ESOPREKS table. 10 mg. 30 tablets
Esopreks contains escitalopram and is used to treat depression (major depressive disorder) and anxiety disorders (such as panic disorder with or without agoraphobia, the fear of which is the presence of areas where assistance may be impossible, social anxiety disorder and obsessive-compulsive disorder).
ESOPREKS table. 10 mg. 30 tablets
ESOPREKS WHAT IS AND WHAT IT IS USED
Esopreks contains escitalopram and is used to treat depression (major depressive disorder) and anxiety disorders (such as panic disorder with or without agoraphobia, the fear of which is the presence of areas where assistance may be impossible, social anxiety disorder and obsessive- compulsive disorder).
Escitalopram belongs to a group of antidepressants called selective serotonin reuptake serotonin (SSR1). These drugs act on the serotonin system in the brain by increasing serotonin levels. Disorders in the serotonin system is considered an important factor in the development of depression and related disorders.
BEFORE YOU TAKE ESOPREKS
Do not take Esopreks
if you are allergic (svrahchuvstvitelni! to escitalopram or any of the other ingredients of Esopreks (see b "Additional information")
if you are taking other medicines that belong to a group called MAO inhibitors, including selegiline (used to treat Parkinson's disease), Mid-moklobe (used to treat depression) and linezolid (an antibiotic)
Take special care with Esopreks
Please tell your doctor if you suffer from any other condition or illness, as your doctor may take this into account. It is particularly important to tell your doctor:
if you have epilepsy. Esopreks therapy should be discontinued if seizures occur or that there is an increased incidence of seizures (see also section 4 "Possible side effects").
if you suffer from liver damage or you have impaired kidney function. You may need your doctor to adjust the dose.
if you have diabetes. Esopreks treatment may alter glycemic control. You may need to adjust the dose of insulin and / or oral hypoglycemic agents.
have a reduced level of sodium in the blood.
If you have a tendency to bleed easily or bruises
If you are receiving electroconvulsive therapy.
if you have coronary heart disease. Please note
As with other medicines for treating depression or related illnesses, improvement is not achieved immediately. After starting treatment with Esopreks may take several weeks before you feel any improvement. In the treatment of panic disorder usually takes 2-4 weeks to reach any improvement. At the beginning of treatment, some patients may experience increased anxiety, which disappeared with continued therapy. It is very important to follow your doctor's instructions exactly and do not discontinue treatment or change the dose without consulting your doctor.
Thoughts of suicide and worsening of your depression or anxiety disorder.
If you are depressed and / or have anxiety disorders you can sometimes have thoughts of harming or killing yourself. They may be worse when taking antidepressants for the first time since these medicines all take time before they begin to work, usually about two weeks but sometimes longer.
Are more likely to think like this:
If you have previously had thoughts about killing or harming yourself.
If you are young. Information from clinical trials has shown an increased risk of suicidal behavior in young adults (25 years old) with psychiatric conditions who were treated with an antidepressant.
If you have thoughts of harming or killing yourself, contact your doctor or go to hospital
It may be helpful to tell a relative or close friend that you are depressed or have an anxiety disorder, and ask them to read this leaflet. You can ask them to tell you if they think your depression or anxiety is getting worse, or if they are worried about changes in your behavior.
Some patients with manic-depressive illness may enter into a manic phase. It is characterized by unusual and rapidly changing ideas, inappropriate happiness and excessive physical activity. If you experience this, contact your baker.
Symptoms such as restlessness or difficulty sitting or standing in one place can also occur during the first weeks of treatment. Tell your doctor if you experience these symptoms.
Sometimes you might not realize the above symptoms and therefore may be helpful to ask a friend IME relative help in monitoring for possible events or changes in your behavior.
Tell your doctor immediately or go to the nearest hospital, if during treatment have disturbing thoughts or conditions or are experiencing any of the above symptoms.
Children and adolescents under 18 years Esopreks should normally not be used for children and adolescents under 18 years. You should also know that patients under 18 have an increased risk of side effects such as suicide attempt, suicidal thoughts and hostility (predominantly aggression, oppositional behavior and anger) when they take this class of drugs. Despite this, your doctor may prescribe Esopreks for patients under 18 because he / she decides that this is in their best interest. If your doctor has prescribed Esopreks for a patient under 18 and you want to discuss this, please go back to your doctor. You should tell your doctor if you develop or worsen any of the above symptoms when patients under 18 are taking Esopreks. Furthermore, the long-term effects on safety Esopreks growth, maturation and cognitive development and behavior in this age group have not yet been demonstrated.
Taking other medicines
Tell your doctor if you are taking or have recently taken any other medicines, including medicines obtained without a prescription.
Inform your doctor if you are taking any of the following:
"Non-selective monoamine oxidase inhibitors (MAOI)" containing phenelzine, iproniazid, izokarboksa-wall niapamid and tranylcypromine as active ingredients. If you are taking any of these drugs, you have to wait 14 days before taking Esopreks. Once you stop taking Esopreks, you must wait seven days before taking any of these medicines.
"Reversible, selective MAO-A inhibitors, containing moclobemide (used to treat depression).
"Irreversible, selective MAO-B inhibitors containing sepezhipin (used to treat Parkinson's disease). They increase the risk of reactions nezhepani baking.
Lithium (used to treat manic-depressive disorder) and tryptophan.
dezimipramin and Imipramine (both izpopzvani to treat depression).
Sumatriptan and similar lekarstvai (used to treat migraine) and tramadol (used for severe pain). They increase the risk of side effects.
Cimetidine and omeprazole (used to treat hundred-Mashni ulcers), fluvoxamine (an antidepressant) and ticlopidine
(Used to reduce the risk of stroke). They can cause increased blood levels of Esopreks.
St. John's wort (hypericum perforatum) - a herbal remedy used for depression.
Atsetilsalitsipova acid and non-steroidal anti-inflammatory drugs (medicines used to relieve pain or blood thinners, etc. antikoagupanti).
Warfarin, dipyridamole, and phenprocoumon (medicines used to thin the blood, so antikoagupanti). Your doctor will probably check the coagulation time of your blood when starting and stopping treatment Esopreks to whether anticoagulant dose you take is still adequate
Mefloquine (used to treat malaria), bupropion (used to treat depression) and tramadol (used to treat severe pain) due to the potential risk of a lowered seizure threshold.
Neuroleptics (medicines to treat schizophrenia, psychosis) due to the possible risk of a lowered seizure threshold, and antidepressants.
flecainide, propafenone and metoprolol (used in cardiovascular diseases), desipramine, klomipra-min and nortriptyline (antidepressants) and resperidon, thio-ridazin and haloperidol (antipsychotics). You may need your doctor to adjust the dose Esopreks.
Esopreks can be taken with or without food (see section 3 "How to take Esopreks"). As with many other bakery, combining Eco-preks alcohol is not recommended, although it is not expected to interact with Esopreks alcohol.
Pregnancy and lactation
Tell your doctor if you are pregnant or plan to become pregnant. Esopreks Do not take if you are pregnant unless you have discussed the risks and potential benefits arising from this with your doctor. If you take Esopreks the last three months of your pregnancy, you should know that the newborn can be observed side effects: difficulty breathing, bluish skin, seizures, changes in body temperature, feeding difficulties, vomiting, low blood sugar, stiff or floppy muscles, vivid reflexes, tremor, jitteriness, irritability, lethargy, constant crying, somnolence and difficulty sleeping. If your baby has any symptoms there, please, contact your doctor immediately. If used during pregnancy, Esopreks under no circumstances should be stopped abruptly. Esopreks Do not take if you are breastfeeding, unless you have discussed the risks and potential benefits arising from this with your doctor.
Ask your doctor or pharmacist before taking any medicine.
Driving and operating machinery
It is not recommended to drive or operate machinery, until you know how you act Esopreks
HOW TO TAKE ESOPREKS
Always Esopreks exactly as your doctor has told you. If you're not sure, ask your doctor or pharmacist.
The usual recommended dose is 10 mg Esopreks as a single daily dose. The dose may be increased by your doctor to a maximum of 20 mg daily.
Esopreks starting dose is 5 mg as a single daily dose for the first week before increasing to 10 mg daily. The dose can be further increased by your doctor to a maximum of 20 mg daily.
Social Anxiety Disorder
The usual recommended dose is 10mg Esopreks as a single daily dose. Depending on how you respond to treatment with this medicine, or your doctor may reduce your dose to 5 mg daily or to increase it to a maximum of 20 mg daily
Obsessive Compulsive Disorder The usual recommended dose is 10 mg Esopreks as a single daily dose. The dose may be increased by your doctor to a maximum of 20 mg daily.
Elderly / aged 65 years /
The usual recommended starting dose is 5 mg Esopreks as a single daily dose.
Children and youth / under 18 /
Usually Esopreks should not be given to children and adolescents. For more information, please see section 2 "Before you take Esopreks."
Esopreks can be taken with or without food. Swallow the tablet whole with some water. Do not chew the tablets, because they have a bitter taste. If necessary, you can split the tablet by placing it on a flat surface with the score up. Then the tablet can be broken by pressing on both ends down and using both index.
Duration of treatment
It may take several weeks before you feel better. Continue to take Esopreks, even if it takes some time before you feel any improvement in your condition.
Do not change the dose of your medicine before you have talked about this with your doctor.
Continue to take Esopreks as long as prescribed by your doctor. If you stop treatment too early, symptoms may reappear. It is recommended that treatment be continued for at least 6 months after you feel better.
If you take more than the dose Esopreks
If you take more than the prescribed dose Esopreks, contact your doctor or the emergency department at your nearest hospital. Do this even if there are no signs of discomfort. Some of the symptoms of overdose could be dizziness, tremor, agitation (agitation), seizures (convulsions), coma, nausea, vomiting, change in heart rate, decreased blood pressure and change velektrolitno-salt balance. Take the container with you Esopreks when you go to the doctor or hospital.
Do not take a double dose to make up for a missed dose. If you forget to take a dose and you remember before you went to bed at night, take it immediately. The next day, continue treatment as usual. If you remember a missed dose at night or the next day, the dose and continue as usual.
If you stop taking Esopreks
Do not stop taking Esopreks until your doctor tells you to do so. When you complete the course of treatment is usually recommended dose Esopreks gradually reduced over several weeks. When you stop taking Esopreks especially if you do it abruptly, you may experience symptoms of withdrawal. They are common in discontinuation Esopreks. The risk is greater when Esopreks has been used for a long time or in high doses or when the dose was reduced too quickly. Most people find these symptoms are mild and go away within two weeks. In some patients, however, they may be severe in intensity or may be prolonged (2-3 months or more). If you get withdrawal symptoms when you cancel the taking Esopreks, please tell your lekar.Toy or she may ask you to resume taking the pills and stop them slower. Withdrawal symptoms include: feeling dizzy (instability or loss of balance), feeling id go baby and numbness, burning sensations and (less frequently) a sense of shock, including the head, sleep disturbances (vivid dreams, nightmares , inability to sleep), feeling anxious, headaches, nausea, sweating (including night sweats), feeling of restlessness or agitation, tremor (shaking), feeling confused or disorientated, emotional or irritable, diarrhea (loose stools), visual disturbances , fluttering or pounding heartbeat (palpitations).
If you have any further questions on the use of this product, ask your doctor or pharmacist.
POSSIBLE SIDE EFFECTS
Like all medicines, Esopreks can cause side effects, although not everybody gets them side effects usually disappear after a few weeks. Please remember that some of the effects may also be symptoms of your illness and therefore disappear when you start to improve.
Visit your doctor if during treatment any of the following side effects:
Uncommon (more than 1 per 1000 and less than 1 in 100 people):
Unusual bleeding, including gastrointestinal
Rare (more than 1 in 10,000 people and less than 1 in 1,000 people):
if you experience swelling of the skin, tongue, lips or face or have difficulty breathing or swallowing (allergic reaction), contact your doctor or hospital immediately.
If you have a fever, agitation, confusion, trembling and abrupt contractions of muscles that may be signs of a rare condition called serotonin syndrome. If you feel well, tell your doctor.
If you experience these side effects, you should immediately contact your doctor or go to hospital immediately:
Seizures (convulsions), see also section. Take special care with Esopreks "
yellowing of the skin and whites of the eyes are signs of liver dysfunction / hepatitis
In addition to the above, has been reported following side effects:
Very common (more than 1 in 10 people):
Feeling sick (nausea) Common (more than 1 100 employees and less than 1 in 10 people:
nasal congestion or nasal discharge (sinusitis)
increased or decreased appetite
anxiety, restlessness, abnormal dreams, difficulty sleeping, drowsiness, dizziness, yawning, tremors, skin pricking
diarrhea, constipation, vomiting, dry mouth
pain in muscles and joints (arthralgia and myalgia) sexual dysfunction (delayed ejaculation, problems with erection, decreased sexual desire, and women may have difficulty reaching orgasm)
Uncommon (more than 1 per 1000 and less than 1 in 100 people):
hives (urticaria), rash, itching (pruritus)
teeth grinding, agitation, nervousness, panic attack, confusion
disturbed sleep, altered taste, fainting (syncope)
dilated pupils (mydriasis), visual disturbances, ringing in the ears (tinnitus)
swelling of the hands or feet
bleeding from the nose
Rare (more than 1 in 10,000 people and less than 1 in 1,000 people):
aggression, depersonalization, hallucinations
Events related to suicide, see also "Take special care with Esopreks"
Some patients have reported (frequency not known):
Reduced levels of sodium in the blood (the symptoms are feeling sick and unwell with weak muscles or confused)
dizziness when standing due to low blood pressure (orthostatic hypotension)
abnormal liver function test (increased liver enzymes in the blood)
movement disorders (involuntary muscle contraction)
painful erections (priapism)
bleeding vtova including the skin and mucous membranes (ecchymosis) and low platelet count (thrombocytopenia)
swelling of skin or mucous membranes (angioedema)
increase the amount of urine output (neadevatna andidiuretichen hormone secretion - ADH)
leaking in women who do not breastfeed
Thoughts of harming yourself or committing suicide (cases of suicidal ideation and suicidal behaviors have been reported during treatment with escitalopram or early discontinuation. (See also tochka.Obarnete special care with Esopreks ")
In addition, some have a number of side effects that occur when drugs acting in a manner similar to that of escitalopram (the active ingredient in Esopreks). They are:
psychomotor restlessness (akataziya)
If any of the side effects gets serious, or you notice other effects not listed in this leaflet, please tell your doctor or pharmacist.
HOW TO STORE ESOPREKS
Keep out of reach of children.
This medicinal product does not require any special storage conditions.
Esopreks Do not use after the expiry date stated on the carton and label after "EXP". The expiry date refers to the last day of that month. Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help to protect the environment.