Description
Release form
coated tablets
Packing
28 pcs.
Pharmacological action of
Selectra is an antidepressant, selectively inhibits serotonin reuptake, increases the concentration of the neurotransmitter in the synaptic cleft, enhances and prolongs the effect of serotonin on postsynaptic receptors. Escitalopram practical selectively inhibits the reuptake of serotonin increases the concentration of the neurotransmitter in the synaptic cleft, enhances and prolongs the effect of serotonin on postsynaptic receptors. Escitalopram practical selectively inhibits the reuptake of serotonin increases the concentration of the neurotransmitter in the synaptic cleft, enhances and prolongs the effect of serotonin on postsynaptic receptors. Escitalopram practicalit does not bind to serotonin (5-HT), dopamine (D1 and D2), alpha-adrenergic, histamine, m-cholinergic receptors, as well as benzodiazepine and opiate receptors. The antidepressant effect usually develops 2-4 weeks after the start of treatment. The maximum therapeutic effect of the treatment of panic disorders is achieved approximately 3 months after the start of treatment.
Indications
Depression, panic disorder (including with agoraphobia).
Contraindications
Hypersensitivity, concomitant use of MAO inhibitors, age up to 15 years, pregnancy, lactation.
Use during pregnancy and lactation
The use of the drug during pregnancy and lactation is contraindicated.
Special instructions
Escitalopram should be prescribed only 2 weeks after the withdrawal of irreversible MAO inhibitors and 24 hours after the cessation of therapy with a reversible MAO inhibitor. Non-selective MAO inhibitors can be prescribed no earlier than 7 days after the withdrawal of escitalopram. In some patients with panic disorder, an increase in anxiety may occur at the beginning of escitalopram treatment, which usually disappears within the next 2 weeks of treatment. To reduce the likelihood of anxiety, it is recommended that low initial doses be used. The drug should be discontinued in case of the development of epileptic seizures or their increase in pharmacologically uncontrolled epilepsy. With the development of a manic state, escitalopram should be abolished. Escitalopram can increase the concentration of glucose in the blood in diabetes mellitus, which may require dose adjustment of hypoglycemic drugs. Clinical experience with the use of escitalopram indicates a possible increase in the risk of suicide attempts in the first weeks of therapy, and therefore it is very important to carefully monitor patients during this period. Hyponatremia associated with a decrease in ADH secretion rarely occurs with escitalopram and usually disappears when the drug is discontinued. With the development of serotonin syndrome, the drug should be immediately withdrawn and symptomatic treatment prescribed. During the treatment period, it is necessary to refrain from driving vehicles and engaging in potentially dangerous activities that require an increased concentration of attention and speed of psychomotor reactions.
Composition
1 tablet comprising escitalopram 10 mg
Dosage and administration of
Selectra is taken orally, regardless of food intake. Depressive episodes: 10-20 mg once a day. After the disappearance of the symptoms of depression, it is necessary to continue therapy to consolidate the effect for 6 months. Panic disorders (including with agoraphobia): 5 mg / day during the first week, then 10-20 mg / day. The maximum daily dose is 20 mg. The duration of treatment is several months. Upon termination of treatment, the dose should be gradually reduced within 1-2 weeks in order to avoid the occurrence of withdrawal syndrome. In elderly patients (over 65 years), the recommended dose is 5 mg / day, the maximum daily dose is 10 mg. In mild to moderate renal failure, dose adjustment is not required. The recommended initial dose for decreased liver function during the first two weeks of treatment is 5 mg / day. Depending on the individual response of the patient, the dose may be increased to 10 mg / day. For patients with weak activity of the CYP2C19 isoenzyme, the recommended initial dose during the first two weeks of treatment is 5 mg / day. Depending on the individual response of the patient, the dose may be increased to 10 mg / day.
Side effects of the
From the side of the central nervous system: dizziness, weakness, insomnia or drowsiness, convulsions, tremors, motor disorders, serotonin syndrome (agitation, tremor, myoclonus, hyperthermia), hallucinations, mania, confusion, agitation, attacks, increased irritability, visual disturbances. From the digestive system: nausea, vomiting, dryness of the oral mucosa, taste disturbances, loss of appetite, diarrhea, constipation. From the CCC: orthostatic hypotension. From the endocrine system: decreased secretion of ADH, galactorrhea. From the genitourinary system: decreased libido, impotence, impaired ejaculation, anorgasmia (in women), urinary retention. From the skin: skin rash, itching, ecchymosis, purpura, angioedema. Allergic reactions: anaphylactic reactions. Laboratory indicators: hyponatremia, a change in laboratory parameters of liver function. Other: excessive sweating, hyperthermia, sinusitis, arthralgia, myalgia, withdrawal syndrome (dizziness, headaches and nausea).
Drug Interactions
When taken with MAO inhibitors, the risk of developing serotonin syndrome and serious adverse reactions increases. Joint use with serotonergic drugs (including with tramadol, sumatriptan and other triptans) can lead to the development of serotonin syndrome. Concomitant use with drugs that lower the threshold of convulsive readiness increases the risk of seizures. Enhances the effect of tryptophan and Li + drugs. Increases the toxicity of St. John’s wort. Enhances the effect of drugs that affect blood coagulation (monitoring of blood coagulation parameters is necessary). Drugs metabolized with the participation of the CYP2C19 system (including omeprazole), as well as being strong inhibitors of CYP A4 and CYP2D6 (including flecainide, propafenone, metoprolol, desipramine, clomipramine, nortriptyline, risperidone, thioridazole, haloperide) escitalopram concentration. Increases the plasma concentration of desipramine and metoprolol 2 times.
Overdose
Symptoms: dizziness, tremor, agitation, drowsiness, eclipse, convulsions, tachycardia, ECG changes (change of ST segment, T-tooth, extension of QRS complex, prolongation of QT interval, arrhythmias , metabolic acidosis, hypokalemia, very rarely – acute renal failure.
Treatment: symptomatic and supportive: gastric lavage, adequate oxygenation. Monitoring of cardiovascular and respiratory function. There is no specific antidote.
Storage Conditions
The product should be stored out of the reach of children at a temperature not exceeding 25 ° C.
Shelf life
2 years.
Deystvuyushtee substance
stsitalopram
Conditions of release from drugstores
Prescription
dosage form
tablets
Possible product names
SELECT 0.01 N28 TABLE P / O
Select 10mg Tab. p / pl / rev X28
Selectra tab p / o 10mg x 28
Selectra tab p / p 10mg N28
SELECTRA TAB. P.P.O. 10MG No.28
