ESOPREX 10 mg. 30 tablets
Esoprex contains escitalopram and is used to treat depression (major depressive episodes) and anxiety disorders (such as panic disorder with or without agoraphobia, which is fear of the presence of areas where assistance may be impossible, social anxiety disorder and obsessive-compulsive disorder).
Escitalopram belongs to a group of antidepressants called selective serotonin reuptake of serotonin (SSR1). These drugs act on the serotonin system in the brain by increasing serotonin levels. Disturbances in the serotonin-system are considered an important factor in development of depression and related diseases.
2. BEFORE YOU TAKE ESOPREX
Do not take Esoprex
• if you are allergic (hypersensitive! To escitalopram or any of the other ingredients of Esoprex (see point B "Additional information")
• if you take other medicines that belong to a group called MAO inhibitors, including selegiline (used to treat Parkinson's disease), moklobe bromide (used to treat depression) and linezolid (an antibiotic).
Take special care with Esoprex
Please tell your doctor if you suffer from any other condition or illness, as your doctor may take this into account. It is particularly important to tell your doctor:
• if you have epilepsy. Esoprex therapy should be discontinued if seizures occur or that there is an increased incidence of seizures (see also section 4 "Possible Side Effects").
• if you suffer from liver damage or are with impaired renal function. You may need your doctor to adjust the dose.
• if you have diabetes. Treatment with Esoprex may alter glycemic control. You may need a dose adjustment of insulin and / or oral hypoglycemic agents.
• If you have a reduced level of sodium in the blood.
• if you have a tendency to bleed easily or bruises
• if you are receiving electroconvulsive treatment.
• if you have coronary heart disease. Please note
As with other drugs for the treatment of depression or related diseases, the improvement is not achieved immediately. Once you start treatment with Esoprex may take several weeks before you feel any improvement. In the treatment of panic disorder usually takes 2-4 weeks before you get to any improvement. At the beginning of treatment, some patients may experience increased anxiety, which disappears with continued therapy. It is therefore very important to follow your doctor's instructions exactly and not discontinue treatment or change the dose without consulting your doctor.
Thoughts of suicide and worsening of your depression or anxiety disorder.
If you are depressed and / or have anxiety disorders, you can sometimes have thoughts of harming or killing yourself. They can be strengthened when taking first antidepressants, since these medicines all take time before they begin to work, usually about two weeks but sometimes longer.
There are more likely to think so:
• If you have previously had thoughts about killing or harming yourself.
• If you are young. Information from clinical trials has shown an increased risk of suicidal behavior in young adults (under 25 years) with psychiatric conditions who were treated with an antidepressant.
If you have thoughts of harming or killing yourself, contact your doctor or go to hospital
It may be 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 if they are worried about changes in your behavior.
Some patients with manic-depressive illness may enter into a manic phase. This is characterized by unusual and rapidly changing ideas, inappropriate happiness and excessive physical activity. If you experience this, contact your baker.
Symptoms such as restlessness or difficulty to sit or stand in one place can also occur during the first weeks of treatment. Tell your doctor if you experience these symptoms.
Sometimes you may not realize the above symptoms and therefore may be useful to ask a friend IME relative help in monitoring for possible events or changes in your behavior.
Tell your doctor immediately or go to the nearest hospital if during treatment have disturbing thoughts or conditions, or are experiencing any of the above symptoms.
Children and adolescents under 18 years Esoprex should normally not be used for children and adolescents under 18 years. Also you should know that patients under 18 have an increased risk of side effects, such as suicide attempt, suicidal thoughts and hostility (predominantly aggression, oppositional behavior and anger) when they take this class of drugs. Despite this, your doctor may prescribe Esoprex for patients under 18 because he / she decides that this is in their best interest. If your doctor has prescribed Esoprex for a patient under 18 and you want to discuss this, please go back to your doctor. You should tell your doctor if you develop or worsen any of the above symptoms when patients under 18 are taking Esoprex. Furthermore, long-term effects on safety Esoprex growth, maturation and cognitive development and behavior in this age group have not yet been demonstrated.
Taking other medicines
Please tell your doctor if you are taking or have recently taken any other medicines, including medicines obtained without a prescription.
Inform your doctor if you are taking any of the following medications:
• "Non-selective monoamine oxidase inhibitors (MAOI)", containing phenelzine, iproniazid, izokarboksa-wall niapamid and tranylcypromine as active ingredients. If you are taking any of these drugs, you have to wait 14 days before taking Esoprex. Once you stop taking Esoprex must wait 7 days before you start taking any of these medicines.
• "Reversible selective MAO-A inhibitors, containing moclobemide (used to treat depression).
• "Irreversible, selective MAO-B inhibitors containing sepezhipin (used to treat Parkinson's disease). They increase the risk of nezhepani bakery reactions.
• The antibiotic linezolid.
• Lithium (used to treat manic-depressive disorder) and tryptophan.
■ Imipramine and dezimipramin (both izpopzvani for depression).
• Sumatriptan and similar lekarstvai (used to treat migraine) and tramadol (used in severe pain). They increase the risk of side effects.
• Cimetidine and omeprazole (used to treat steel captive ulcers), fluvoxamine (antidepressant) and ticlopidine
(used to reduce the risk of stroke). They can cause increased blood levels of Esoprex.
■ St. John's wort (hypericum perforatum) - a herbal product used for depression.
• Atsetilsalitsipova acid and non-steroidal anti-inflammatory drugs (medicines used to relieve pain or blood thinners, anti-coagulants etc.).
• Warfarin, dipyridamole, and phenprocoumon (medicines used to thin the blood, so anti-coagulants). Your doctor will probably check the coagulation time of your blood when starting and stopping treatment with Esoprex to verify that your dose of anticoagulant that taking still adequate,
• Mefloquine (used for the treatment of 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 a possible risk of a lowered threshold for seizures, and antidepressants.
• flecainide, propafenone, and metoprolol (used in cardiovascular diseases), desipramine, klomipra-min and nortriptyline (antidepressants) and risperidone, thio pyridazine and haloperidol (antipsychotics). You may need your doctor to adjust the dose Esoprex.
Esoprex can be taken with or without food (see section 3 "How to take Esoprex"). As with many other bakery, the combination of Eco-preks with alcohol is not advisable, although not expected Esoprex interact with alcohol.
Pregnancy and lactation
Tell your doctor if you are pregnant or planning to become pregnant. Esoprex not take if you are pregnant unless you have discussed the risks and possible benefits arising from this with your doctor. If you take Esoprex in the last three months of your pregnancy, you should know that the newborn can be observed side effects: difficulty breathing, bluish skin, fits, body temperature changes, feeding difficulties, vomiting, low blood sugar, stiff or floppy muscles, vivid reflexes, tremor, jitteriness, irritability, lethargy, constant crying, somnolence and difficulty sleeping. If your baby has any symptoms there, please; contact your doctor immediately. If used during pregnancy, Esoprex under no circumstances should not be stopped abruptly. Do not take Esoprex if you are breastfeeding, unless you have discussed the risks and possible benefits arising from this with your doctor.
Ask your doctor or pharmacist before taking any medicine.
Driving and using machines
It is not recommended to drive or operate machinery -Before you know how act Esoprex
3. HOW TO TAKE ESOPREX
Always take Esoprex exactly as prescribed by your doctor. If you are not sure, ask your doctor or pharmacist.
The usual recommended dose is 10 mg Esoprex as a single daily dose. The dose may be increased by your doctor to a maximum of 20 mg daily.
Esoprex starting dose is 5 mg as a single daily dose for the first week before increasing to 10 mg daily. The dose can be further increased by your doctor to a maximum of 20 mg per day.
Social Anxiety Disorder
The usual recommended dose is 10mg Esoprex as a single daily dose. Depending on how you respond to treatment with this medicine, or your doctor may reduce your dose to 5 mg daily or to increase it to a maximum of 20 mg daily
Obsessive-compulsive disorder The usual recommended dose is 10 mg Esoprex as a single daily dose. The dose may be increased by the doctor to a maximum of 20 mg per day.
Elderly / 65+ /
The usual recommended starting dose is 5 mg Esoprex as a single daily dose.
Children and Youth / under 18 /
Esoprex generally should not be given to children and adolescents. For additional information, please see section 2 "Before you take Esoprex".
Esoprex can be taken with or without food. Swallow the tablet whole with some water. Do not chew the tablets because they have a bitter taste. If necessary, you can split the tablet as you put it on a flat surface with the score facing upwards. Then the tablet can be broken by pressing in both ends down, using both index fingers.
Duration of treatment
It may take several weeks before you feel better. Continue to take Esoprex, even if it takes some time before you feel any improvement in your condition.
Do not change the dose of the drug before you have talked about it with your doctor.
Continue to take Esoprex as long as prescribed by your doctor. If you stop treatment too early, the symptoms may reappear. It is recommended to continue treatment for at least 6 months after you feel well.
If you take more dose Esoprex
If you take more than the prescribed dose Esoprex, contact your doctor or the emergency department at the nearest hospital. Do this even if there are no signs of discomfort. Some of the signs of overdose may be dizziness, tremor, agitation (agitation), convulsions (seizures), coma, nausea, vomiting, change in heart rate, decreased blood pressure and change velektrolitno-salt balance. Take the container with you Esoprex when you go to the doctor or hospital.
Do not take a double dose to make up the missed dose. If you forget to take a dose and you remember before you went to bed in the evening, take it immediately. The next day continue treatment as usual. If you remember the missed dose at night or the next day, do not take the dose and continue as usual.
If you stop taking Esoprex
Do not stop taking Esoprex until your doctor tells you to do. When you complete the course of treatment is usually recommended dose Esoprex gradually reduced over several weeks. When you stop taking Esoprex especially if you do suddenly, you may feel symptoms of withdrawal. They are common in discontinuation of Esoprex. The risk is greater when Esoprex has been used for a longer time or at high doses, or when the dose was reduced too quickly. Most people find that the symptoms are mild and go away within two weeks. In some patients, however, they may be severe in intensity or be prolonged (2-3 months or more). If you get withdrawal symptoms when Int-s taking Esoprex, please tell your lekar.Toy or she may ask you to restart taking the tablets and make them stop slower. Withdrawal symptoms include: feeling dizzy (unsteady or off-balance), feeling cour-shrimps and tingling, burning sensations and (less commonly) a sense of shock, including in the head, sleep disturbances (vivid dreams, nightmares , inability to sleep), feeling anxious, headaches, nausea, sweating (including night sweats), feeling restless or agitation, tremor (shakiness), feeling confused or disorientated, feeling emotional or irritable, diarrhea (loose stools), visual disturbances , fluttering or pounding heartbeat (palpitations).
If you have any further questions on the use of this product, ask your doctor or pharmacist.
4. POSSIBLE SIDE EFFECTS
Like all medicines, Esoprex can cause side effects, although not everybody gets them side effects usually disappear after a few weeks of treatment. Please remember that some of the effects may also be symptoms of your illness and therefore when you start to improve.
Visit your doctor if during the treatment you experience any of these side effects:
Uncommon (more than 1 in 1,000 and less than 1 in 100 people):
• unusual bleeding, including the gastrointestinal tract
Rare (more than 1 in 10,000 people and less than 1 in 1000 people):
• if you experience swelling of skin, tongue, lips or face, or have difficulties breathing or swallowing (allergic reaction), contact your doctor or go to a hospital immediately.
• If you have a fever, agitation, confusion, trembling and abrupt contractions of muscles these may be signs of a rare condition called serotonin syndrome. If you feel so, tell your doctor.
If you experience these side effects, you should immediately contact your doctor or go to hospital immediately:
- Difficulties in urination
- Seizures (convulsions), see also .Obarnete special care with Esoprex "
• yellowing of the skin and whites of the eyes are signs of liver dysfunction / hepatitis
In addition to the above, and also reported the following side effects:
Very common (more than 1 in 10 people):
- Feeling sick (nausea) Common (more than 1 in 100 people and less than 1 in 10 people:
• nasal congestion or nasal discharge (sinusitis)
• decreased or increased appetite
• anxiety, restlessness, abnormal dreams, difficulty sleeping, drowsiness, dizziness, yawning, tremors, skin prickle
• diarrhea, constipation, vomiting, dry mouth
• increased sweating
• pain in muscles and joints (arthralgia and myalgia) sexual dysfunction (delayed ejaculation, problems with erection, decreased sexual desire, and women may have difficulty in reaching orgasm)
• fatigue, fever
• weight gain
Uncommon (more than 1 in 1,000 and less than 1 in 100 people):
• hives (urticaria), rash, itching (pruritus)
• gnashing of teeth, agitation, nervousness, panic attack, confusion
• disturbed sleep, altered taste, fainting (syncope)
• dilated pupils (mydriasis), visual disturbances, ringing in the ears (tinnitus)
• hair loss
• vaginal bleeding
• reduced weight
• rapid heartbeat
• swelling of the hands or feet
• bleeding from the nose
Rare (more than 1 in 10 000 and less than 1 in 1000 people):
• aggression, depersonalization, hallucinations
• slow heartbeat
• events associated with suicide attempts, see also "Take special care with Esoprex"
Some patients have reported (frequency unknown):
• reduced levels of sodium in the blood (the symptoms are feeling sick and unwell with weak muscles or confused)
• dizziness when standing due to low blood pressure (orthostatic hypotension)
• abnormal liver function test (increased liver enzymes in the blood)
• movement disorders (involuntary muscle contraction)