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These brands contain the same active ingredient (Escitalopram Oxalate). Same strength and form. Confirm the switch with your doctor or pharmacist.
More from Epram
Other strengths and forms by Albion Laboratories Ltd.
Indications & Uses
Epram is indicated for:
Pharmacology
Escitalopram is a selective serotonin reuptake inhibitor (SSRI) that you take by mouth. It is the pure S-enantiomer of citalopram, a racemic bicyclic phthalate derivative. Against the R-enantiomer, escitalopram is at least 100 fold more potent at blocking the reuptake of 5-HT. It has no affinity, or only very low affinity, for serotonergic or other receptors, including alpha- and beta-adrenergic, Dopamine, Histamine, Muscarinic and benzodiazepine receptors.
Dosage Reference
Reference Information Only
Dosages shown are general references from official sources. Always consult your doctor or pharmacist for personalized dosing.
Adults:
Dosage safety: daily doses above 20 mg have not been shown to be safe. Escitalopram Oxalate is given as a single daily dose, and you can take it with or without food.
Major depressive episodes: The usual dose is 10 mg once daily. Depending on how the patient responds, the doctor may increase it to a maximum of 20 mg daily. It usually takes 2 to 4 weeks to get an antidepressant response. Once the symptoms have settled, treatment is needed for at least 6 months to consolidate the response.
Panic disorder with or without agoraphobia: Start with 5 mg for the first week, then increase to 10 mg daily. The dose can be raised further, up to a maximum of 20 mg daily, depending on the patient's response. Maximum effectiveness comes after about 3 months. Treatment lasts several months.
Social anxiety disorder: The usual dose is 10 mg once daily. Symptom relief usually takes 2 to 4 weeks. After that, depending on the patient's response, the dose may be lowered to 5 mg or raised to a maximum of 20 mg daily. Social anxiety disorder is a disease with a chronic course, and 12 weeks of treatment is recommended to consolidate the response. Long-term treatment of responders has been studied for 6 months and can be considered case by case to prevent relapse. The benefits of treatment should be re-evaluated at regular intervals. Social anxiety disorder is a well-defined diagnosis for a specific disorder, and it should not be confused with excessive shyness. Medicine is indicated only if the disorder interferes significantly with professional and social activities. The place of this treatment compared to cognitive behavioural therapy has not been assessed. Pharmacotherapy is part of an overall therapeutic strategy.
Generalised anxiety disorder: The initial dose is 10 mg once daily. Depending on the patient's response, it may be increased to a maximum of 20 mg daily. Long-term treatment of responders has been studied for at least 6 months in patients taking 20 mg/day. The benefits of treatment and the dose should be re-evaluated at regular intervals.
Obsessive-Compulsive Disorder: The initial dose is 10 mg once daily. Depending on the patient's response, it may be increased to a maximum of 20 mg daily. OCD is a chronic disease, so patients should be treated for long enough to make sure they are symptom-free. The benefits of treatment and the dose should be re-evaluated at regular intervals.
Side Effects
Escitalopram oxalate belongs to the SSRIs, which are less sedating than tricyclic antidepressants and have fewer antimuscarinic and cardiotoxic effects. They still cause side-effects, though. Gastrointestinal effects are fairly common and depend on the dose. These include nausea, vomiting, dyspepsia, abdominal pain, diarrhoea and constipation. SSRIs can also cause anorexia with weight loss, and increased appetite and weight gain have been reported too. Hypersensitivity reactions can occur, including rash, urticaria, angioedema, anaphylaxis, arthralgia, myalgia and photosensitivity. Other side-effects of escitalopram and the SSRIs are dry mouth, nervousness, anxiety, headache, insomnia, tremor, dizziness, asthenia, hallucinations, drowsiness, convulsions, galactorrhoea, sexual dysfunction, urinary retention, sweating, hypomania or mania, movement disorders and dyskinesias, and visual disturbances.
Cautions & Contraindications
Warnings & Precautions
Escitalopram, like other SSRIs, should be used with caution in patients with epilepsy. It should be avoided if the epilepsy is poorly controlled, and stopped if convulsions develop. Care is also needed in patients having electroconvulsive therapy at the same time (prolonged seizures have been reported with fluoxetine). The same caution applies to patients with a history of mania, cardiac disease, diabetes mellitus or angle-closure glaucoma. It also applies to patients taking other drugs that increase the risk of bleeding, and to those with a history of bleeding disorders, especially gastrointestinal bleeding. Hepatic and renal impairment call for caution as well.
Contraindications
Escitalopram should not be given to anyone who is known to be allergic to escitalopram or citalopram, or to any of the inactive ingredients in the product. It also must not be used in patients who are taking a monoamine oxidase inhibitor or pimozide at the same time.
Pregnancy & Breastfeeding
If a pregnant woman is being treated with Escitalopram in the third trimester, the doctor should weigh the possible risks of treatment against the benefits. Escitalopram passes into human breast milk. So the decision to continue or stop either breastfeeding or Escitalopram therapy should take into account the risk of citalopram exposure for the infant and the benefits of Escitalopram treatment for the mother.
⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
Use in Special Populations
Elderly patients (over 65 years)
The starting dose of escitalopram is 5 mg once daily. Depending on how the patient responds, the dose may be raised to 10 mg daily. Escitalopram has not been studied for social anxiety disorder in elderly patients, so its efficacy there is not known.
Children and adolescents (under 18 years)
Escitalopram Oxalate should not be used to treat children and adolescents under 18 years of age.
Reduced renal function
No dose adjustment is needed in patients with mild or moderate renal impairment. In severely reduced renal function (CLCR less than 30 ml/min), caution is advised.
Reduced hepatic function
For mild or moderate hepatic impairment, a starting dose of 5 mg daily is recommended for the first two weeks of treatment. Depending on the individual response, the dose may then be increased to 10 mg daily. In severely reduced hepatic function, caution and extra careful dose titration are advised.
Poor metabolizers of CYP2C19
If a patient is known to be a poor metaboliser with respect to CYP2C19, the recommended starting dose is 5 mg daily during the first two weeks of treatment. Depending on the individual response, the dose may be increased to 10 mg daily.
Discontinuation symptoms
Symptoms can appear when treatment is stopped, so abrupt discontinuation should be avoided. When stopping escitalopram, the dose should be reduced gradually over at least one to two weeks to lower the risk of these symptoms. If intolerable symptoms occur after a dose decrease or when treatment is stopped, going back to the previously prescribed dose may be considered. The physician may then continue to decrease the dose, but at a slower rate.
Overdose
Symptoms: In reported overdoses of escitalopram, the symptoms mostly involve the central nervous system. These range from dizziness, tremor and agitation to rare cases of serotonin syndrome, convulsion and coma. The gastrointestinal system can be affected too (nausea/vomiting). So can the cardiovascular system (hypotension, tachycardia, QT interval prolongation and arrhythmia). Electrolyte and fluid balance problems (hypokalaemia, hyponatremia) have also been seen.
Management: There is no specific antidote. Establish and maintain an airway, and make sure oxygenation and respiratory function are adequate. Gastric lavage and activated charcoal should be considered. Gastric lavage should be done as soon as possible after oral ingestion. Cardiac and vital signs monitoring is recommended, along with general symptomatic supportive measures. ECG monitoring is advised in case of overdose, in patients with congestive heart failure or bradyarrhythmias, in patients using other medicines that prolong the QT interval, and in patients with altered metabolism, for example liver impairment.
⚠️ In an emergency call 999 or go to the nearest hospital emergency department.
Storage
Keep Escitalopram Oxalate below 30°C, and protect it from light and moisture. Always keep the medicine out of the reach of children.
Drug Interactions
Common questions about Epram 10 mg
What is Epram 10 mg Tablet?
Epram 10 mg Tablet is a medicine that contains Escitalopram Oxalate. It is made by Albion Laboratories Ltd. It belongs to the SSRIs & related anti-depressant drugs group of medicines.
What is Epram used for?
Epram is used for: Anxiety.
What are the side effects of Epram?
Escitalopram oxalate belongs to the SSRIs, which are less sedating than tricyclic antidepressants and have fewer antimuscarinic and cardiotoxic effects. They still cause side-effects, though.
Can I take Epram during pregnancy or while breastfeeding?
If a pregnant woman is being treated with Escitalopram in the third trimester, the doctor should weigh the possible risks of treatment against the benefits. Escitalopram passes into human breast milk. Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
What happens if I take too much Epram?
Symptoms: In reported overdoses of escitalopram, the symptoms mostly involve the central nervous system. These range from dizziness, tremor and agitation to rare cases of serotonin syndrome, convulsion and coma. In an emergency call 999 or go to the nearest hospital emergency department.
How should I store Epram?
Keep Escitalopram Oxalate below 30°C, and protect it from light and moisture. Always keep the medicine out of the reach of children.
Can I take other medicines with Epram?
Some medicines can interact with Escitalopram Oxalate, for example: Sertraline, Paroxetine, Fluoxetine. Tell your doctor or pharmacist about every medicine you take.
Is there a cheaper medicine with the same ingredient?
Seropam by Beximco Pharmaceuticals Ltd. has the same ingredient and strength for ৳8.00 per unit, compared with ৳10.00 for Epram. Ask your doctor or pharmacist before switching.
Do I need a prescription for Epram?
Epram is a prescription (Rx) medicine. Take it as your doctor advises.