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ESSOBEL 20 mg. 28 tablets

Brand: NOBEL
Product Code: ESSOBEL 20 mg. 28 tablets
Availability: In Stock
Product viewed: 950

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What is ESOBEL and what to use
ESOBEL contains the active ingredient escitalopram and is used to treat depression (major depression) and anxiety disorders (e.g., panic disorder with or without agoraphobia, social anxiety disorder, generalized anxiety disorder and obsessive-compulsive disorder).
Escitalopram belongs to a group of antidepressants, known as Selective inhibitors of reverse down of serotonin. These drugs Act on the serotoninovata system in the brain by increasing the level of serotonin. Distortions in the serotoninovata system is considered to be an important factor in the development of depression and related illnesses.

2. What you need to know before you take ESOBEL
Do not take ESOBEL:
If you are allergic to escitalopram or any of the other ingredients of this medication listed in point 6;
If you take other drugs that belong to the group called monoamine oxidase inhibitors (MAOIs), including selegilin (used to treat Parkinson's disease), moklobemid (used in the treatment of depression) and linezolid (an antibiotic);
If you have prolonged QT-interval, including congenital syndrome, extended QT-interval;
If you are taking other medications that lead to prolongation of QT-interval. If you are not sure, ask your doctor or pharmacist.
Take special care with ESOBEL:
Consult your doctor if you are suffering from any other condition or illness since your doctor may decide to take this into account.
In particular, inform your doctor:
If you have epilepsy. Treatment should be discontinued if the first seizures occur or increase the frequency of seizures (see also point 4 "possible side effects");
If you are suffering from a disease of the liver or kidney. Your doctor may consider that it is necessary to adjust your dose;
If you suffer from diabetes. Treatment with ESOBEL can affect glycemic control. You may need to adapt the dosage of insulin or oral antidiabetic and/or drugs;
If you have reduced sodium levels in the blood;
If you have a tendency toward easy bruising or bleeding;
If you are undergoing electroconvulsive therapy;
If you suffer from coronary heart disease;
If during the treatment with escitalopram experience symptoms suggestive of impaired heart rate, such as discomfort in the chest, dizziness or fainting, you should consult your doctor immediately.
Note
Like other drugs used to treat depression and related disorders, improvement in the situation is not achieved immediately. After initiation of treatment with ESOBEL may take several weeks before you feel better. At the beginning of treatment may feel heightened anxiety that will pass in the course of treatment. For this reason, it is particularly important to follow your doctor's advice and not to interrupt the treatment, or change the dosage without being consulted with him.
Sometimes the symptoms of depression or panic disorder may include thoughts of suicide or self-harm. It is possible that these symptoms continue or get worse, while the full has a certain antidepressive effect of the drug does not become obvious. This is more characteristic of younger (under 30) people who did not use antidepressants.
In some patients with manijno-depressive illness can manifest itself manijnata phase. It is characterized by abnormal and rapidly changing ideas, for no good reason happiness and excessive physical activity. If you experience this, contact your doctor.
Symptoms such as anxiety or difficulty to stay in one place may also occur during the first weeks of treatment. Check with your doctor as soon as you manifest these symptoms.
It is possible to you to decide if you have the above symptoms, so ask a friend or relative to help you monitor the occurrence of similar signs of change in your behavior.
Consult your doctor immediately or go to the nearest hospital, if you appear mournful thoughts or feeling, or some of the above symptoms occur during treatment.

Thoughts of suicide and worsening of your depression or anxiety disorder
If you are depressed and/or have an anxiety disorder, can sometimes have thoughts of self-harm or suicide. These thoughts can be enhanced when, for the first time taking antidepressants, since all these drugs take time to take effect-usually about two weeks but sometimes longer.

You may be more predisposed to think in this way:
If you have thoughts of suicide or self-injury;
If you are a young person. Data from clinical studies suggest an increased risk of suicide-related behavior in people under the age of 25 with mental illnesses that are treated with an antidepressant.
Thoughts of suicide and worsening of your depression or anxiety disorder
If you are depressed and/or have an anxiety disorder, can sometimes have thoughts of self-harm or suicide. These thoughts can be enhanced when, for the first time taking antidepressants, since all these drugs take time to take effect-usually about two weeks but sometimes longer.

You may be more predisposed to think in this way:
If you have thoughts of suicide or self-injury;
If you are a young person. Data from clinical studies suggest an increased risk of suicide-related behavior in people under the age of 25 with mental illnesses that are treated with an antidepressant.
If at any time you experience thoughts of self-harm or suicide, contact your doctor or go to hospital immediately.

May decide that it is useful to share with the family or a 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 are worried about changes in your behavior.

Use in children and adolescents under 18 years of age
ESOBEL is not recommended for use in children and adolescents under 18 years of age. Patients under 18 years of age have a higher risk of side effects such as suicide attempts, suicidal thoughts and hostility (mostly aggression, oppositional behavior and anger) when using this class of drugs. However, your doctor may prescribe ESOBEL for patients under 18 years of age, if it considers that it is in their interest. If your doctor has prescribed him ESOBEL of a patient under the age of 18 and wish to discuss it, visit your doctor and check again. Inform your doctor if any of the above symptoms occur or worsen in patients under 18 years of age, who accept ESOBEL. There is no data on the safety of growth, maturation, cognitive and behavioral development in long-term use of escitalopram in this age group.

Other drugs and ESOBEL
Inform your doctor or pharmacist if you are taking, you have recently taken or may take other medications.

Consult your doctor if you are taking any of the following medicines:
Non-selective monoamine oxidase inhibitors (MAO inhibitors), containing phenelzine, iproniazid, izokarkoksazid, nialamid and tranylcypromine as active substances. If you have taken any of these drugs, you don't have to wait 14 days before you start taking ESOBEL. After stopping the use of ESOBEL you have to wait 7 days before taking any of these medicines;
Reversible selective Mao-a inhibitors containing moklobemid (medicine for the treatment of depression);
Irreversible MAO-inhibitors containing selegilin (medicine for the treatment of Parkinson's disease). Their use increases the risk of side effects;
The antibiotic linezolid;
Lithium (a medicine for the treatment of manijno-polar) and tryptophan;
Imipramine and dezipramin (medicine for treating depression);
Sumatriptan and similar drugs (for the treatment of migraine) and tramadol (used in severe pain). Their use increases the risk of side effects;
IV, and omeprazole (drugs for the treatment of gastric ulcer), fluvoxamine (antidepressant) and tiklopidin (medication to lower the risk of stroke). Their use can increase the level of ESOBEL in the blood;
St. John's wort (Hypericum perforatum)-fitopreparat used for depression;
Aspirin and non-steroidal anti-inflammatory drugs (medications to relieve pain or to thin the blood, so called anticoagulants). These drugs may increase the propensity to bleeding;
Warfarin, dipyridamole and fenprokumon (medicines used against blood clotting, so called anticoagulants). Your doctor will probably check your time of coagulation at the start and during the intake of ESOBEL to check whether Your dose of anticoagulant appointees is still appropriate;
Meflohin (used for the treatment of malaria), bupropion (drug for depression) and tramadol (pain treatment), because of the risk of lowering the threshold g″rčoviâ;
Neuroleptics (drugs to treat schizophrenia, psychosis), because of the risk of lowering the threshold g″rčoviâ and antidepressants;
Flecainide, propafenone and metoprolol (used in cardiovascular diseases); Clomipramine and nortriptyline (antidepressants) and risperidone, haloperidol and tioridazin (antipsychotics). It may be necessary for the determination of ESOBEL to be adapted.
ESOBEL with food and drinks
ESOBEL can be taken with or without food (see section "how to take ESOBEL").
As with many other medications, combining ESOBEL with alcohol should be avoided, although ESOBEL is not expected to interact with alcohol.
Pregnancy and lactation
If you are pregnant or breastfeeding, you think you may be pregnant or planning pregnancy, ask your doctor or pharmacist before taking this medication.
In the event that you are pregnant or nursing, do not take ESOBEL unless you have discussed this in advance with your doctor the risks and benefits of treatment.
If you take ESOBEL during the last 3 months of your pregnancy, it is necessary to know that your newborn baby can show the following symptoms: difficulty in breathing, bluish skin, seizures, changes in body temperature, feeding difficulties, vomiting, low blood sugar, stiff or relaxed muscles, bright reflexes, tremors, timidity, lethargy, razdraznimost, constant crying, inability to sleep or difficulty falling asleep. If your newborn baby have any of the listed symptoms, please notify your doctor immediately.
Make sure your midwife and/or doctor know that you are taking ESOBEL. When taken during pregnancy, especially during the last 3 months of pregnancy, similar to ESOBEL drugs could increase the risk of occurrence of a serious condition in babies, called persistentna pulmonary hypertension in newborns (PPHN), in which the baby breathe rapidly and turning blue. These symptoms usually begin within the first 24 hours after the baby is born. If this happens to your baby, you should immediately contact your midwife and/or GP.
If you use ESOBEL during pregnancy, preustanovâvajte never use suddenly.
Ask your doctor or pharmacist before using any medicine.

Driving and operating machinery
It is recommended that you do not drive or operate machinery until you determine how this affects the use of ESOBEL.

Important information about some of the ingredients of ESOBEL
This medicinal product contains lactose. If your doctor has told you that you have an intolerance to some sugars, ask him, before taking this product.

3. How to take ESOBEL
Always take this medicine exactly as your doctor has told you. If you are unsure of something, ask your doctor or pharmacist.

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

Panic disorder
The starting dose is 5 mg once daily during the first week of treatment, then increased to 10 mg daily. The dose may be increased by your doctor to a maximum of 20 mg daily.

Social anxiety disorder
Normally recommended dose is 10 mg ESOBEL once a day. Depending on your response to the medication, your doctor may reduce the dose or your 5 mg daily or to increase it up to a maximum of 20 mg per day.

Generalized anxiety disorder
Normally recommended dose is 10 mg ESOBEL once a day. The dose may be increased by your doctor to 20 mg daily.

Obsessive compulsive disorder
Normally recommended dose is 10 mg ESOBEL once a day. The dose may be increased by your doctor to a maximum of 20 mg daily.

Patients in old age (over 65 years old)
Normally the recommended starting dose is 5 mg ESOBEL once a day. The dose may be increased by your doctor to a maximum of 10 mg daily.

Children and adolescents (under 18 years of age)
ESOBEL generally should not be given to children and adolescents. For more information, please see point 2 "what you need to know before you take ESOBEL".
Can you take ESOBEL with or without food. Pregl″ŝajte tablets with a drink of water. Do not chew the tablets, as they taste bitter.
If necessary, you can separate the Tablet by first place it on a flat surface with the separating feature pointing upwards. Then the tablet can be broken by pressing down each of the edges with her index fingers.

Duration of treatment
It may take several weeks before you begin to feel better. Continue to take ESOBEL even to take some time before you feel an improvement in your condition.
Do not change the dose of Your own medicine without you have consulted with your doctor.
Continue to take ESOBEL so long as you recommend your doctor. If you stop using too soon, your symptoms may resume. It is recommended that intake of ESOBEL to last for at least 6 months after you have already felt good.
If you forget to take the tablets ESOBEL
Do not take a double dose to make up for the missed dose.
If you forget to take a dose and remember before you go to bed, take it immediately. The next day continue as usual. If you are remembered during the night or the next day, skip the forgotten dose and then continue as normal.

If you stop taking the ESOBEL
Do not stop the use of ESOBEL, as long as your doctor tells you to do so. When you have finished Your course of treatment, dosage ESOBEL is recommended to be reduced gradually in a few weeks.
When you stop taking the ESOBEL and especially if you do it suddenly, you can show withdrawal symptoms. These are common symptoms that occur with cessation of treatment with ESOBEL. The risk is higher when the ESOBEL is used for a long time or in high doses, or when the dose is reduced too quickly. Most people find that symptoms are mild and resolve within two weeks. However, in some patients they may be severe as intensity or continue longer (2-3 months or more). If you experience severe withdrawal symptoms after stopping the intake of ESOBEL, please contact your doctor. He/she may advise you to start taking ESOBEL again and to discontinue accepting slower.
Symptoms of withdrawal include: lightheadedness (instability or imbalances), needles, burning sensation and (more rare) feeling of electric shock, including in the head, sleep disorder (vivid dreams, nightmares, lack of sleep), anxiety, headache, nausea, sweating (including night sweats), anxiety, tremor, confusion or disorientation, increased emotionality or irritability, diarrhea (rare shit), visual disturbances, wobbly or heavy heartbeat (palpitations).
If you have any further questions related to the use of this medicine, ask your doctor or pharmacist.

4. Possible side effects
Like all drugs, this medication can cause side effects, although not everybody gets them.
Adverse reactions usually resolve after several weeks of treatment. You should know that many of the effects may also be symptoms of your illness and will be improved in the course of treatment.

The side effects are evaluated depending on the frequency with which they occur. To this end, the following categories are used for frequency of side effects:
Frequent: side effects that may occur in less than 1 person in 10;
Uncommon: adverse reactions that may occur in less than one of 100 patient;
Rare: adverse reactions that may occur in less than one in 1,000 patients;
Very rare: adverse reactions that may occur in less than 1 person per 10,000 patient;
Isolated cases: adverse reactions that may occur in an even smaller number of patients.
Visit your doctor if during the treatment you receive any of the following side effects:
Uncommon:
Abnormal bleeding, including bleeding gastrointestinalno;
Rare:
Swelling of the skin, lips, tongue or face, or you have trouble breathing or swallowing (an allergic reaction). In these cases, immediately contact your doctor or go to the nearest hospital;
High temperature, agitation, confusion, tremors and sudden contraction of muscles. This could be symptoms of the rare serotonin syndrome. If you feel so, contact your doctor.
If you experience any of the following side effects, contact your doctor or go to the nearest hospital:
Difficulty in urination;
Seizures (seizures, convulsions), see also the section "take special care with ESOBEL";
Yellowing of the skin and whites of the eyes are symptoms of impairment of liver function/hepatitis;
Signs or symptoms of abnormal heart rate or rhythm.
In addition to the above mentioned side-effects were reported the following cases:
Very common:
Nausea.
Frequent:
Stuffy or runny nose (sinusitis);
Decreased or increased appetite;
Anxiety, restlessness, unusual dreams, trouble sleeping, dizziness, drowsiness, yawning, trembling, nastr″hvane of the skin;
Diarrhea, constipation, vomiting, dry mouth;
Increased sweating;
Muscle aches and pains (myalgia and arthralgia);
Sexual offences (delayed ejaculation, erection problems, low sex drive and difficulty reaching orgasm in women);
Exhaustion, high temperature;
Increased weight.
Uncommon:
Urticaria, rash, itching;
Teeth grinding, agitation, nervousness, panic, confusion;
Sleep disorder, taste disturbances, fainting;
Dilated pupils (Mydriasis), visual disturbances, ringing in the ears (Tinnitus);
Balding;
Vaginal bleeding;
Reduced weight;
Increased heart rate;
Sweating of the hands or feet;
Bleeding from the nose.
Rare:
Aggression

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