Elicea coated pills 10mg N28
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Description
Elyceum pills belong to the group of antidepressants. Antidepressant effect usually develops after 2-4 weeks. after starting treatment. The maximum therapeutic effect of treating panic disorders is reached approximately 3 months after the start of treatment.
Active ingredients
Escitalopram
Release form
Pills
Composition
Escitalopram oxalate 12.78 mg, which corresponds to the content of escitalopram 10 mg. Excipients: lactose monohydrate - 107.220 mg, crospovidone - 7.5 mg, povidone K30 - 0.75 mg, microcrystalline cellulose - 15 mg, pregelatinized starch - 3.75 mg, 1998 mg, magnesium, 58 mg of microcrystalline cellulose, pregelatinized starch - 3.75 mg, magnesium, magnesium, 156 mg of microcrystalline cellulose, pregelatinized starch - 3.75 mg, magnesium, magnesium, 156 mg of microcrystalline cellulose, pregelatinized starch - 3.75 mg, magnesium, magnesium, microcrystalline cellulose - 15 mg; The composition of the film shell: opadry white 33G28707 - 3.75 mg (hypromellose 6cP - 40%, titanium dioxide - 24%, lactose monohydrate - 22%, macrogol 3000 - 8%, triacetin - 6%).
Pharmacological effect
Selectively inhibits serotonin reuptake, increases neurotransmitter concentration in the synaptic cleft, enhances and prolongs the action of serotonin on postsynaptic receptors. Estsitalopram practically does not bind to serotonin (5-HT), dopamine (D1 and D2) receptors, alpha-adreno-, m-cholinergic receptors, as well as benzodiazepine and opioid receptors. Antidepressant effect usually develops after 2-4 weeks. after starting treatment. The maximum therapeutic effect of the treatment of panic disorders is reached approximately 3 months after the start of treatment.
Pharmacokinetics
Suction does not depend on food intake. Bioavailability - 80%. The time to reach Cmax in plasma is 4 h. The escitalopram kinetics is linear. Css is reached after 1 week. The average Css is 50 nmol / l (from 20 to 125 nmol / l) and is achieved at a dose of 10 mg / Apparent Vd - from 12 to 26 l / kg. Plasma protein binding - 80%. Metabolized in the liver to active demethylated and dimethylated metabolites. After repeated use, the average concentration of demethyl and dimethylmetabolites is 28–31% and less than 5%, respectively, of the concentration of escitalopram. The metabolism of escitalopram with the formation of a demethylated metabolite occurs mainly with the participation of the isoenzymes CYP2C19, CYP3A4 and CYP2D6. In persons with a weak activity of the CYP2C19 isoenzyme, the concentration of escitalopram can be 2 times higher than in individuals with a high activity of this isoenzyme. Significant changes in the concentration of the drug with a weak activity of the isoenzyme CYP2D6 is not observed. T1 / 2 after repeated use - 30 h. The major metabolites of escitalopram T1 / 2 are longer. Clearance - 0.6 l / min.Escitalopram and its major metabolites are excreted by the liver and most of it by the kidneys, partially excreted in the form of glucuronides. T1 / 2 and AUC increases in elderly patients.
Indications
Depression, panic disorders (including with agoraphobia).
Contraindications
- Simultaneous use with MAO inhibitors; - simultaneous use with pimozide; - age up to 18 years (efficacy and safety have not been studied); - pregnancy; - breastfeeding period; - galactosemia, lactase deficiency, glucose-galactose malabsorption syndrome; - hypersensitivity to escitalopram and other components of the drug. The drug should be used with caution in pharmacologically uncontrolled epilepsy, a history of mania / hypomania, diabetes mellitus, depression with suicidal attempts, liver cirrhosis, chronic renal failure (CK less than 30 ml / min), ischemic heart disease, bleeding tendency; simultaneous use with drugs that can cause hyponatremia, lowering the threshold of convulsive readiness, with anticoagulants or drugs that affect platelet aggregation, with alcohol, with lithium, St. John's wort, with tryptophan, drugs, metabolized using the CYP2C19 isoenzyme system; with the simultaneous use of electroconvulsive therapy, as well as in patients aged 18-24 years (due to the risk of developing suicidal behavior) and in elderly patients.
Dosage and administration
The drug is taken orally 1 time / day, regardless of the meal. Depressive episodes. The recommended dose is 10 mg / day. Depending on the patient's individual response, the dose may be increased to a maximum of 20 mg / day. The antidepressant effect develops 2-4 weeks after the start of treatment. After the disappearance of symptoms of depression, it is necessary to continue therapy for at least 6 months to consolidate the effect obtained. To stop therapy with escitalopram, the dose should be gradually reduced within 1-2 weeks in order to reduce the risk of withdrawal syndrome. Panic disorders (including with agoraphobia). Assign 5 mg / day for the first week, then 10-20 mg / day. The maximum daily dose is 20 mg. The maximum therapeutic effect is achieved approximately 3 months after the start of treatment. Older patients (over 65).The recommended dose is 5 mg / day, the maximum daily dose is 10 mg / day.
Side effects
Classification of the incidence of side effects (WHO): very often (> 1/10), often (from> 1/100 to less than 1/10), infrequently (from> 1/1000 to less than 1/100), rarely (from> 1/10 000 to less than 1/1000), very rarely (from less than 1/10 000, including individual messages). Since the cardiovascular system: infrequently - tachycardia; rarely bradycardia; very rarely - orthostatic hypotension. From the hematopoietic system: very rarely - thrombocytopenia. On the part of the nervous system: often - insomnia, drowsiness, dizziness, paresthesias, tremor, anxiety, anxiety, nightmarish dreams; infrequently - taste disorders, sleep disorders, fainting, gnashing of teeth, psychomotor agitation, akathisia, irritability, panic disorders, confusion; rarely, serotonin syndrome (agitation, tremor, myoclonus, hyperthermia), aggressiveness, depersonalization, hallucinations, suicidal thoughts and behavior; very rarely - dyskinesia, convulsive and manic disorders. On the part of the respiratory system: often - sinusitis, yawning; infrequently - nosebleeds. On the part of the digestive system: very often - nausea; often - increased or decreased appetite, diarrhea, constipation, vomiting, dryness of the oral mucosa; infrequently - gastrointestinal bleeding (including rectal bleeding); very rarely - hepatitis. From the genitourinary system: often - ejaculation disorders, impotence, decreased libido, anorgasmia (in women); rarely - metrorrhagia, menorrhagia; very rarely - urinary retention, priapism, galactorrhea. From the senses: infrequently - mydriasis, visual disturbances, tinnitus. For the skin: often - excessive sweating, alopecia; very rarely - ecchymosis. From the musculoskeletal system: often - arthralgia, myalgia. On the part of the endocrine system: very rarely - inadequate secretion of antidiuretic hormone, galactorrhea. Allergic reactions: often - urticaria, skin rash, pruritus; rarely, anaphylactic reactions; very rarely - angioedema (angioedema). Other: often - weakness, fever; Infrequently - swelling. From the laboratory indicators: often - an increase in body weight; infrequently - weight loss; very rarely - hyponatremia, changes in laboratory parameters of liver function.With the abrupt cancellation of the drug may develop withdrawal syndrome.