausea, vomiting, change in heart rate, decreased blood pressure and change in the balance of body fluids and salt balance. Take the box / packaging Estsitil with you when you go to the doctor or hospital.
If you forget to take Escitil
Do not take a double dose to make up for missed doses. If you forget to take a dose and you remember before you go to bed, take the dose immediately. The next day proceed as usual.
If you only remember during the night or the next day, skip the missed dose and continue as usual.
If you stop taking Escitil
Do not stop taking Estsitil until your doctor tells you to do. When you finish a course of treatment is generally recommended dose Estsitil be decreased gradually over a few weeks.
When stop taking Estsitil, especially if suddenly, you may experience withdrawal symptoms. They are commonly found in discontinuation of Estsitil. The risk is greater when administered Estsitil long time or at high doses, or when the dose is reduced too quickly. According to most people symptoms are mild and resolve on their own within two weeks. In some patients, however, may be strong or prolonged (2-3 months or more). If you show strong withdrawal symptoms when you stop taking Estsitil, please contact your doctor. He may prescribe you start taking the tablets again and come off them more slowly.
Withdrawal symptoms include: dizziness (instability or disequilibrium), stabbing, burning and (more rarely) a feeling of electric shock, including in the head, sleep problems (vivid dreams, nightmares, inability to sleep), anxiety, headache, nausea (nausea), sweating (including night), nervousness or excitability, tremors (shaking), confusion or disorientation, emotional or irritable, diarrhea (loose stools), visual problems, uneven or hard heartbeat (palpitations).
If you have any further questions on the use of this medicine, ask your doctor or pharmacist.
4. Possible side effects
Like all medicines, this medicine can cause side effects, although not everybody gets them.
Side effects usually disappear after a few weeks of treatment. You should know that a lot of the reactions may also symptoms of your illness and therefore will improve when you start to feel better.