Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Cipralex (Escitalopram).
Abnormal heart rhythm: Cipralex (Escitalopram) may cause an abnormal heart rhythm, especially at higher doses. Your doctor may occasionally monitor your heart rate and rhythm with a test called an electrocardiogram. People with a history of a heart rhythm disturbance called QT prolongation should not take Cipralex (Escitalopram). If you have Congestive Heart Failure, have slow heart rhythm, are at risk of low potassium or magnesium levels because of certain illnesses or medications, or are taking certain medications that can affect the heart rhythm (e.g., Amiodarone, Sotalol), you should discuss with your doctor how Cipralex (Escitalopram) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Cipralex (Escitalopram), and whether any special monitoring is needed.
Bleeding disorders: Other medications from the same class as Cipralex (Escitalopram) may cause bleeding disorders. Report any unusual bruising or bleeding to your doctor, especially if you are taking medications that affect platelets (special blood cells that help the blood to clot). These medications include Asa, Clopidogrel, Dipyridamole, nonsteroidal anti-inflammatory drugs (NSAIDs; e.g., Ibuprofen or Naproxen), and certain antipsychotic medications.
Bone health: Studies have shown that there is an increased risk of bone fractures with the use of medications similar to Cipralex (Escitalopram). If you have Osteoporosis, or are at risk of developing osteoporosis, discuss with your doctor how Cipralex (Escitalopram) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Cipralex (Escitalopram), and whether any special monitoring is needed.
Diabetes: If you have diabetes, your doctor should closely monitor your condition while you are taking Cipralex (Escitalopram), as it may affect blood sugar control (either increase or decrease blood sugar levels).
Glaucoma: Cipralex (Escitalopram) may cause the symptoms of glaucoma (increased pressure in the eye) to become worse. If you have glaucoma, discuss with your doctor how Cipralex (Escitalopram) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Cipralex (Escitalopram), and whether any special monitoring is needed. Report any changes in vision to your doctor as soon as possible while you are taking Cipralex (Escitalopram).
Kidney function: If you have severely reduced kidney function, your doctor should closely monitor your condition while you are taking Cipralex (Escitalopram).
Liver function: Decreased liver function or liver disease may cause Cipralex (Escitalopram) to build up in the body, causing increased side effects. If you have reduced liver function, discuss with your doctor how Cipralex (Escitalopram) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Cipralex (Escitalopram), and whether any special monitoring is needed.
Mania: Cipralex (Escitalopram) may cause activation of mania. This means that people who are prone to mania may be more likely to have their mania start up again. If you have a history of mania or bipolar disorder, your doctor should closely monitor your condition while you are taking Cipralex (Escitalopram).
Neuroleptic malignant syndrome (NMS): Cipralex (Escitalopram), like other similar medications that act on serotonin, can cause a potentially fatal syndrome known as neuroleptic malignant syndrome (NMS). If you notice the symptoms of NMS such as high fever, muscle stiffness, confusion or loss of consciousness, sweating, racing or irregular heartbeat, or fainting, get immediate medical attention.
Seizures: If you have a history of seizures, your doctor should closely monitor your condition while you are taking Cipralex (Escitalopram). If you develop seizures, stop taking the medication and contact your doctor.
Serotonin syndrome: Severe reactions are possible when Cipralex (Escitalopram) is combined with other medications that act on serotonin, such as tricyclic antidepressants and "triptan" migraine medications. Symptoms of a reaction may include muscle rigidity and spasms, difficulty moving, changes in mental state including delirium and agitation. Coma and death are possible.
Stopping the medication: Cipralex (Escitalopram) should not be stopped abruptly due to the risk of discontinuation symptoms (dizziness, abnormal dreams, numbness, electric shock feelings, agitation, anxiety, difficulty concentrating, headache, tremor, nausea, vomiting, and sweating). A gradual reduction in dose over a period of time is recommended. If you are thinking of stopping the medication, talk to your doctor or pharmacist about how to do this safely.
Suicidal or agitated behaviour: Adults and children taking Cipralex (Escitalopram) may feel agitated (restless, anxious, aggressive, emotional, and feeling not like themselves), or they may want to hurt themselves or others. These symptoms may occur within several weeks after a person starts taking Cipralex (Escitalopram) or when doses are adjusted. People taking Cipralex (Escitalopram) should be closely monitored by their doctor for emotional and behavioural changes.
Pregnancy: The safe use of Cipralex (Escitalopram) during pregnancy has not been established. Newborn babies may experience serious adverse effects if the mother is taking citalopram during the 3 months before the baby is born. Doctors and pregnant women should carefully consider the benefits and the risks of all treatment options. If you become pregnant while taking Cipralex (Escitalopram), contact your doctor immediately.
Breast-feeding: It is known that the medication citalopram, which is similar to Cipralex (Escitalopram), passes into breast milk. If you are a breast-feeding mother and are taking Cipralex (Escitalopram), it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children and adolescents: The safety and efficacy of Cipralex (Escitalopram) for children and adolescents under 18 years of age have not been established. It may cause behavioural and emotional changes, such as suicidal thoughts and behaviour.
