Escitalopram Oxalate (Lexapro)

Active Ingredients: escitalopram oxalate

Common Brand Name Lexapro, Cipralex

Buying Escitalopram (generic Lexapro) Without Prescription

Manufacturer: Micro Labs

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• Payment methods: VISA
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• Delivery: Registered Air Mail, and delivery can take anywhere between 8 and 15 business days.

Medical uses:
Escitalopram Oxalate (Lexapro) is an anti-depressant prescription medication from the family of drugs known as selective serotonin reuptake inhibitors or SSRIs. This medication is indicated for the treatment of:

• Generalized Anxiety Disorder
• Major Depressive Disorder

Escitalopram Dosage:

• Generalized Anxiety Disorder: Initial: 10 mg/day; dose may be increased to 20 mg/day after at least 1 week.
• Major Depressive Disorder: Initial: 10 mg/day; dose may be increased to 20 mg/day after at least 1 week. However, 20 mg has not shown a clinical benefit over 10mg.
• Elderly/Hepatic Function Impairment Adults: 10 mg/day. Bioavailability and half-life are increased by 50% in the elderly.

Side effects:
Escitalopram is well tolerated by most people. Because it relieves depression by increasing serotonin levels with minimal effect on many of the other chemicals in the brain, it may cause relatively few and mild side effects, which generally tend to go away with continued treatment and they usually do not cause patients to stop taking Escitalopram. The most frequent side effects are:

• Gastrointestinal: nausea (18%); diarrhea (14%); dry mouth (9%); constipation, indigestion (6%); vomiting (3%); abdominal pain, flatulence, toothache (2%); abdominal cramp, gastroenteritis, heartburn; GI hemorrhage, pancreatitis (postmarketing).
• Central & Peripheral Nervous System: headache (24%); insomnia (14%); somnolence (13%); decreased libido, dizziness (7%); abnormal dreaming, decreased appetite, lethargy (3%); paresthesia (2%); yawning (2%); impaired concentration, increased appetite, irritability, light-headedness, migraine (1%); abnormal gait, aggression, akathisia, anger, choreoathetosis, delirium, delusion, dysarthria, dyskinesia, dystonia, extrapyramidal disorder, generalized tonic-clonic seizures, hypoesthesia, nightmare, nystagmus, paranoia, seizures, tardive dyskinesia, visual hallucinations (postmarketing).
• Musculoskeletal: neck/shoulder pain (3%); arthralgia, limb pain, myalgia (1%); myoclonus, rhabdomyolysis.
• Urogenital: ejaculation disorder (14%); anorgasmia (6%); impotence (3%); menstrual disorder (2%); menstrual cramps, menstrual disorder, urinary frequency, UTI (1%); acute renal failure, priapism, spontaneous abortion.
• Respiratory System: rhinitis (5%); sinusitis (3%); bronchitis, coughing, sinus congestion, sinus headache (1%).
• General: fatigue (8%); influenza-like symptoms (5%); increased sweating (4%); allergy, chest pain, fever, hot flushes; neuroleptic malignant syndrome, photosensitivity, serotonin syndrome.
• Cardiovascular: hypertension, palpitation (1%); atrial fibrillation, hypotension, orthostatic hypotension, QT prolongation, thrombosis, torsades de pointes, ventricular arrhythmia, ventricular tachycardia.
• Dermatologic: rash (at least 1%); erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis.
• Hepatic: fulminant hepatitis, hepatic failure, hepatic necrosis, hepatitis.
• Hypersensitivity: allergic reaction, angioedema.
• Metabolic and Nutritional: increased weight; decreased weight, hyperglycemia, thirst, bilirubin increased, hepatic enzymes increased, gout, hypercholesterolemia.

Contraindications

• Concurrent use of MAOIs or within 14 days of discontinuing MAOI treatment
• Coadministration of pimozide
• Hypersensitivity to escitalopram or citalopram

Precautions:

• May activate hypomania or mania.
• Use with caution in patients with history of seizures.
• Withdrawal: Do not stop taking Escitalopram without consulting with your doctor about gradual tapering off. If you suddenly stop taking the drug, you may experience withdrawal symptoms.

Drug interations:

It is important to tell you doctor about all prescription and non-prescription (over-the-counter) medications you are taking. Escitalopram can interact with:

• 5-HT 1 agonists (triptans): Risk of serotonin syndrome may be increased.
• Alcohol: May potentiate the effects of alcohol; use of alcohol is not recommended.
• Aspirin, NSAIDs (eg, ibuprofen), warfarin: Risk of bleeding may be increased.
• Carbamazepine: Consider possibility of decreased escitalopram serum concentrations and reduced efficacy.
• Cimetidine: Serum levels may be increased by cimetidine.
• CNS drugs: Use with caution.
• Cyproheptadine: May decrease the pharmacologic effect of escitalopram.
• Drugs metabolized by CYP2D6: Use with caution.
• Ketoconazole: Plasma concentrations may be reduced by escitalopram, decreasing therapeutic effect of ketoconazole.
• Linezolid, St. John's wort: Serotonin syndrome may occur.
• Lithium: Serotonergic effects of escitalopram may be enhanced; use with caution.
• MAOIs: Do not use in patients receiving MAOI therapy or within 14 days of stopping treatment.
• Metoprolol: Serum levels may be increased by escitalopram.
• Pimozide: Concurrent use is contraindicated with escitalopram.
• Sibutramine: May increase the risk of serotonin syndrome with SSRIs.
• Tramadol: Concurrent use with tramadol may cause serotonin syndrom.

Pregnancy and Lactation:
Pregnancy Risk Factor C.
Teratogenic effects have been reported in animal studies. Nonteratogenic effects including respiratory distress, cyanosis, apnea, seizures, temperature instability, feeding difficulty, vomiting, hypoglycemia, hypo- or hypertonia, hyper-reflexia, jitteriness, irritability, constant crying, and tremor have been reported in the neonate immediately following delivery after exposure late in the third trimester. Exposure to SSRIs late in pregnancy has also been associated with persistent pulmonary hypertension of the newborn (PPHN). Adverse effects may be due to toxic effects of SSRI or drug discontinuation. In some cases, effects may present clinically as serotonin syndrome. There are no adequate and well-controlled studies in pregnant women. Use during pregnancy only if the potential benefit to the mother outweighs the possible risk to the fetus. If treatment during pregnancy is required, consider tapering therapy during the third trimester.

Lactation
Enters breast milk/not recommended.

Overdose:
If overdose is suspected, contact your local poison control center or emergency room immediately. Symptoms of overdose include: coma, dizziness, ECG changes (including QTc prolongation and very rare cases of torsades de pointes), hypotension, insomnia, nausea, seizures, sinus tachycardia, somnolence, vomiting.

Missed dose:
Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Price:
If you would like to buy generic Lexapro (Escitalopram) with no prescription, choose the offer from the above table.

Storage:
Keep out of the reach of children. Store away from heat and direct light. Do not store the capsule or tablet form of this medicine in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down. Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

References:

• 1. U.S. Food and Drug Administration. Escitalopram (Lexapro) U.S. Prescribing Information. (PDF format)