Epram 5 mg (Tablet)

Unit Price: ৳ 6.50 (5 x 10: ৳ 325.00)

Strip Price: ৳ 65.00

Medicine Details

Category	Details
Generic	Escitalopram oxalate
Company	Albion laboratories limited
Also available as	Epram 10 mg tablet

Escitalopram is an orally administered selective serotonin reuptake inhibitor (SSRI)
Pure S-enantiomer of the racemic bicyclic phthalate derivative citalopram
Pure S-enantiomer at least 100 fold more potent than the R-enantiomer with respect to inhibition of 5-HT reuptake
No or very low affinity for serotonergic or other receptors including alpha- and beta-adrenergic Dopamine, Histamine, Muscarinic and benzodiazepine receptors

Safety of daily doses above 20 mg has not been demonstrated
Administered as a single daily dose and may be taken with or without food
Usual dosage for major depressive episodes is 10 mg once daily with possible increase to a maximum of 20 mg daily
Usual dosage for panic disorder with or without agoraphobia is 5 mg initially, increasing to 10 mg daily with a possible maximum of 20 mg daily
Usual dosage for social anxiety disorder is 10 mg once daily, may be decreased to 5 mg or increased to a maximum of 20 mg daily
Initial dosage for generalised anxiety disorder is 10 mg once daily, maximum of 20 mg daily
Initial dosage for obsessive-compulsive disorder is 10 mg once daily, maximum of 20 mg daily

SSRI or related antidepressants should not be started until 2 weeks after stopping an MAOI
Conversely, an MAOI should not be started until at least a week after an SSRI or related antidepressant has been stopped

Contraindicated in patients with known hypersensitivity to Escitalopram or Citalopram or any of the inactive ingredients of the drug product
Concomitant use of escitalopram in patients taking monoamine oxidase/pimozide is contraindicated

Less sedating and have fewer antimuscarinic and cardiotoxic effects than tricyclic antidepressants
Side-effects include gastrointestinal effects, anorexia with weight loss or increased appetite and weight gain, hypersensitivity reactions, dry mouth, nervousness, anxiety, headache, insomnia, tremor, dizziness, asthenia, hallucinations, drowsiness, convulsions, galactorrhoea, sexual dysfunction, urinary retention, sweating, hypomania or mania, movement disorders and dyskinesias, visual disturbances

Caution should be exercised when treating a pregnant woman with Escitalopram during the third trimester
Excreted in human breast milk. The decision to continue or discontinue nursing or Escitalopram therapy should consider the risk of citalopram exposure for the infant and the benefits of escitalopram treatment for the mother

SSRIs should be used with caution in patients with epilepsy, concurrent electroconvulsive therapy, history of mania, cardiac disease, diabetes mellitus, angle-closure glaucoma, concomitant use of drugs that increase risk of bleeding, history of bleeding disorders, hepatic and renal impairment

Elderly patients (>65 years of age) should start with an initial dosage of 5 mg once daily, increase to 10 mg daily
Epram not to be used in the treatment of children and adolescents under the age of 18 years
Dosage adjustment not necessary in patients with mild or moderate renal impairment
Caution advised in patients with severely reduced renal function (CLCR less than 30 ml/min)
An initial dose of 5 mg daily for the first two weeks of treatment recommended in patients with mild or moderate hepatic impairment, increase to 10 mg daily with caution in severe hepatic impairment
For poor metabolizers of CYP2C19, start with an initial dose of 5 mg daily, increase to 10 mg daily, and avoid abrupt discontinuation

Symptoms mainly related to the central nervous system, gastrointestinal system, and cardiovascular system
No specific antidote. Management includes establishing and maintaining an airway, ensuring adequate oxygenation and respiratory function, considering gastric lavage and activated charcoal, and recommending cardiac and vital signs monitoring along with general symptomatic supportive measures