Escitalopram brands and prices in Pakistan

About Escitalopram

Escitalopram is an antidepressant from the group called SSRIs (selective serotonin reuptake inhibitors). It is thought to work by raising the level of serotonin, a brain chemical that helps keep mood balanced. It is a prescription medicine and comes as tablets to swallow, tablets that melt on the tongue (orodispersible tablets) and liquid drops. It does not work straight away: it can take several weeks to feel the full benefit.

Who should not take it, or should take care

• Do not take it if you are allergic to escitalopram or have had a serious side effect from it or another antidepressant.
• Do not take it if you take, or have recently stopped, an MAOI antidepressant (such as moclobemide, phenelzine or selegiline), or if you take linezolid.
• Do not take it if you were born with or have a heart rhythm problem called long QT, or if you take other medicines that affect heart rhythm.
• Tell your doctor if you have heart disease, a slow heartbeat, heart failure or a recent heart attack, or low potassium or magnesium in your blood.
• Tell your doctor if you have a bleeding problem, especially bleeding in the stomach or gut.
• Tell your doctor if you have kidney or liver problems.
• Tell your doctor if you have diabetes, as it can change blood sugar control and your diabetes medicines may need adjusting.
• Tell your doctor if you have epilepsy or have had fits, or glaucoma (raised pressure in the eye). Ask whether you need an eye check before starting.
• Tell your doctor if you have ever had mania or very high mood (for example in bipolar disorder), or if you are having electroconvulsive therapy (ECT).
• Older people may have higher levels of the medicine in the body and are more likely to get low sodium (salt) in the blood, so they may need extra checks.
• Pregnancy: it can be used if needed. Your doctor will discuss the benefits and risks. When it is taken late in pregnancy, the baby may need checking after birth, so giving birth in hospital is usually advised. There is also a small extra risk of a breathing problem in the newborn and of heavier bleeding after the birth.
• Breastfeeding: it passes into breast milk. The NHS says it is sometimes used while breastfeeding, while the UK product information advises against breastfeeding. Ask your doctor, and contact a healthcare professional if you are worried about your baby.

Medicines and drinks that can interact

• MAOI antidepressants (such as moclobemide, phenelzine and selegiline) and linezolid: must not be taken with escitalopram. Methylene blue should also be discussed with your doctor
• Medicines that affect heart rhythm, such as some heart rhythm medicines, some antipsychotics, tricyclic antidepressants, some antibiotics (such as moxifloxacin), some antimalarials and some antihistamines
• Blood thinners such as warfarin, and anti-inflammatory painkillers (NSAIDs) such as aspirin, ibuprofen and naproxen, which raise the risk of bleeding
• Medicines for stomach acid or ulcers such as omeprazole, esomeprazole, lansoprazole and cimetidine, and fluconazole, which can raise escitalopram levels
• Other medicines that raise serotonin, such as triptans for migraine, tramadol, buprenorphine, lithium and tryptophan
• Medicines that can make fits more likely, such as bupropion and mefloquine
• Some heart and mental health medicines such as flecainide, metoprolol, risperidone and some tricyclic antidepressants, whose levels escitalopram can change
• St John's wort (a herbal remedy for low mood): do not take it with escitalopram without checking with your doctor
• Alcohol: best avoided, as it can make side effects such as sleepiness worse

Always tell your doctor and pharmacist about every medicine, supplement and herbal product you take.

Using it safely

• Keep taking it even if you do not feel better at first. It can take several weeks to work.
• Do not stop taking it suddenly, even if you feel better, as this can cause withdrawal symptoms such as dizziness, feeling sick, irritability or mood changes. Your doctor will lower the dose slowly when it is time to stop.
• You can take it with or without food.
• If you forget a dose, take it when you remember unless the next one is nearly due. Never take two doses to make up for a missed one.
• If you take too much, contact a doctor or pharmacist straight away or get urgent help.
• Do not drive, ride a bike or use machines until you know how it affects you, especially if you feel dizzy or sleepy or have blurred vision.
• Tell your doctor or pharmacist about all medicines, herbal remedies, vitamins and supplements you take, including any you have stopped recently.
• Store it out of the reach of children. Do not flush unwanted medicine down the toilet; return it to a pharmacy.

Common questions

How long does escitalopram take to work?
It usually takes several weeks before you notice your symptoms getting better, so keep taking it. Tell your doctor if you feel worse, especially early on or after a dose change.

Can I stop taking it when I feel better?
Do not stop suddenly. Stopping all at once can cause withdrawal symptoms such as dizziness, nausea, irritability and mood changes. Your doctor will plan how to reduce the dose slowly.

Can I drink alcohol while taking escitalopram?
It is best to avoid alcohol. It can make side effects such as sleepiness worse.

Can escitalopram affect my sex life?
Yes, sexual problems such as lower sex drive or trouble reaching orgasm are common. The UK product information notes some reports of these problems continuing after the medicine was stopped. Talk to your doctor if this worries you.

Can I take escitalopram in pregnancy?
It can be used if needed, after your doctor talks with you about the benefits and risks. Call your doctor if you become pregnant, and do not stop taking it without talking to them.

Prepared from the sources listed by the MedInfoBase team. General information, not medical advice: it gives no doses. Your doctor or pharmacist decides the medicine and dose for you.