Citalopram, 10 mg, film-coated tablets, 30 pcs.

Compound

The main substance is distributed in accordance with the tablet form of 5,10, 20 mg, so the Cipralex tablet contains: 6.39;
12.77; 25.54 mg escitalopram oxalate. The drug also consists of preservative and formative elements: hypromelose, macrogol, talc, starch, silicon dioxide, magnesium stearate, etc.

Externally, the antidepressant Cipralex is a white tablet labeled “EK”, “E” and “L”, “E” and “N”.

One tablet contains 40, 20 or 10 milligrams of the active ingredient - citalopram hydrobromide.

The auxiliary ingredients included in the medicine include:

• magnesium stearate;
• copovidone;
• microcrystalline cellulose;
• lactose monohydrate;
• corn starch;
• croscarmellose sodium.

For the shell we use:

• macrogol;
• hypromellose;
• titanium dioxide.

Composition, description of the medicinal product, its form and packaging

In what form can Citalopram be purchased? Reviews from patients claim that in pharmacy chains this product is sold in the form of biconvex and round tablets, coated with a white film coating. On cross-section, this medicine has a slightly yellowish inner layer.

What is included in the composition of the drug "Citalopram"? Instructions and reviews report that the active ingredient of this medicine is the substance of the same name - citalopram, which is presented in the form of hydrobromide. As for the auxiliary components, microcrystalline cellulose, pregelatinized starch and magnesium stearate are used.

It should also be noted that the film shell of this product consists of polyvinyl alcohol, opadry II, macrogol, talc and titanium dioxide.

The medicine in question goes on sale in contour cells made of PVC or aluminum, which are packaged in cardboard boxes.

Mechanism of action

The main active ingredient escitalopram is an effective remedy for combating depressive disorders.

The medicine belongs to the SSRI family.

Drugs of this series block the reuptake of serotonin, which contributes to its increase in the synoptic cleft of nerve cells.

And since the appearance of depression is currently explained precisely by the serotonin theory, that is, in fact, by a deficiency of the neurotransmitter - the hormone serotonin, the use of escitalopram helps to compensate for this deficiency.

The drug “removes” very well the manifestations of bad mood, vital melancholy, total fear, anxiety, and pathological changes in appetite.

Symptoms of an overdose of Citalopram are:

• drowsiness;
• epileptic condition;
• the appearance of seizures;
• arrhythmia;
• nausea;
• gagging;
• perspiration;
• cyanosis of the skin.

A severe complication of an overdose is falling into a coma.

If such signs appear, you should rinse your stomach and take sorbents and laxatives. For convulsions, Diazepam is prescribed.

Pharmacological profile

The active substance acts on the synapses of CNS neurons, namely on the selective blockade of the uptake of the hormone serotonin.

The therapeutic effect is observed approximately a week after the start of therapy.

The largest amount of the active component accumulates approximately four hours after using the drug. Binds to plasma proteins up to eighty percent. Changes in the content of the active substance in the blood are linear.

It is partially excreted through urination and defecation after a day and a half.

Pharmacokinetics

Eating does not affect the action of the antidepressant, so high concentrations of the drug are observed 3-4 hours after taking the tablets.

The bioavailability of Cipralex is 80%.

Metabolism of the antidepressant occurs in the liver, and the drug is excreted in the urine.

Cipralex has its own characteristics of use in different age groups.

Elderly people tolerate the medicine quite well, but they eliminate it much more slowly; doctors take this feature into account when dosing Cipralex.

Pregnancy and lactation

This antidepressant should not be prescribed to pregnant women and nursing mothers. The use of this medicine in the third trimester can negatively affect the psychophysical development of the baby. The following disorders are also possible: cyanosis, respiratory failure, hypoglycemia, shortness of breath, vomiting, convulsions, tremor, temperature instability, nervousness, feeding difficulties, irritability, muscle hypertension, insomnia, hyperreflexia, constant crying, lethargy, drowsiness.

Scope of application and contraindications

Citalopram is prescribed for depression in women after childbirth, menopause and pregnancy. It is also recommended to use tablets for alcoholism, which is accompanied by depression.

It is possible to take medication if phobic anxiety disorder occurs in elderly patients.

The main limitation for prescribing the drug is the patient's hypersensitivity to the components of the drug.

Also limiting the use of the drug are the patient's use of MAO inhibitors and serotonin syndrome.

1. Hypersensitivity to escitalopram or additives to the tablets.
2. Taking other antidepressants from the MAO series, tinctures based on St. John's wort, anticoagulants or pimozide.
3. Age up to 18 years.
4. Kidney or liver pathologies.
5. Manias, including hypomania.
6. Epilepsy (a variant of its course uncontrolled with medication).
7. Patients' tendency to commit suicide.
8. Diabetes.
9. Predisposition to bleeding.
10. Abstinence.
11. Taking a course of electroconvulsive therapy.
12. Pregnancy.
13. Lactation period.

Contraindications to medication use

For what conditions should you not use Citalopram?

Reviews indicate the following contraindications to the use of this medicine:

• the patient’s minor age (according to the instructions, the safety and effectiveness of using such tablets at this age have not been established);
• high sensitivity of the patient to citalopram, as well as to any of its excipients;
• when taken simultaneously with monoamine oxidase inhibitors, including moclobemide, selegiline, linezolid (within two weeks after stopping their use);
• while taking medications that prolong the QT period on the ECG (including pimozide), as well as with congenital prolongation of this interval).

Price

Today, the most common form of antidepressant is 10 mg tablets, released in 14 pieces, it costs 1012-1024 rubles, and the drug comes in 28 pieces. can be bought for 1600-2030 rubles.

An antidepressant in a dosage of 20 mg is prescribed much less frequently and costs from 2500 to 2800 rubles.

5 mg tablets have the lowest cost; they can be bought in Moscow with a prescription for 870-970 rubles per pack.

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The medicine is patented by Lundbeck (Denmark).

The shelf life of Cipralex is 3 years.

Reviews from patients who took the drug

Cirapralex is a prescription drug that belongs to the group of SSRI antidepressants; it inhibits the reuptake of serotonin in the synaptic cleft. Due to this, its pronounced antidepressant effect is observed.

The advantages of this medicine include its relatively easy tolerability by patients. The most difficult thing I have encountered is the adverse reactions to stopping it. But in general, patients tolerate it well, provided they strictly adhere to the treatment regimen.

The disadvantage of an antidepressant is that it takes weeks to wait for the effect and it is not suitable as a first aid remedy.

I have persistent vegetative-vascular dystonia, and I constantly experience the pressure of panic attacks. I am constantly treated in neurology, as the fear is very strong.

I took courses of Cipralex. The opinion about it is positive, it relieves the severity of the manifestations of the disease. It’s a pity not immediately, but only after two weeks of treatment. I had no side effects and tolerated it well.

I experienced a strong crisis during staff reductions; I, the head of a large department, was fired. Always busy and socially active, I was left out of work. On this basis, a mental disorder and severe depression developed. I wanted to die, but my daughter placed me in a psychiatric clinic in time.

I was treated for a long time, including Cipralex. The drug is effective, but it must be taken with caution. Since the beginning of treatment, I have had interruptions in cardiac activity and tachycardia. Gradually it passed and the course of therapy was completed and depression was overcome.

I have been suffering from social phobia for a long time, which is why I am constantly receiving treatment. I tried Cipralex several times, it’s a good product, it helps to consolidate the results for a long time.

Side effects include dry mouth, increased appetite, and decreased libido. But against the backdrop of my fears, this is not the point; the main thing is to eradicate them, at least for a short time.

Take the tablets once a day, one at a time, with water.

First, start with the minimum dosage, gradually increasing it under medical supervision. It is important to remember that the dosage is determined by an experienced doctor, who takes into account the tolerability of the drug, as well as the individual characteristics of the body.

Side effects

Adverse reactions from taking Citalopram tablets are rare. In practice, there are no cases where patients came with such complaints.

But theoretically, when using the drug, the heart rate may decrease, so taking the pills provokes bradycardia.

In addition, the instructions indicate that the following side effects may occur on various body systems:

• nervous system: sleep disorders, migraine, apathy, asthenia, panic, hallucinations, dizziness, confusion, mania, psychosis, loss of performance, convulsions, amnesia, tremor;
• digestive system: diarrhea, flatulence, vomiting, nausea, dyspepsia, dry mouth, pain in the erigastric region, constipation, anorexia;
• respiratory organs: sinusitis, shortness of breath, coughing;
• sensory organs: disturbances of taste, vision, hearing;
• cardiovascular system: orthostatic hypotension, pressure surges, increased heart rate, arrhythmia;
• genitourinary system: increased frequency of urination, polyuria, menstrual irregularities, anorgasmia, impotence.

Fatigue, fever, itching and rash on the skin, joint and muscle pain, an allergic reaction, and fainting may also occur.

Typically, such effects make themselves felt extremely rarely, in case of a significant excess of the dose of the drug and with prolonged use.

Discomfort when taking Cipralex most often occurs in the first days or weeks of treatment.

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Patients are concerned about:

• dry mouth;
• nausea;
• slight dizziness;
• changes in appetite, both increase and decrease;
• the appearance of rash, itching and burning on the skin;
• anxiety, sleep disorders;
• sexual disorders (decreased potency in men, lack of orgasm in women);
• the appearance of suicidal thoughts;
• the occurrence of tinnitus;
• brady- or tachycardia, arrhythmias;
• aches and moderate pain in the muscles and bones;
• changes in blood composition;
• disturbances in the functioning of the kidneys and liver (decreased amount of urine, yellowing of the skin, sclera).

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** The Drug Directory is intended for informational purposes only. For more complete information, please refer to the manufacturer's instructions. Do not self-medicate; Before starting to use the drug Citalopram, you should consult a doctor. EUROLAB is not responsible for the consequences caused by the use of information posted on the portal. Any information on the site does not replace medical advice and cannot serve as a guarantee of the positive effect of the drug.

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** Attention! The information presented in this medication guide is intended for medical professionals and should not be used as a basis for self-medication. The description of the drug Citalopram is provided for informational purposes and is not intended for prescribing treatment without the participation of a doctor. Patients need to consult a specialist!

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Special patients

Patients who are depressed and whose work requires increased attention should avoid actions that require quick reactions.

Medicine for depression is not compatible with alcohol, so when using it, you must avoid drinking alcoholic beverages.

If the patient has a history of renal failure, then there is no need to adjust the dosage of the drug. If the liver functions are impaired, the tablets should be taken in minimal doses.

When Citalopram is used simultaneously with psychotropic drugs, concentration of attention is usually reduced.

It is prohibited to use tablets in conjunction with the use of MAO blockers, as well as within fourteen days after taking them. Their simultaneous use can cause a hypertensive crisis.

Concomitant use with serotonergic drugs enhances the effect of the drugs.

When breastfeeding and carrying a child, Citalopram can be used. However, it is used with caution and only under the supervision of a specialist.

The drug is not allowed to be taken by children under eighteen years of age.

Citalopram: instructions, synonyms, analogs, indications, contraindications, scope and doses

Citalopram* (Citalopram*)Antidepressants

Name Manufacturer Average price

02.002 (Antidepressant)

Antidepressant. The mechanism of action is associated with selective blockade of neuronal reuptake of serotonin at the synapses of CNS neurons.

Does not have or has a very weak ability to bind to histamine, m-cholinergic and adrenergic receptors.

Pharmacokinetics

After oral administration, Cmax of citalopram in plasma is reached within 2-4 hours. Bioavailability when taken orally is about 80%.

Changes in plasma concentrations of citalopram are linear. Css in plasma is established after 1-2 weeks of therapy.

Plasma protein binding is less than 80%.

In blood plasma, citalopram is present mainly unchanged. Metabolized by demethylation, deamination and oxidation.

T1/2 is 1.5 days.

Excreted by the kidneys and through the intestines.

Dosage

Take orally 1 time/day.

For adults, depending on the indications, the initial dose is 10-20 mg/day, if necessary, it can be increased to 60 mg/day. In patients over 65 years of age - 20 mg/day, if necessary, it can be increased to 40 mg/day.

Drug interactions

When used simultaneously with MAO inhibitors, the development of a hypertensive crisis (serotonin syndrome) may occur.

The inhibitory effect on the CYP2D6 isoenzyme is very weak, so interaction with drugs whose metabolism is affected by this enzyme is minimal.

However, a decrease in the concentration of citalopram in the blood plasma cannot be excluded due to increased metabolism due to the induction of microsomal liver enzymes by carbamazepine when used simultaneously.

With simultaneous use of cimetidine, a moderate increase in the Css of citalopram in the blood plasma is possible.

The effects of sumatriptan and other serotonergic agents may be potentiated by citalopram when used concomitantly.

Use during pregnancy and lactation

The safety of citalopram during pregnancy and lactation has not been established. The use of the drug is justified only in cases where the potential benefit of therapy for the mother outweighs the possible risk to the fetus and child.

Experimental studies did not reveal a teratogenic effect or any effect of citalopram on reproductive function and perinatal development of the fetus.

Side effects

From the digestive system: often – dry mouth, nausea.

From the side of the central nervous system: often – drowsiness, tremor; in isolated cases - convulsive seizures (when used in high doses).

From the cardiovascular system: a slight decrease in heart rate is possible.

Other: often - increased sweating.

Adverse reactions are, as a rule, transient in nature and mildly expressed. They are observed mainly during the first 2 weeks of treatment and usually decrease significantly as the patient's condition with depression improves.

Indications

Depression of various etiologies, panic disorders, obsessive-compulsive disorders.

Contraindications

Hypersensitivity to citalopram.

special instructions

In patients with liver failure, citalopram should be used in minimal doses.

In case of mild and moderate renal failure, no adjustment of the citalopram dosage regimen is required; there is no information on use in severe renal failure.

When using citalopram, a slight decrease in heart rate is possible, which has no clinical significance, however, in patients with an initially reduced heart rate, citalopram can cause more pronounced bradycardia.

The effectiveness and safety of citalopram in children has not been established.

Citalopram should not be used simultaneously with MAO inhibitors.

Caution should be exercised when prescribing citalopram in maximum doses while taking high doses of cimetidine).

Impact on the ability to drive vehicles and operate machinery

It should be borne in mind that patients with depression often experience a decrease in the ability to concentrate, which can be aggravated by the use of psychotropic drugs.

Preparations containing CITALOPRAM

• OPRA® (OPRA®) tab., coated. film-coated, 40 mg: 30 pcs. • OPRA® (OPRA®) tab., coated. film-coated, 20 mg: 30 pcs.• OPRA® (OPRA®) tab., coated. film-coated, 20 mg: 30 pcs. • CITALON tab., coated. film-coated, 40 mg: 7, 10, 14, 20, 21, 28, 30, 35, 40, 50, 56, 70, 100 or 140 pcs. • OPRA® tablets, coated.

film-coated, 20 mg: 30 pcs. • HUMORAP tablet, coated. film-coated, 20 mg: 14 or 28 pcs. • SIOZAM tablets, coated. film-coated, 40 mg: 10, 14, 20, 28, 40, 42 or 56 pcs. • SIOZAM tablets, coated. film-coated, 20 mg: 10, 14, 20, 28, 40, 42 or 56 pcs. • OPRA® tablets, coated.

film-coated, 40 mg: 30 pcs.• CITALORIN tab., coated. coated, 20 mg: 10 or 20 pcs. • CIPRAMIL tablets, coated. film-coated, 40 mg: 28 pcs. • PRAM (PRAM) tab., coated. coated, 20 mg: 10 pcs. • CITALON tablets, coated. film-coated, 30 mg: 7, 10, 14, 20, 21, 28, 30, 35, 40, 50, 56, 70, 100 or 140 pcs.

• CITALORIN tab., coated. coated, 10 mg: 10 or 20 pcs. • OPRA® (OPRA®) tablets, coated. film-coated, 40 mg: 30 pcs. • OPRA® (OPRA®) tab., coated. film-coated, 20 mg: 30 pcs. • CITALON tab., coated. film-coated, 20 mg: 7, 10, 14, 20, 21, 28, 30, 35, 40, 50, 56, 70, 100 or 140 pcs. • SEDOPRAM tablets, coated.

coated, 20 mg: 7 pcs. • PRAM (PRAM) tablets, coated. coated, 10 mg: 10 pcs. • CITALIFT tab., coated. film coating, 40 mg: 14, 28, 56 or 98 pcs. • CITALON tablets, coated. film-coated, 60 mg: 7, 10, 14, 20, 21, 28, 30, 35, 40, 50, 56, 70, 100 or 140 pcs. • CIPRAMIL® tablets, coated.

film-coated, 20 mg: 14 or 28 pcs. • CITALIFT tab., coated. film coating, 20 mg: 14, 28, 56 or 98 pcs. • CITOL tablets, coated. film-coated, 40 mg: 28 pcs.• HUMORAP tablet, coated. film-coated, 40 mg: 14 or 28 pcs. • OPRA® (OPRA®) tablets, coated. film-coated, 40 mg: 30 pcs.• PRAM (PRAM) tab., coated.

coated, 40 mg: 10 pcs.

• CITOL tab., coated. film-coated, 20 mg: 28 pcs.

Source: https://pharmacevtika.ru/annotation/Citalopram.html

Cautions and Limitations

1. Incompatible with drugs from the group of MAO inhibitors, as it can provoke the appearance of serotonin syndrome, as well as with anticoagulants, due to the fact that joint use causes changes in the composition of the blood.
2. Elderly people should not take the standard dose of the drug; doctors usually prescribe half of it.
3. Cipralex is contraindicated in children under 18 years of age; it is used with caution in people with renal and hepatic pathologies.

Instructions for use

The standard dosage regimen involves taking Cipralex once a day.

• For depressive disorders, it is recommended to use 10 mg of the drug per day, the maximum dose (20 mg) is used less frequently. The effect of treatment begins to appear after 2-4 weeks. The course of therapy for these disorders is at least six months.
• Panic attacks and disorders are treated with a dose of 5 mg, with a gradual increase to 10 mg. The results of the course of treatment appear in the third month of taking the medicine. The course of Cipralex in these cases lasts from 2-3 months or more.
• Social phobia requires 10 mg. drug per day for at least three months. Relief of painful symptoms can be expected 2-4 weeks from the start of therapy.
• Anxiety disorders are treated according to the dosage regimen of 10 mg/day. This is the initial dose, which is gradually increased to 20 mg. Therapy can last from 6 months to a year.
• For obsessive-compulsive disorder, the drug is taken 10 mg. per day, the doctor can increase its dose to 20 mg per day. Treatment is carried out in courses from 3 to 6 months or more.

Signs of overdose and actions to take when dealing with it

Adverse effects associated with treatment discontinuation in short-term placebo-controlled trials. In placebo-controlled trials lasting up to 6 weeks, 16% of 1063 patients receiving citalopram at doses ranging from 10 to 80 mg per day discontinued treatment due to side effects, compared with 8% of 446 patients receiving placebo.

Adverse effects associated with discontinuation of treatment and found to be due to citalopram (i.e. observed in at least 1% of patients receiving citalopram, 2 times more often than placebo) include the following: asthenia 1%({amp}lt;1%) , nausea 4%(0%), dry mouth 1%({amp}lt;1%), vomiting 1%(0%), dizziness 2%({amp}lt;1%), insomnia 3%(1 %), drowsiness 2%(1%), agitation 1%({amp}lt;1%).

Side effects observed in placebo-controlled clinical trials. The table shows the side effects that were observed in patients receiving citalopram in doses of 10 to 80 mg per day for 6 weeks (adverse effects noted in at least 2% of patients and exceeding the frequency of placebo are indicated).

* Recorded only in women: N=638 (citalopram), N=252 (placebo).** Recorded only in men: N=425 (citalopram), N=194 (placebo)

Adverse effects noted in these clinical trials in 2% of patients and observed less frequently than placebo: headache, asthenia, dizziness, constipation, palpitations, pharyngitis, urinary disturbances, back pain.

A dose-response assessment of the incidence of side effects was performed at fixed doses in depressed patients receiving placebo or citalopram at doses of 10, 20, 40 and 60 mg. Using Jonckheer's test, a positive correlation (p{amp}lt;0.05) was revealed for the following effects: fatigue, impotence, insomnia, drowsiness, yawning.

Changes in vital functions. There were no clinically significant changes in vital signs (pulse, SBP, DBP), incl. orthostatic changes with changes in body position during treatment with citalopram compared with placebo.

Change in body weight. In controlled trials, weight loss was approximately 0.5 kg (no change in the placebo group).

Changes in laboratory parameters. No clinically significant changes in laboratory tests were observed.

ECG change. Comparison of ECG in patients receiving citalopram (n=802) and placebo (n=241) showed that only a decrease in heart rate while taking citalopram was a statistically significant difference.

Concomitant use with MAO inhibitors may lead to increased blood pressure and agitation. Citalopram may enhance the effects of sumatriptan and other serotonergic drugs, increases the plasma level of metoprolol (the result of the interaction is not clinically significant) and the plasma concentration (by 50%) of the active metabolite imipramine (the clinical significance of the effect is unknown).

Cimetidine increases the AUC (by 43%) and Cmax (by 39%) of citalopram. No clinically significant interactions have been identified with digoxin, warfarin, carbamazepine, triazolam, ketoconazole, lithium (care should be taken when used together, as lithium may increase the serotonergic effect of citalopram) and alcohol.

Updating information

Interaction with drugs that prolong the QT interval

Due to the risk of QT prolongation, citalopram should not be used in patients taking other drugs that prolong the QT interval. Such drugs include class 1A (eg, quinidine, procainamide) and class III antiarrhythmics (eg, amiodarone, sotalol, some antipsychotics (eg, chlorpromazine, thioridazine), some antibacterial drugs (eg, gatifloxacin, moxifloxacin), etc.

A source of information

www.fda.gov

[Updated 07/26/2013]

Practical application experience

Reviews from doctors and opinions of patients who have taken or are taking Citalopram.

The use of Citalopram and products based on it is considered an effective way to get rid of depression. However, in some cases, taking pills can have side effects on various organs and their systems.

That is why, first take a small dose of the medicine, gradually increasing it. The active component of the tablets has a positive effect on the production of serotonin, which helps reduce the symptoms of mental disorders.

Taras Pavlovich, neurologist

Recently, menopause began, which, among all other symptoms, provoked depression in me. At the hospital I was prescribed Citalopram. This is the second week I have been taking the drug.

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I would like to note that it is indeed very effective, since my mood has improved, apathy, nervousness and irritability have disappeared. There were no adverse reactions from taking the tablets.

Natalya Ivanovna, 50 years old

My daughter was prescribed medication after the birth of the child, since she also developed a depressive state against the background of the divorce. The doctor wrote out a prescription for Citalopram. He helped his daughter quickly - she began to enjoy life again and believed in herself. But the tablets are not very cheap.

Olga Stanislavovna, 43 years old

Thus, in order to experience the therapeutic effect, but at the same time avoid cases of overdose and side effects, it is necessary to adhere to all medical instructions regarding the dosage and course of taking the medication.

The advantages of the drug are effectiveness, availability, speed of action and a minimal list of contraindications.

Disadvantages include the relatively high cost and the possibility of side effects.

Additional instructions

It is strictly unacceptable to combine an antidepressant with alcohol-containing drinks.

It is recommended to completely abstain from alcohol for the entire treatment period.

When combining tablets with alcohol, there is a high risk of intoxication of the body, increased manifestation of adverse reactions (obsessive suicidal thoughts are especially dangerous), coma, and death.

Pills can cause addiction. It is prohibited to increase the dose of the drug independently, without the recommendation of the attending physician.

It is not advisable to abruptly stop taking the pills. To avoid “withdrawal syndrome,” it is necessary to slowly reduce the dose until you completely stop taking the antidepressant.

During treatment with an antidepressant, it is not recommended to drive vehicles or work at dangerous objects that require high concentration of attention.

Patients who are overweight often take antidepressants to reduce appetite. In a person who does not suffer from depressive or severe mental disorders, antidepressants cause severe apathy, reduce vital activity, and suppress cravings for food.

However, this method of losing weight is extremely dangerous.

Citalopram tablets have a powerful effect on the liver, which, if taken inappropriately, can lead to its destruction.

Withdrawal of the drug

Abrupt cessation of Cipralex therapy can cause temporary but noticeable discomfort in patients, which is expressed in: dizziness, sensory disturbances, insomnia, diarrhea, emotional imbalance, changes in appetite, desire to die.

To minimize unpleasant symptoms when discontinuing the drug, its dosage is reduced gradually.

The withdrawal regimen is to reduce the amount of medication to 5 mg per week.

That is, when treating with 20 mg of the drug, in the first week they drink 15 mg of the drug, in the second - 10, in the third - 5. Then the 5 mg treatment is continued for another couple of weeks, and only then is completely stopped.