Escitalopram Oral Solution

— THERAPEUTIC CATEGORIES —
  • Anxiety/OCD
  • Mood disorders
PAGE CONTENTS
  • Jump to Section
  • Generic Name & Formulations
  • Indications
  • Dosage and Administration
  • Contraindications
  • Boxed Warnings
  • Warnings/Precautions
  • Pharmacokinetics
  • Interactions
  • Adverse Reactions
  • Clinical Trials
  • Note
  • Patient Counseling

    • Escitalopram Oral Solution Generic Name & Formulations

    Legal Class

    Rx

    General Description

    Escitalopram (as oxalate) 1mg/mL; peppermint flavor; contains parabens.

    Pharmacological Class

    SSRI.

    See Also

    How Supplied

    Tabs—100; Soln—contact supplier

    Manufacturer

    Various generic manufacturers

    Mechanism of Action

    The mechanism of antidepressant action of escitalopram, the S-enantiomer of racemic citalopram, is presumed to be linked to potentiation of serotonergic activity in the CNS resulting from its inhibition of CNS neuronal reuptake of serotonin (5-HT).

    Escitalopram Oral Solution Indications

    Indications

    Generalized anxiety disorder.

    Escitalopram Oral Solution Dosage and Administration

    Adult

    Initially 10mg once daily; may increase to max 20mg once daily at an interval of no less than 1 week. Elderly or hepatic impairment: 10mg once daily.

    Children

    <7yrs: not established. Initially 10mg once daily; may increase to max 20mg once daily at an interval of no less than 2 weeks. Hepatic impairment: 10mg once daily.

    Escitalopram Oral Solution Contraindications

    Contraindications

    During or within 14 days of MAOIs; do not start an MAOI during or within 14 days of escitalopram. Concomitant pimozide, linezolid, IV methylene blue.

    Escitalopram Oral Solution Boxed Warnings

    Boxed Warning

    Suicidality and antidepressant drugs.

    Escitalopram Oral Solution Warnings/Precautions

    Warnings/Precautions

    Increased risk of suicidal thinking and behavior in children, adolescents, and young adults; monitor for clinical worsening and unusual changes. History of seizures or mania/hypomania. Monitor for serotonin syndrome; discontinue if occurs. Hepatic impairment: see Adult and Children Dosage. Renal impairment (CrCl <20mL/min): not studied. Angle-closure glaucoma. Conditions that affect metabolic or hemodynamic responses. Recent MI. Unstable heart disease. Volume-depleted. Hyponatremia (esp. elderly). Sexual dysfunction. Avoid abrupt cessation. Reevaluate periodically. Write ℞ for smallest practical amount. Elderly. Labor & delivery. Pregnancy (during 3rd trimester; see full labeling for effects on neonate). Nursing mothers: monitor.

    Escitalopram Oral Solution Pharmacokinetics

    Absorption

    Absolute bioavailability: ~80%.

    Peak blood levels occur at ~5 hours.

    Distribution

    Volume of distribution: ~12 L/kg.

    Plasma protein bound: ~56%.

    Metabolism

    Hepatic (CYP3A4, CYP2C19).

    Elimination

    Half-life: ~27–32 hours.

    Oral clearance: 600 mL/min.

    Escitalopram Oral Solution Interactions

    Interactions

    See Contraindications. Do not give with citalopram. Increased risk of serotonin syndrome with other serotonergic drugs (eg, SSRIs, SNRIs, triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, meperidine, methadone, tryptophan, buspirone, amphetamines, St. John's Wort) or with drugs that impair serotonin metabolism (eg, MAOIs, linezolid, IV methylene blue). Avoid alcohol. Increased risk of bleeding with concomitant NSAIDs, aspirin, warfarin, and others that affect coagulation. May be antagonized by carbamazepine. Caution with drugs metabolized by CYP2D6 or other centrally-acting drugs. Increases metoprolol levels.

    Escitalopram Oral Solution Adverse Reactions

    Adverse Reactions

    Insomnia, ejaculation disorder, nausea, increased sweating, fatigue, somnolence, decreased libido, anorgasmia.

    Escitalopram Oral Solution Clinical Trials

    See Literature

    Escitalopram Oral Solution Note

    Not Applicable

    Escitalopram Oral Solution Patient Counseling

    See Literature

    Escitalopram Oral Solution Generic Name & Formulations

    Legal Class

    Rx

    General Description

    Escitalopram (as oxalate) 1mg/mL; peppermint flavor; contains parabens.

    Pharmacological Class

    SSRI.

    See Also

    How Supplied

    Tabs—100; Soln—contact supplier

    Manufacturer

    Various generic manufacturers

    Mechanism of Action

    The mechanism of antidepressant action of escitalopram, the S-enantiomer of racemic citalopram, is presumed to be linked to potentiation of serotonergic activity in the CNS resulting from its inhibition of CNS neuronal reuptake of serotonin (5-HT).

    Escitalopram Oral Solution Indications

    Indications

    Major depressive disorder (MDD).

    Escitalopram Oral Solution Dosage and Administration

    Adult

    Initially 10mg once daily; may increase to max 20mg once daily at an interval of no less than 1 week. Elderly or hepatic impairment: 10mg once daily.

    Children

    <12yrs: not established. 12–17yrs: initially 10mg once daily; may increase to 20mg once daily after 3 weeks.

    Escitalopram Oral Solution Contraindications

    Contraindications

    During or within 14 days of MAOIs; do not start an MAOI during or within 14 days of escitalopram. Concomitant pimozide, linezolid, IV methylene blue.

    Escitalopram Oral Solution Boxed Warnings

    Boxed Warning

    Suicidality and antidepressant drugs.

    Escitalopram Oral Solution Warnings/Precautions

    Warnings/Precautions

    Increased risk of suicidal thinking and behavior in children, adolescents, and young adults; monitor for clinical worsening and unusual changes. History of seizures or mania/hypomania. Monitor for serotonin syndrome; discontinue if occurs. Hepatic impairment: see Adult and Children Dosage. Renal impairment (CrCl <20mL/min): not studied. Angle-closure glaucoma. Conditions that affect metabolic or hemodynamic responses. Recent MI. Unstable heart disease. Volume-depleted. Hyponatremia (esp. elderly). Sexual dysfunction. Avoid abrupt cessation. Reevaluate periodically. Write ℞ for smallest practical amount. Elderly. Labor & delivery. Pregnancy (during 3rd trimester; see full labeling for effects on neonate). Nursing mothers: monitor.

    Escitalopram Oral Solution Pharmacokinetics

    Absorption

    Absolute bioavailability: ~80%.

    Peak blood levels occur at ~5 hours.

    Distribution

    Volume of distribution: ~12 L/kg.

    Plasma protein bound: ~56%.

    Metabolism

    Hepatic (CYP3A4, CYP2C19).

    Elimination

    Half-life: ~27–32 hours.

    Oral clearance: 600 mL/min.

    Escitalopram Oral Solution Interactions

    Interactions

    See Contraindications. Do not give with citalopram. Increased risk of serotonin syndrome with other serotonergic drugs (eg, SSRIs, SNRIs, triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, meperidine, methadone, tryptophan, buspirone, amphetamines, St. John's Wort) or with drugs that impair serotonin metabolism (eg, MAOIs, linezolid, IV methylene blue). Avoid alcohol. Increased risk of bleeding with concomitant NSAIDs, aspirin, warfarin, and others that affect coagulation. May be antagonized by carbamazepine. Caution with drugs metabolized by CYP2D6 or other centrally-acting drugs. Increases metoprolol levels.

    Escitalopram Oral Solution Adverse Reactions

    Adverse Reactions

    Insomnia, ejaculation disorder, nausea, increased sweating, fatigue, somnolence, decreased libido, anorgasmia.

    Escitalopram Oral Solution Clinical Trials

    See Literature

    Escitalopram Oral Solution Note

    Not Applicable

    Escitalopram Oral Solution Patient Counseling

    See Literature

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