escitalopram oxalate


Also found in: Dictionary.

escitalopram oxalate

Cipralex (UK), Lexapro

Pharmacologic class: Selective serotonin reuptake inhibitor

Therapeutic class: Antidepressant

Pregnancy risk category C

Action

Prevents serotonin reuptake by CNS neurons, making more serotonin available in brain and thereby relieving depression

Availability

Oral solution: 5 mg/5 ml

Tablets: 5 mg, 10 mg, 20 mg

Indications and dosages

Major depression

Adults: Initially, 10 mg P.O. daily as a single dose. After at least 1 week, may increase to 20 mg P.O. daily, as needed.

Adolescents ages 12 to 17: Initially, 10 mg P.O. daily. After at least 3 weeks, may increase to 20 mg P.O. daily as needed.

Elderly adults and patients with hepatic impairment: Maximum dosage of 10 mg P.O. daily as a single dose

Generalized anxiety disorder

Adults: Initially, 10 mg P.O. daily as a single dose. After at least 1 week, may increase to 20 mg P.O. daily as needed.

Dosage adjustment

• Hepatic impairment
• Elderly patients

Contraindications

• Hypersensitivity to drug
• Concurrent use of pimozide
• MAO inhibitor use within past 14 days

Precautions

Use cautiously in:
• renal or hepatic impairment, other conditions that cause altered metabolism or hemodynamic responses, history of mania or seizures, suicidal tendency
• concomitant use of nonsteroidal anti-inflammatory drugs (NSAIDs), aspirin, warfarin, or other drugs that affect coagulation
• elderly patients
• pregnant or breastfeeding patients
• children younger than age 12 with major depression and younger than age 18 with generalized anxiety disorder (safety and efficacy not established).

Administration

• Give with or without food in the morning or evening.

Don't give within 14 days of MAO inhibitor.

Adverse reactions

CNS: drowsiness, dizziness, insomnia, fatigue, neuroleptic malignant syndrome-like reactions, increased risk of suicide or suicidal ideation (especially in child or adolescent)

EENT: rhinitis, sinusitis

GI: nausea, vomiting, diarrhea, constipation, dyspepsia, abdominal pain, dry mouth

GU: ejaculatory disorders, erectile dysfunction, anorgasmia (in females), decreased libido

Metabolic: hyponatremia (in association with syndrome of inappropriate antidiuretic hormone secretion)

Other: increased appetite, flulike symptoms, serotonin syndrome

Interactions

Drug-drug.Aspirin, NSAIDs, warfarin: increased risk of bleeding

Carbamazepine, lithium: decreased effects of escitalopram

Citalopram: increased risk of serious toxic effects

MAO inhibitors: increased escitalopram blood level and risk of toxicity

Pimozide: prolonged QT interval

Triptans: weakness, hyperreflexia, incoordination

Drug-diagnostic tests.Sodium: decreased level

Drug-herbs.Ginkgo, St. John's wort: increased risk of adverse effects

Drug-behaviors.Alcohol use: increased motor impairment

Patient monitoring

Assess patient's mood closely. Watch for signs and symptoms of increased depression or suicidal ideation (especially in child or adolescent).

Monitor patient closely for serotonin syndrome or neuroleptic malignant syndrome-like reactions; immediately discontinue drug if these occur.
• Be aware that gradual dosage reduction rather than abrupt cessation is recommended. When drug is discontinued, monitor for dysphoric mood, irritability, agitation, dizziness, sensory disturbances, anxiety, confusion, headache, lethargy, emotional lability, and insomnia.

Patient teaching

• Advise patient to minimize GI upset by eating small, frequent servings of food and drinking plenty of fluids.
• Inform patient that full drug effect may take up to 4 weeks. Caution him not to overuse drug or stop drug abruptly.

Tell patient (and parent or significant other as appropriate) to contact prescriber immediately if depression worsens or suicidal thoughts develop (especially in child or adolescent).

Instruct patient to immediately discontinue drug and notify prescriber if the following symptoms occur: overheating, muscle rigidity, altered mental status, irregular pulse or blood pressure, rapid or irregular heart beat, excessive sweating, involuntary muscle movements, fever, or seizures.
• Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration and alertness.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, herbs, and behaviors mentioned above.

escitalopram oxalate

Lexapro® Neurology A serotonin reuptake inhibitor-type antidepressant, an isomer of citalopram Adverse events N&V, insomnia, ejaculation disorder, diaphoresis, fatigue

Escitalopram oxalate

Lexapro; a SSRI that is very similar to Celexa but contains only the active chemical form.
References in periodicals archive ?
Mark Schobel, president and chief executive officer of MonoSol Rx, stated, "Our completion of prototype development has advanced our thin film escitalopram oxalate product to the clinical investigation stage of the project.
The Company is currently exploring potential partnerships to market their thin film formulation of escitalopram oxalate and expects to solidify an agreement prior to global regulatory submissions.
IVAX believes it has valid claims against the Lexapro(R) patents and that its Abbreviated New Drug Application for escitalopram oxalate pending with the FDA is a first-to-file application that will entitle IVAX to a six-month period of exclusivity.
Investors are cautioned that forward-looking statements, including the statements regarding IVAX' first to file status and litigation, involve risks and uncertainties which may affect the company's business and prospects, including the difficulty in predicting the timing or outcome of legal proceedings; that final approval of IVAX' ANDA for escitalopram oxalate may be delayed or not received at all, and that if finally approved, the product will not be successfully commercialized; the difficulty of predicting the timing of U.
The products include 3000 kgs/month atenolol, 5000 kgs/month cinnarizine, 5000 kgs/month cyano diol base, 5000 kgs/month dextromethorphan HBr, 2000 kgs/month DFTA, 4000 kgs/month epoxy mesylate, 1500 kgs/month escitalopram oxalate, 5000 kgs/month fexofenadine HCl (BCN), 5000 kgs/month fexofenadine HCl, 5000 kgs/month Fexo Stage-10, 5000 kgs/month Fluconazole, 10,000 kgs/month Metaprolol Succinate, 2000 kgs/month Tramadol Base, 25,000 kgs/month Tramadol Hydrochloride (MBA), 25,000 kgs/month Tramadol Hydrochloride (MCA), 5,000 kgs/month Tramadol nitrate.
Lexapro is contraindicated in patients taking monoamine oxidase inhibitors (MAOIs), pimozide (see DRUG INTERACTIONS - Pimozide and Celexa), or in patients with hypersensitivity to escitalopram oxalate.
Lundbeck have filed suit against IVAX regarding IVAX' filing of a generic drug application for escitalopram oxalate, the generic equivalent of Lexapro(TM).
L) confirms that it has filed an Abbreviated New Drug Application on escitalopram oxalate in 5, 10, and 20 mg tablet dosage strengths, containing a Paragraph IV certification.
LEXAPRO is contraindicated in patients taking monoamine oxidase inhibitors (MAOIs), pimozide, or in patients with a hypersensitivity to escitalopram oxalate.