Drug Action
Escitalopram is the active enantiomer of citalopram.
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Drug reference
Escitalopram is the active enantiomer of citalopram.
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Depressive illness | Generalised anxiety disorder | Obsessive-compulsive disorder ▶BY MOUTH ▶Adult: 10 mg once daily; increased if necessary up to 20 mg daily ▶Elderly: Initially 5 mg once daily; maximum 10 mg per day Panic disorder ▶BY MOUTH ▶Adult: Initially 5 mg once daily for 7 days, then increased to 10 mg daily; maximum 20 mg per day ▶Elderly: Initially 2.5 mg once daily; maximum 10 mg per day Social anxiety disorder ▶BY MOUTH ▶Adult: Initially 10 mg once daily for 2–4 weeks, dose to be adjusted after 2-4 weeks of treatment; usual dose 5–20 mg daily
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QT-interval prolongation
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Susceptibility to QT-interval prolongation
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→Appendix 1: SSRIs
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▶Common or very common Sinusitis ▶Uncommon Oedema
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Present in breast milk; avoid.
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Dose adjustments Manufacturer advises initially 5 mg once daily for 2 weeks in mild to moderate impairment, thereafter increased to 10 mg once daily according to response; titrate dose with extra caution in severe impairment.
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Caution if eGFR less than 30 mL/minute/1.73m2.
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Oral drops can be mixed with water, orange juice, or apple juice before taking.
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There can be variation in the licensing of different medicines containing the same drug. Oral drops ▶Cipralex (Lundbeck Ltd) Escitalopram (as Escitalopram oxalate) 20 mg per 1 ml Cipralex 20mg/ml oral drops sugar-free | 15 ml P £20.16 DT = £20.16 Tablet ▶Escitalopram (Non-proprietary) Escitalopram (as Escitalopram oxalate) 5 mg Escitalopram 5mg tablets | 28 tablet P £8.97 DT = £2.41 Escitalopram (as Escitalopram oxalate) 10 mg Escitalopram 10mg tablets | 28 tablet P £14.91 DT = £2.37 Escitalopram (as Escitalopram oxalate) 20 mg Escitalopram 20mg tablets | 28 tablet P £25.20 DT = £2.92 ▶Cipralex (Lundbeck Ltd) Escitalopram (as Escitalopram oxalate) 5 mg Cipralex 5mg tablets | 28 tablet P £8.97 DT = £2.41 Escitalopram (as Escitalopram oxalate) 10 mg Cipralex 10mg tablets | 28 tablet P £14.91 DT = £2.37 Escitalopram (as Escitalopram oxalate) 20 mg Cipralex 20mg tablets | 28 tablet P £25.20 DT = £2.92 eiiii F 381
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The dose should preferably be reduced gradually over about 4 weeks, or longer if withdrawal symptoms emerge (6 months in patients who have been on long-term maintenance treatment).
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Counselling on administration of oral drops advised. Driving and skilled tasks Patients should be counselled about the effects on driving.
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Initially 5 mg once daily; maximum 10 mg per
First-line fragment. Read the complete Indications and Dose section above.
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Initially 2.5 mg once daily; maximum 10 mg
First-line fragment. Read the complete Indications and Dose section above.
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