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Escipram 20 mg. 30 tablets

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WHAT IS Escipram  AND WHAT IS USED FOR?
Escitalopram contains escitalopram and is used to treat depression (major depressive episodes) and anxiety disorders (such as panic disorder with or without agoraphobia, which is afraid to be in areas where you may not receive relief, social anxiety disorder with people), obsessive-compulsive disorder (intrusive thoughts and intrusive actions).
Escitalopram belongs to a group of antidepressants called selective serotonin reuptake inhibitors (SSRIs). These drugs act on the serotonin system in the brain by increasing serotonin levels. The disorders of the serotonin system are considered an important factor in the development of depression and related diseases.

2. BEFORE YOU TAKE ECOTRIM
Do not take Escspar if:
• if you are allergic (hypersensitive) to escitalopram or any of the other ingredients of Escadram (see section 6 "Further information").
• if you are taking other medicines that belong to a group called MAOIs, including selegiline (used to treat Parkinson's disease), moclobamide (used to treat depression), and linezolid (an antibiotic).
• if you were born or have had an abnormal heart rhythm (ECG, cardiac function)
• if you are taking medicines for heart rhythm problems or who may have an effect on your heartbeat (see section 2 "Taking other medicines")

Take special care with Escipram 
Please tell your doctor if you have any other condition or illness because you may need to take it into consideration. In particular, tell your doctor:
• if you experience seizures for the first time in your life or you suffer from epilepsy and see seizure frequency, treatment with Escitalam should be discontinued (see also section 4, Possible side effects *).
• if you suffer from impaired hepatic or renal function. Your dose may need to be adjusted by your doctor.
• if you have diabetes. Escidental treatment can alter glycemic control. A dose adjustment of insulin and / or oral hypoglycaemic agents may be necessary.
• if you have a low level of sodium in the blood.
• if you have a tendency to easily bleed or bruise.
• if you are having electroconvulsive therapy.
• if you suffer from coronary heart disease.
• if you have or have had other heart problems or have recently had a heart attack.
• if you have a slow heartbeat and / or you are likely to have salt depletion in the body due to severe diarrhea and vomiting (illness) or diuretic use (drainage tablets).
• if you notice an accelerated or irregular heartbeat, weakness, collapse or dizziness in an upright position, this may be an abnormal heart rate indicator.

Please note
As with other medicines used to treat depression or related illness, improvement is not achieved immediately. It may be several weeks after initiating Escimpar treatment until you notice an improvement. Panic disorder usually takes 2-4 weeks to improve. At the start of treatment, some patients may have an increase in anxiety that resolves with continued treatment. For this reason, it is very important that you follow exactly the instructions of your doctor and do not stop the treatment or change the dose without consulting it.

Thoughts of suicide and worsening of your depressive or anxiety disorder
If you are depressed and / or have an anxiety disorder, you may sometimes have thoughts of being self-inflicted or suicidal. They can be tightened when you start taking antidepressants for the first time, because it takes a long time before they start to work, usually about two weeks, but sometimes longer.

You are more likely to think like this:
"If you had any thoughts of committing suicide or self-harm before
If you have any thoughts of self-harm or suicide, contact your doctor and go to the hospital immediately.
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 worry about changes in your behavior.
Some patients with a manic-depressive illness may enter a manic phase. It is characterized by unusual and rapidly changing ideas, inadequate joy and excessive physical activity. If you notice any of these, contact your doctor.
Symptoms such as restlessness or difficulty sitting or standing in a calm state may also occur during the first few weeks of treatment. If you notice such manifestations,
Escidram should not normally be used in children and adolescents under 18 years of age. In addition, you should be aware that there is an increased risk of side effects such as suicide attempts, suicidal thoughts and hostile behavior (mostly aggression, oppositional behavior and anger) in patients under 18 years of age when taking medicines from this group. However, your doctor may prescribe Escimpar to a patient under 18 because he / she thinks it is in their interest. If your doctor has prescribed Escimpar to a patient under the age of 18 and you want to discuss it, please go back to your doctor. You should tell it if any of the symptoms described above occurs or worsens when patients under 18 years of age take Escsparam. In addition, this age group has not been shown to be safe for long-term use of Escadram in terms of growth, maturation and cognitive and behavioral development.

Taking other medicines
Please tell your doctor if you are taking or have recently taken any other medicines, including medicines obtained without a prescription.
DO NOT TAKE ESOTHYRAM if you are taking any medicines you may have
some antibacterial agents (eg spafafloxacin, moxifloxapine, erythromycin iv, rifampicin, anti-malaria agents, especially halofantrine), some antihistamines (astemizole, mizolastine). If you have further questions, talk to your doctor.

Tell your doctor if you are taking any of the following medicines:
• "Nonselective Monoamine Oxidase Inhibitors (MAOIs)" containing phenelzine, ipraniazide, isocarboxazide, nyalamide and tranylcypromine as active ingredients If you have taken any of these medicines, you will have to wait 14 days before taking Escidram. with Escracam should take 7 days before taking any of these medicines.
• "Reversible, selective MAO-A inhibitors" containing moclobemide (used to treat depression).
• "Irreversible MAO-B inhibitors" containing selegiline used to treat Parkinson's disease.) These medicines increase the risk of side effects.
• The antibiotic linezolid.
• Lithium (used to treat manic depressive disorders) and tryptophan.
Imipramine and desipramine (both used to treat depression).
• Sumatriptan and similar medicines (used to treat migraine) and tramadol (used in severe pain). These medicines increase the risk of side effects.
• Cimetidine and omeprazole (used to treat stomach ulcers), fluvoxamine (antidepressant) and ticlopidine (used to reduce the risk of stroke). These medicines can cause an increase in escipram blood levels.
• St John's wort (hypericum perforatum) - a herbal medicine used in depression.
• Acetylsalicylic acid and non-steroidal anti-inflammatory drugs (medicines to relieve pain or dilute blood, so-called anticoagulants). They may increase the tendency to bleed.
• Warfarin, dipyridamole and fenprocoumon (blood thinners, so-called anticoagulants). Your doctor will probably investigate the clotting time of your blood when starting and stopping treatment with Escidram to confirm that the dose of anticoagulant you are taking is still adequate.
• Mefloquine (used to treat malaria), bupropion (used to treat depression) and tramadol (used to treat severe pain) due to a potential risk of lowering the seizure threshold.
• Neuroleptics (medicines for the treatment of schizophrenia, psychoses) due to a potential risk of lowering the threshold for seizures and anticonvulsants.
• Flecannide, propafenone and metoprolol (used in cardiovascular diseases), desipramine, clomipramine and nortriptyline (antidepressants) and risperidone, thioridazine and haloperidol (antipsychotics). It may be necessary to adjust the dose of Escimpar.

Take Escipram  with food and drink
Escidram can be taken with or without food (see section 3 "How to take Escracam
As with many medicines, it is not recommended to combine Escitalopram with alcohol, although it is not expected to interact with escitalopram.
Pregnancy, breastfeeding and fertility
Tell your doctor if you are pregnant or planning to become pregnant. Do not take Escitalopram if you are pregnant unless you have discussed with your doctor the risks and benefits that result from this.
If you take Escitalopram during the last three months of pregnancy, you should be aware that the following side effects could be observed in the newborn baby: difficulty in breathing, bluish skin, seizures, changes in body temperature, feeding difficulties, vomiting, low blood sugar, stiffness or muscle relaxation, live reflexes, tremor, nervousness, irritability, lethargy, constant weeping, sleepiness and sleeping difficulties. If your baby has any of these symptoms, please contact your doctor immediately.
Ask your doctor or pharmacist for advice before taking any medicine.
Driving and using machines
It is not recommended to drive or use machines before you know how Escimpar works.

3. HOW TO TAKE Escipram?

Always take Escipram exactly as your doctor has told you. If you are not sure, ask your doctor or pharmacist.

Adults
Depression
The usual recommended dose of Escidram is 10 mg once a day. The dose may be increased by your doctor to a maximum of 20 mg per day.

Panic disorder
The initial dose of Escipram is 5 mg once a day in the first week, before increasing the dose to 10 mg daily. The dose can then be increased by your doctor up to a maximum of 20 mg per day.
Social anxiety disorder
The usual recommended dose of Escidram is 10 mg once a day. Your doctor may either reduce the dose to 5 mg a day or increase it to a maximum of 20 mg per day depending on your response.

Total anxiety disorder
The usual recommended dose of Escidram is 10 mg once a day. The dose may be increased by your doctor to a maximum of 20 mg per day.

Obsessive-compulsive disorder
The usual recommended dose of Escidram is 10 mg once a day. The dose may be increased by your doctor to a maximum of 20 mg per day.
The recommended dose of Escracam is 5 mg once a day. Your doctor may increase the dose to 10 mg daily.
Children and adolescents (under 18 years of age)
Escident should not normally be given to children and adolescents. For more information, please see section 2 "Before you take Escsparam".
You may take Escahram with or without food. Swallow the tablets with water. Do not chew them because they have a bitter taste.
If necessary, you can separate the tablets by first placing the tablet on a flat surface with the score line up. Then, the tablet may break by pressing both tabs and the bottom down with the two pointers.

Duration of treatment
It may take a few weeks before you feel better. Continue to take Escort, even if it takes some time before you feel any improvement in your condition.
Do not change the dose of your medicine before talking to your doctor.
Continue to take Escitalopram for as long as your doctor has recommended. If you discontinue your treatment too early, your symptoms may recur. It is recommended that treatment last for at least 6 months after you feel well again.

If you take more Escipram than you should
If you take more than the prescribed dose of Escitalopram, contact your doctor or your nearest Emergency Medical Service immediately. Do this even if you have no signs of discomfort. Some signs of overdosage may be dizziness, tremor, agitation, convulsions, coma, nausea, vomiting, changes in heart rhythm, decreased blood pressure and changes in the balance of body fluids / salts. Take the Escidental box / container with you when you go to the doctor or the hospital.

If you forget to take Escipram
Do not take a double dose to make up for the missed dose. If you forget to take a dose and think about it before you go to bed, take it immediately. The next day continue to take the medicine as usual. If you remember the missed dose overnight or the next day, do not take the missed dose and continue to take the medicine as usual.

If you stop taking Escipram
Do not stop taking Escitalopram until your doctor tells you to do so. When completing the course of treatment, it is usually advisable to gradually reduce the dose of Escidram over a period of several weeks.
When you stop taking Escitalopram, especially if it is sudden, you may experience withdrawal symptoms. These are common when stopping treatment with Escimpar. The risk of this is greater after prolonged use of Escadram or with too rapid dose reduction. Most people find these symptoms as mild and self-limiting within two weeks. However, in some patients, they may be severe or prolonged (2-3 months or more). If you have severe withdrawal symptoms after stopping Escadramine, please contact your doctor. He or she may ask you to start taking your tablets again and stopping them more slowly.
Symptoms of withdrawal include: feeling dizzy (instability or loss of balance), numbness and tingling of the limbs, burning sensations and (less often) electric shock including headaches, sleep disturbances (vivid dreams, nightmares, difficulty in sleeping), feeling of anxiety, headache, nausea, sweating (including night sweats), feeling nervous or excited, tremor (trembling), feeling confused and disorientated, increased emotion or irritability, diarrhea (rare stools) he broke th, unequal
If you get swollen skin, tongue, lips or face, or have difficulty in breathing or swallowing (allergic reaction), contact your doctor or go to hospital immediately.
• If you have high fever, agitation, confusion, trembling and sudden muscle contractions, these may be signs of a rare condition called a syndrome. If you feel so, contact your doctor.

If you experience the following side effects, you should contact your doctor immediately or go to hospital:
• Difficulty in urinating
• Seizures, see also Take special care with Escracam.
• Yellowing of the skin and whites of the eyes are signs of impaired hepatic function / hepatitis.
There is an increased risk of bone fractures in patients taking this type of medicinal product.

In addition to the above, the following side effects have been reported:
Very common (in more than 1 in 10 people):
• Nausea (nausea)

Common (more than 1 in 100 and less than 1 in 10 people):
• Clogged nose or nasal discharge (sinusitis)
• Decreased or increased appetite
• Anxiety, anxiety, abnormal dreams, difficulty falling asleep, feeling sleepy, dizziness, yawning, tremor, skin prickling
• Diarrhea, constipation, vomiting, dry mouth
• Increased sweating
• Pain in muscles and joints (arthralgia and myalgia)
• Sexual disturbances (delayed ejaculation, erection problems, decreased sexual desire, and women having difficulty reaching orgasm).
• Fatigue, fever
• Increased weight

Uncommon (more than 1 in 1,000 and less than 1 in 100 people):
• Hives (urticaria), rash, itching (pruritus)
• Gnashing, agitation, nervousness, panic attack, confusion
• Sleep disturbances, taste changes, seizures (syncope)
• enlarged pupils (mydriasis), visual disturbances, ringing in the ears (tinnitus)
• Hair loss
• Vaginal bleeding
• Weight loss
• Accelerated cardiac activity
• Swelling of the hands or feet
• Bleeding from the nose

Rare (more than 1 in 10,000 and less than 1 in 1,000 people):
• Aggression, loss of a sense of reality (depersonalisation), hallucinations
• Delayed heartbeat

Some patients have reported adverse reactions that can not be estimated from the available data:
• Decreased levels of sodium in the blood (symptoms are nausea and malaise with muscle weakness or confusion)
• Dizziness due to low blood pressure (orthostatic hypotension)
• Abnormal liver function test scores (increased levels of liver enzymes in the blood)
• Motoric disturbances (involuntary movements of the muscles)
• Painful erection (priapism)
• Bleeding disorders including skin and mucous membranes (ecchymosis) and low platelet counts (thrombocytopenia)
• Sudden swelling of the skin or mucous membranes (angioedema)
• Increased urine output (inadequate antidiuretic hormone secretion)
• Breast leakage in women who do not breast-feed
• Mania
• Changing heart rate (known as "QT prolongation that is established on ECG, electrical cardiac activity)
Cases of self-harm or suicide (cases of suicidal thoughts and suicidal behaviors) have been reported during treatment with escitalotram or early discontinuation of treatment. (See also section "Take special care with Escparam")
In addition, some side effects are known to occur with medicines that work in an escitalopram-like way (the active ingredient of Escrasam). They are:
• Motoric anxiety (akathisia)
• Anorexia
If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist.
HOW TO STORE Escipram?
Keep out of the reach and sight of children.
This medicinal product does not require any special storage conditions.
Do not use Escidra after the expiry date which is stated on the label or carton after EXP: The expiry date refers to the last day of the month in question Medicines should not be disposed of via wastewater or household waste containers Ask your pharmacist how to destroy your unnecessary medicines These measures will help protect the environment.

6. ADDITIONAL INFORMATION
What does Escipram contain?
The active substance is escitalopram. Each tablet of Escidram contains 10 mg or 20 mg of escitalopram (as oxalate).
The other ingredients are:
Core: microcrystalline cellulose (E460), croscarmellose sodium (E468), colloidal anhydrous silica, magnesium stearate (E470).
Wrap: hypromellose (E 464), titanium dioxide (E171) and macrogol 400. What Escipram looks like and contents of the pack
Escidram is available as 10 mg and 20 mg film-coated tablets. The tablets are described below
Escipram 10 mg were oval (approximately 8.1 x 5.6 mm), white, film-coated tablets scored on one side. The tablets may be divided into two equal halves.

Escipram 20 mg were oval (approximately I, 6 x 7.1 mm), white film-coated tablets scored on one side. The tablets may be divided into two equal halves.
Escidram is available in the following packs:
x 7,10, 14,15,20,28,30,49, 50, 56,60,84,90,98,100,500 tablets
Not all pack sizes may be marketed.

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