Cipralex Meltz

The recommended dose is usually started at 10 mg daily, preferably at the same time each day. Cipralex Meltz (Escitalopram) should be taken once daily in the morning or evening, with or without food. The dose can be increased by your doctor as needed to a maximum of 20 mg daily. For seniors, people with liver problems, and people taking the medications Omeprazole or Cimetidine, the maximum recommended daily dose is 10 mg. In some cases, the doctor may recommend a 5 mg starting dose.

Regular tablets: The tablet should be swallowed whole (not chewed) with a glass of water.

Oral dispersible tablets: The tablet should be placed on the tongue. It will rapidly disintegrate and can be swallowed without water. The tablets break easily, so they should be handled carefully with dry hands.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take Cipralex Meltz (Escitalopram) exactly as prescribed by your doctor. If you miss a dose, skip the missed dose and continue on with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store Cipralex Meltz (Escitalopram) at room temperature, protect it from light and moisture, and keep it out of the reach of children. The oral dispersible tablets should be kept in their original package.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

In addition to its desired action, this medication may cause some adverse effects, notably: it may cause dryness of the mouth; it may cause diarrhea; it may cause dizziness - use caution when getting up from a lying or sitting position and use caution if driving; it may cause either drowsiness or excitability - use caution until you know how you will react; it may cause nausea or, rarely, vomiting. Each person may react differently to a treatment. If you think this medication may be causing adverse effects (including those described here, or others), talk to your health care professional. He or she can help you to determine whether or not the medication is the source of the problem.

Regular tablets

10 mg
Each film-coated, white, oval, scored tablet, marked with "EL" on one side, contains 10 mg of Cipralex Meltz (Escitalopram) (as Cipralex Meltz (Escitalopram) oxalate). Nonmedicinal ingredients: colloidal silicon dioxide, croscarmellose sodium, hydroxypropyl methylcellulose, magnesium stearate, microcrystalline cellulose, polyethylene glycol 400, talc, and titanium dioxide (white E-171).

20 mg
Each film-coated, white, oval, scored tablet, marked with "EN" on one side, contains 20 mg of Cipralex Meltz (Escitalopram) (as Cipralex Meltz (Escitalopram) oxalate). Nonmedicinal ingredients: colloidal silicon dioxide, croscarmellose sodium, hydroxypropyl methylcellulose, magnesium stearate, microcrystalline cellulose, polyethylene glycol 400, talc, and titanium dioxide (white E-171).

Do not take Cipralex Meltz (Escitalopram) if you:

• are allergic to Cipralex Meltz (Escitalopram), Citalopram, or any ingredients of the medication
• have a condition known as congenital long QT syndrome or have a heart rhythm disturbance called QT prolongation
• are taking the medication Pimozide
• have taken a MAO inhibitor medication (e.g., Phenelzine, Tranylcypromine, Moclobemide) in the past 2 weeks – MAO inhibitors should not be taken until at least 2 weeks after stopping treatment with Cipralex Meltz (Escitalopram)

There may be an interaction between Cipralex Meltz (Escitalopram) and any of the following:

• acetylsalicylic acid (ASA)
• alcohol
• amiodarone
• amphetamines (e.g., Dextroamphetamine, Lisdexamfetamine)
• anticoagulants (e.g., Apixaban, clopidogrel, dabigatran, Rivaroxaban, Warfarin)
• antihistamines (e.g., cetirizine, doxylamine, Diphenhydramine, Hydroxyzine, Loratadine)
• antipsychotics (e.g., Chlorpromazine, Clozapine, Haloperidol, Olanzapine, Paliperidone, pimozide, Quetiapine, Risperidone)
• Anagrelide
• Apalutamide
• Asenapine
• barbiturates (e.g., butalbital, pentobarbital, Phenobarbital)
• benzodiazepines (e.g., Alprazolam, Diazepam, Lorazepam)
• Bosentan
• Buserelin
• Buspirone
• chloral hydrate
• chloroquine
• cimetidine
• Clonidine
• Deferasirox
• Desmopressin
• Dextromethorphan
• diabetes medications (e.g., Canagliflozin, chlorpropamide, Glyburide, insulin, Metformin, Rosiglitazone)
• dipyridamole
• Disopyramide
• dofetilide
• Domperidone
• efavirenz
• Entacapone
• Enzalutamide
• ergot alkaloids (e.g., ergotamine, Dihydroergotamine)
• etravirine
• Flecainide
• fluconazole
• Heparin
• herbal products that affect blood clotting (e.g., cat's claw, chamomile, fenugreek, evening primrose, feverfew, garlic, ginger, ginseng, glucosamine, turmeric)
• itraconazole
• ketoconazole
• laxatives
• Lanreotide
• Linezolid
• lithium
• lopinavir
• low molecular weight heparins (e.g., Dalteparin, Enoxaparin, Tinzaparin)
• macrolide antibiotics (e.g., clarithromycin, erythromycin)
• Metoclopramide
• Methadone
• Methylphenidate
• metoclopramide
• Mexiletine
• mifepristone
• Mirtazapine
• Mitotane
• monoamine oxidase inhibitors (M.O.S. e.g., moclobemide, Rasagiline, Selegiline, tranylcypromine, methylene blue)
• multivitamin supplements
• Modafinil
• muscle relaxants (e.g., Baclofen, Cyclobenzaprine, methocarbamol, orphenadrine)
• narcotic pain relievers (e.g., Codeine, Fentanyl, Morphine, Oxycodone)
• nefazodone
• non-steroidal anti-inflammatory medications (NSAIDs; e.g., Diclofenac, ibuprofen, naproxen)
• Obinutuzumab
• Octreotide
• omeprazole
• Pasireotide
• pentamidine
• Pentoxifylline
• procainamide
• Propafenone
• protein kinase inhibitors (e.g., Crizotinib, Nilotinib, Lapatinib, Pazopanib, Sunitinib)
• quinidine
• quinine
• quinolone antibiotics (e.g., ciprofloxacin, Ofloxacin)
• rifampin
• St. John's wort
• saquinavir
• scopolamine
• seizure medications (e.g., Clobazam, Levetiracetam, phenobarbital, Phenytoin, primidone, Topiramate, Valproic acid, zonisamide)
• other selective serotonin reuptake inhibitors (SSRIs; e.g., citalopram, Fluoxetine, Paroxetine, Sertraline)
• serotonin antagonists (anti-emetic medications; e.g., Dolasetron, Granisetron, Ondansetron)
• serotonin/norepinephrine reuptake inhibitors (SNRIs; e.g., Desvenlafaxine, Duloxetine, Venlafaxine)
• siltuximab
• sotalol
• Stiripentol
• sulfonamide antibiotics ("sulfas"; e.g., sulfisoxazole, sulfamethoxazole)
• Tapentadol
• Tetrabenazine
• thiazide diuretics (water pills; e.g., Hydrochlorothiazide, Indapamide, Metolazone)
• Thyroid replacements (e.g., desiccated thyroid, Levothyroxine)
• tipranavir
• Tocilizumab
• tolcapone
• Tramadol
• Trazodone
• tricyclic antidepressants (e.g., Clomipramine, Desipramine, Imipramine)
• triptans (e.g., Naratriptan, Sumatriptan, Zolmitriptan)
• Tryptophan
• vitamin E
• Voriconazole
• Zolpidem
• Zopiclone

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Cipralex Meltz (Escitalopram). Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

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 Meltz (Escitalopram).

Abnormal heart rhythm: Cipralex Meltz (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 Meltz (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 Meltz (Escitalopram) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Cipralex Meltz (Escitalopram), and whether any special monitoring is needed.

Bleeding disorders: Other medications from the same class as Cipralex Meltz (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 Meltz (Escitalopram). If you have Osteoporosis, or are at risk of developing osteoporosis, discuss with your doctor how Cipralex Meltz (Escitalopram) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Cipralex Meltz (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 Meltz (Escitalopram), as it may affect blood sugar control (either increase or decrease blood sugar levels).

Glaucoma: Cipralex Meltz (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 Meltz (Escitalopram) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Cipralex Meltz (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 Meltz (Escitalopram).

Kidney function: If you have severely reduced kidney function, your doctor should closely monitor your condition while you are taking Cipralex Meltz (Escitalopram).

Liver function: Decreased liver function or liver disease may cause Cipralex Meltz (Escitalopram) to build up in the body, causing increased side effects. If you have reduced liver function, discuss with your doctor how Cipralex Meltz (Escitalopram) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Cipralex Meltz (Escitalopram), and whether any special monitoring is needed.

Mania: Cipralex Meltz (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 Meltz (Escitalopram).

Neuroleptic malignant syndrome (NMS): Cipralex Meltz (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 Meltz (Escitalopram). If you develop seizures, stop taking the medication and contact your doctor.

Serotonin syndrome: Severe reactions are possible when Cipralex Meltz (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 Meltz (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 Meltz (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 Meltz (Escitalopram) or when doses are adjusted. People taking Cipralex Meltz (Escitalopram) should be closely monitored by their doctor for emotional and behavioural changes.

Pregnancy: The safe use of Cipralex Meltz (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 Meltz (Escitalopram), contact your doctor immediately.

Breast-feeding: It is known that the medication citalopram, which is similar to Cipralex Meltz (Escitalopram), passes into breast milk. If you are a breast-feeding mother and are taking Cipralex Meltz (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 Meltz (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.

Avoid touching the tablet or take it with dry hands. Place the tablet on your tongue and allow it to melt. Then swallow it with your saliva. This medication is typically used only once a day. However, your pharmacist may have suggested a different schedule that is more appropriate for you. Take it regularly and continuously to maintain its beneficial effects. It is not advisable to stop using this product suddenly, particularly if you have been on it for several weeks. If you are considering stopping the medication, talk to your pharmacist first. If you forget a dose, take it as soon as you remember -- unless it is almost time for your next dose. In that case, skip the missed dose. Do not double the next dose to catch up. This medication may be taken with or without food. Consuming alcohol may intensify the effect of this product. If you choose to drink alcohol, do so in moderation. Talk to your health care professional to find out exactly how much alcohol you can drink.