Selektra tablets 10mg, no. 56

It is taken orally, regardless of the meal. Depending on the indications, a single dose is 10-20 mg / day. The maximum daily dose is 20 mg. The duration of treatment is several months. Upon discontinuation of treatment, the dose should be gradually reduced over a period of 1Ц2 weeks. in order to avoid the onset of the 'withdrawal' syndrome.

For elderly patients (over 65 years old), the recommended dose is 5 mg / day, the maximum daily dose is 10 mg.

In case of impaired liver function, the recommended initial within the first 2 weeks. treatment is 5 mg / day. Depending on the individual response, the dose may be increased to 10 mg / day.

For patients with weak activity of the isoenzyme CYP2C19, the recommended starting dose for the first 2 weeks. treatment - 5 mg / day. Depending on the individual response, the dose may be increased to 10 mg / day.

Film-coated tablets, white, oval, biconvex, engraved with 'E' on one side, scored on the other side and side scoring.

Active substance:

escitalopram oxalate

Simultaneous intake of MAO inhibitors, children and adolescents up to 15 years, pregnancy, lactation, hypersensitivity to escitalopram.

pharmachologic effect

Antidepressant. Selectively inhibits serotonin reuptake; increases the concentration of a neurotransmitter in the synaptic cleft, enhances and prolongs the action of serotonin on postsynaptic receptors. Escitalopram practically does not bind to serotonin (5-HT), dopamine (D1 and D2) receptors, ?-adrenergic, m-cholinergic receptors, as well as benzodiazepine and opioid receptors.

The antidepressant effect usually develops within 2-4 weeks. after starting treatment. The maximum therapeutic effect of the treatment of panic disorder is achieved approximately 3 months after the start of treatment.

Indications of the active substances of the drug Selectra

Depression, panic disorder (including agoraphobia).

Dosage regimen

It is taken orally, regardless of the meal. Depending on the indications, a single dose is 10-20 mg / day. The maximum daily dose is 20 mg. The duration of treatment is several months. Upon discontinuation of treatment, the dose should be gradually reduced over a period of 1Ц2 weeks. in order to avoid the onset of the 'withdrawal' syndrome.

For elderly patients (over 65 years old), the recommended dose is 5 mg / day, the maximum daily dose is 10 mg.

In case of impaired liver function, the recommended initial within the first 2 weeks. treatment is 5 mg / day. Depending on the individual response, the dose may be increased to 10 mg / day.

For patients with weak activity of the isoenzyme CYP2C19, the recommended starting dose for the first 2 weeks. treatment - 5 mg / day. Depending on the individual response, the dose may be increased to 10 mg / day.

Side effect

From the nervous system: dizziness, weakness, insomnia or drowsiness, convulsions, tremors, movement disorders, serotonin syndrome (agitation, tremor, myoclonus, hyperthermia), hallucinations, mania, confusion, agitation, anxiety, depersonalization, panic attacks, increased irritability , visual disturbances.

From the digestive system: nausea, vomiting, dryness of the oral mucosa, impaired taste, decreased appetite, diarrhea, constipation, changes in liver function indicators.

On the part of the cardiovascular system: orthostatic hypotension.

From the endocrine system: decreased secretion of ADH, galactorrhea.

From the reproductive system: decreased libido, impotence, ejaculation disorders, anorgasmia (in women).

From the urinary system: urinary retention.

Dermatological reactions: skin rash, itching, ecchymosis, purpura, increased sweating.

Allergic reactions: angioedema, anaphylactic reactions.

From the side of metabolism: hyponatremia, hyperthermia.

From the musculoskeletal system: arthralgia, myalgia.

Others: sinusitis, withdrawal syndrome (dizziness, headaches and nausea).

Contraindications for use

Simultaneous intake of MAO inhibitors, children and adolescents up to 15 years, pregnancy, lactation, hypersensitivity to escitalopram.

Application during pregnancy and lactation

Use during pregnancy and lactation (breastfeeding) is contraindicated.

Application for violations of liver function

Use with caution in liver cirrhosis.

Application for impaired renal function

It should be used with caution in patients with renal insufficiency (CC less than 30 ml / min).

Application in children

Contraindicated in children and adolescents under 15 years of age.

Use in elderly patients

Use with caution in elderly patients.

special instructions

It should be used with caution in patients with renal insufficiency (CC less than 30 ml / min), hypomania, mania, with pharmacologically uncontrolled epilepsy, with depression with suicidal attempts, diabetes mellitus, in elderly patients, with cirrhosis of the liver, with a tendency to bleeding, concurrently with taking drugs that reduce the threshold of convulsive readiness, causing hyponatremia, with ethanol, with drugs metabolized with the participation of isoenzymes of the CYP2C19 system.

Escitalopram should be given only after 2 weeks. after the cancellation of irreversible MAO inhibitors and 24 hours after discontinuation of therapy with a reversible MAO inhibitor. Non-selective MAO inhibitors can be prescribed no earlier than 7 days after discontinuation of escitalopram.

In some patients with panic disorder, at the beginning of treatment with escitalopram, an increase in anxiety may be observed, which usually disappears within the next 2 weeks. treatment. Low starting doses are recommended to reduce the likelihood of anxiety.

Escitalopram should be discontinued in case of development of epileptic seizures or their increase in pharmacologically uncontrolled epilepsy.

With the development of a manic state, escitalopram should be canceled.

Escitalopram is able to increase the concentration of glucose in the blood in diabetes mellitus, which may require a dose adjustment of hypoglycemic drugs.

Clinical experience with escitalopram indicates a possible increase in the risk of suicidal attempts in the first weeks of therapy, and therefore it is very important to closely monitor patients during this period.

Hyponatremia associated with a decrease in the secretion of ADH, while taking escitalopram, rarely occurs and usually disappears when it is canceled.

With the development of serotonin syndrome, escitalopram should be discontinued immediately and symptomatic treatment should be prescribed.

Influence on the ability to drive vehicles and use mechanisms

During the period of treatment, patients should avoid driving vehicles and other activities that require high concentration of attention and speed of psychomotor reactions.

Drug interactions

With simultaneous use with MAO inhibitors, the risk of developing serotonin syndrome and serious adverse reactions increases.

Combined use with serotonergic drugs (including tramadol, triptans) can lead to the development of serotonin syndrome.

When used simultaneously with drugs that reduce the seizure threshold, it increases the risk of seizures.

Escitalopram enhances the effects of tryptophan and lithium preparations, increases the toxicity of St. John's wort, the effects of drugs that affect blood clotting (monitoring of blood clotting parameters is necessary).

Drugs metabolized with the participation of the isoenzyme CYP2C19 (including omeprazole), as well as being strong inhibitors of CYP3A4 and CYP2D6 (including flecainide, propafenone, metoprolol, desipramine, clomipramine, nortriptyline, risperidone, thioridazine) the concentration of escitalopram in blood plasma.

Escitalopram increases the plasma concentration of desipramine and metoprolol by 2 times.