Aciprex – composition, action, dosage, indications, contraindications and side effects

Proven content

Aciprex is a drug used in depression, anxiety disorders, as well as social phobia and obsessive-compulsive disorder. What does Aciprex contain? How should you take Lexaprim and in what doses? What is the treatment and is it long-term? What are the side effects of Lexaprim? When should you not take Lexaprim?

Aciprex – what kind of drug is it?

Aciprex is a medicine containing escitalopram. Aciprex is used to treat:

1. depression (major depressive episodes),
2. anxiety disorders such as panic attacks with or without agoraphobia (fear of going to places where you may not be able to get help)
3. social anxiety disorder (fear of dealing with people), generalized anxiety disorder and obsessive-compulsive disorder.

The active substance in this medicine, escitalopram, belongs to a group of antidepressants called selective serotonin reuptake inhibitors (SSRIs). These drugs affect the activity of the serotonergic system in the brain, increasing the levels of serotonin. The dysfunction of the serotonergic system is considered to be an important factor in the occurrence of depression and related disorders.

Aciprex – composition and action

As already mentioned above, the active ingredient of Lexaprim is escitalopram oxalate. The auxiliary substances are:

1. microcrystalline cellulose,
2. croscarmellose sodium,
3. colloidal anhydrous silica,
4. magnesium stearate.

Tablet coating:

white fallow Y-1-7000 with the following composition:

1. hypromeloza 6cP,
2. titanium dioxide (E 171),
3. macrogol 400.

Escitalopram is a selective serotonin (5-HT) reuptake inhibitor with high affinity for its primary binding site. It also binds to an allosteric site on the serotonin transporter, but its affinity is 1000 times lower.

Escitalopram has little or no affinity for many receptors, including 5-HT1A, 5-HT2, DA D1 and D2, α1, α2 and β adrenergic receptors, histamine H1, cholinergic muscarinic, benzodiazepine and opioid receptors. The inhibition of 5-HT reuptake is the only likely mechanism of action explaining the pharmacological and clinical effects of escitalopram.

See: Serotonin syndrome. Find out what it is, what its symptoms are and how is it treated?

Aciprex – dosage

The dose of Lexaprim depends on the disease / disorder it is used under:

Depression:

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

Panic Disorder (Panic attacks):

The starting dose of Lexaprim is 5 mg once a day for the first week of treatment. The dose is then increased to 10 mg daily. The dose may be further increased by your doctor, up to a maximum of 20 mg per day.

Social anxiety:

the usual recommended dose of Lexaprim is 10 mg once a day. Depending on the patient’s response to treatment, the doctor may reduce the dose to 5 mg per day or increase it to a maximum dose of 20 mg per day.

Generalized anxiety disorder:

the usual recommended dose of Lexaprim is 10 mg taken as one daily dose. The dose may be increased by your doctor to a maximum of 20 mg per day.

Obsessive Compulsive Disorder:

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

Elderly patients (over 65 years of age):

the recommended starting dose of Lexaprim is 5 mg once a day. The dose may be increased by your doctor to 10 mg per day.

Liver dysfunction:

people with hepatic impairment should not exceed the dose of 10 mg a day. The drug should be used according to the doctor’s instructions.

Poor metabolisers of drugs with the participation of the isoenzyme CYP2C19:

people with this known genotype should not exceed a dose of 10 mg per day. The drug should be used according to the doctor’s instructions.

See: Depression medications can reduce the risk of stroke

Aciprex – contraindications

Lexaprim should not be taken if you are allergic to escitalopram or any of the other ingredients of this medicine. In addition, Lexaprim should not be used if:

1. you are taking other medicines that belong to the group of monoamine oxidase inhibitors (MAOIs), including selegiline (used to treat Parkinson’s disease), moclobemide (used to treat depression) or linezolid (an antibiotic).
2. if you are born with or have had heart rhythm problems (found on ECG, a test to assess how your heart is working),
3. you are taking medicines used to treat abnormal heart rhythms or medicines that may affect the heart rhythm.

See: Heart arythmia. Experts answer patients’ questions

Aciprex – warnings and precautions

Talk to your doctor before using Lexaprim. Tell your doctor about any other medical conditions or illnesses as you may need to take them into account. In particular, tell your doctor:

1. if the person has epilepsy. If you have seizures for the first time or your seizures become more frequent, stop taking Lexaprim if you have liver or kidney problems. Your doctor may need to adjust your dosage
2. if you have diabetes. Taking Lexaprim may affect blood glucose control. It may be necessary to adjust the dosage of insulin and / or oral antidiabetics
3. if you suffer from low sodium levels in your blood,
4. if the patient is more prone to bleeding or bruising,
5. if you have a history of blood clotting disorders or if you are pregnant,
6. if the patient is treated with electroconvulsive therapy,
7. if you suffer from ischemic heart disease,
8. if you have or have had heart problems, or have had a recent heart attack,
9. if you have a low resting heart rate and / or know that you may be salt deficient as a result of prolonged acute diarrhea and vomiting or use diuretics (medicines that increase urine output),
10. if you have a fast or irregular heartbeat, weakness, fainting or dizziness when standing up, which may indicate an abnormal heartbeat
11. if you have or have had eye problems, such as certain types of glaucoma (increased pressure inside the eye).

It is very important that the person taking Lexaprim knows that, as with other medicines used to treat depression or related diseases, improvement does not occur immediately after treatment is started. It may take several weeks for you to use Lexaprim to feel better. In panic attacks, improvement usually takes 2-4 weeks of treatment.

At the beginning of treatment, some patients may experience an increase in anxiety, which will disappear if treatment is continued.. Therefore, you should strictly follow your doctor’s instructions and do not stop taking the medicine or change the dosage without consulting your doctor first.

Read: Depression in a senior. Characteristic symptoms of depression in the elderly

Aciprex – interactions with other drugs

Before taking Lexaprim, tell your doctor or pharmacist if you are taking any of the following medicines:

1. non-selective monoamine oxidase inhibitors (MAOIs), including phenelzine, iproniazid, isocarboxazid, nialamide, and tranylcypromine. If you take any of them, you must wait 14 days before taking Lexaprim. When you stop taking Lexaprim, you must wait 7 days before taking any of the listed medicines.
2. selective reversible MAO-A inhibitors, including moclobemide (a medicine to treat depression),
3. irreversible MAO-B inhibitors, including selegiline (a medicine to treat Parkinson’s disease). These drugs increase the risk of side effects.
4. linezolid (an antibiotic)
5. lithium (used to treat manic depression) and tryptophan,
6. imipramine and desipramine (antidepressants)
7. sumatriptan and similar medicines (used to treat migraine) and tramadol (used for severe pain). These drugs increase the risk of side effects.
8. cimetidine, lansoprazole and omeprazole (used to treat stomach ulcers),
9. fluconazole (a medicine to treat fungal infections), fluvoxamine (an antidepressant) and ticlopidine (used to reduce the risk of stroke). These drugs can increase the blood levels of Lexaprim.
10. St. John’s wort (Hypericum perforatum) – a herbal remedy with antidepressant properties,
11. acetylsalicylic acid and non-steroidal anti-inflammatory drugs (used as painkillers and to thin the blood, so-called anti-clotting drugs). These drugs may make you more likely to bleed,
12. warfarin, dipyridamole and phenprocoumon (medicines that thin the blood, i.e. anticoagulants). At the start and after stopping Lexaprim, your doctor will check the clotting time of your blood to see if the dose of the anticoagulant you are taking is still appropriate),
13. mefloquine (an antimalarial medicine), bupropion (an antidepressant) and tramadol (a medicine to treat severe pain) due to the risk of lowering the seizure threshold,
14. neuroleptics (drugs used to treat schizophrenia and psychosis) due to the risk of lowering the seizure threshold and antidepressants,
15. flecainide, propafenone, and metoprolol (used to treat cardiovascular disease), desipramine, clomipramine, and nortriptyline (antidepressants), and risperidone, thioridazine, and haloperidol (antipsychotics). If you are taking any of these medicines, the dosage of Lexaprim may need to be adjusted.
16. Medicines that lower the levels of potassium or magnesium in the blood increase the risk of life-threatening cardiac arrhythmias.

Read: Depression in children – causes, symptoms. How to help a child with depression?

Aciprex – pregnancy and breastfeeding

Lexaprim is not recommended during pregnancy and breastfeeding. Taking Lexaprim in the last three months of pregnancy may cause the following symptoms in the newborn baby: difficulty breathing, cyanosis, fits, fluctuations in body temperature, difficulty feeding, vomiting, low blood sugar, muscle stiffness or laxity, worsening of reflexes, tremor , shaking, nervousness, drowsiness, constant crying, sleepiness or difficulty falling asleep. If your newborn baby has any of these symptoms, please contact your doctor immediately.

Taking Lexaprim during pregnancy, especially in the last three months, may increase the risk of developing a serious disorder in the baby, the so-called persistent pulmonary hypertension in newborns (PPHN) as manifested by rapid breathing and a bluish color of the skin of the newborn. These symptoms usually begin during the first 24 hours after the baby is born.

Taking Lexaprim near the end of pregnancy may increase the risk of serious vaginal bleeding shortly after birth, especially if the pregnant woman has a history of blood clotting disorders.

Aciprex – side effects

Lexaprim can cause certain side effects. There are side effects that are very common, common, uncommon and rare. Here are the side effects of Lexaprim that occur:

very common (may affect more than 1 in 10 people):

1. nausea,
2. headaches.

common (may affect up to 1 in 10 people):

1. Blocked or runny nose (sinusitis)
2. increase or decrease in appetite,
3. anxiety, restlessness (especially with movement), abnormal dreams, difficulty falling asleep, sleepiness, dizziness, yawning, tremors, tingling,
4. diarrhea, constipation, vomiting, dry mouth
5. excessive sweating
6. joint and muscle pain,
7. sexual problems (delayed ejaculation, erectile dysfunction, decreased sex drive, difficulty achieving orgasm in women),
8. fatigue, fever
9. weight gain.

uncommon (may affect up to 1 in 100 people):

1. hives, skin rash, itching
2. teeth grinding, agitation, nervousness, panic attacks, confusion states,
3. sleep disturbance, taste disturbance, fainting
4. pupil dilation, visual disturbance, tinnitus
5. hair loss,
6. heavy menstrual bleeding,
7. irregular menstruation
8. weight loss
9. increased heart rate
10. swelling of the arms and legs
11. epistaxis.

rare (may affect up to 1 in 1000 people):

1. aggression, depersonalization (feeling of losing one’s own identity), hallucinations,
2. slow heart rate.

Aciprex – overdose

Taking more Lexaprim than recommended may cause negative health consequences. The most common symptoms of an overdose of Lexaprim may include symptoms such as:

1. central nervous system (from dizziness, tremors and agitation to rare cases of serotonin syndrome, seizures and coma),
2. gastrointestinal tract (nausea and / or vomiting),
3. cardiovascular system (hypotension, tachycardia, QT prolongation and arrhythmia),
4. electrolyte and / or water disturbances (hypokalaemia, hyponatraemia).