Cipramil 20mg pills №28

Indications

- Depression of various etiologies and structures (in adults);

- panic disorders with / without agoraphobia;

- obsessive compulsive disorder (OCD).

Dosing regimen

The drug is prescribed 1 time / day.

At depressed the drug is prescribed at a dose of 20 mg / day. Depending on the individual response of the patient and the severity of depression, the dose may be increased to a maximum of 60 mg / day.

At panic disorders during the first week of treatment, the recommended dose is 10 mg / day, then the dose is increased to 20 mg / day. Depending on the patient's individual response to the drug, the daily dose may be further increased. The maximum dose is 60 mg / day.

At obsessive compulsive disorders The initial dose of the drug is 20 mg / day. If necessary, the dose may be increased. The maximum dose is 60 mg / day.

Have elderly patients The recommended dose is 20 mg / day. Depending on the individual response and the severity of depression, the dose may be increased to a maximum of 40 mg / day.

Patients with severe impaired liver function the drug is prescribed in the minimum recommended doses. Tsipramil can be taken regardless of the meal, at any time of the day.

Adverse Effects

Gastrointestinal: dry mouth, nausea, diarrhea.

From the side of the central nervous system: drowsiness, tremor, weakness, agitation, insomnia; in exceptional cases, convulsive seizures (when using the drug in high doses).

Cardiovascular: perhaps a slight decrease in heart rate, which usually has no clinical significance. However, in patients with initially low heart rate, the drug may cause bradycardia.

Other: increased sweating, sexual dysfunction. It is extremely rare that hyponatremia, manifestations of serotonin syndrome, withdrawal syndrome, extrapyramidal disorders, purpura can occur.

Side effects are usually transient in nature and weakly expressed. They are observed mainly during the first 2 weeks of treatment and usually decrease significantly as the patient's condition improves.

Contraindications

- Hypersensitivity to the drug.

Use during pregnancy and lactation

The safety of Tsipramil during pregnancy and lactation has not been established. Use of the drug is justified only in cases where the potential benefits of therapy for the mother outweighs the possible risk to the fetus and child.

AT experimental studies no teratogenic effect and no effect of Tsipramil on the reproductive function and perinatal development of the fetus.

Special notes

Tsipramil, as well as other selective serotonin reuptake inhibitors, should not be prescribed against the background of the use of MAO inhibitors, as well as within 14 days after discontinuation of their intake. Treatment with MAO inhibitors can be started 7 days after discontinuing Tsipramil.

With moderate renal impairment, dosing regimen adjustment is not required.

With the inversion of the phase of depression and the development of the manic state, Tsipramil should be canceled.

Influence on ability to drive motor transport and control mechanisms

Tsipramil does not reduce the ability to think and the speed of psychomotor reactions. However, it should be borne in mind that patients with depression often have a decrease in their ability to concentrate, which can be aggravated with the use of psychotropic drugs. Considering this, when prescribing Tsipramil for depression, the patient should be warned about a possible decrease in the ability to concentrate and the speed of psychomotor reactions while driving a car and working with mechanisms.

Overdosage

Symptoms: drowsiness, coma, articulation disorders, episodically - large convulsive seizures (grand mal), sinus tachycardia, sometimes nodal rhythm, increased sweating, nausea, vomiting, cyanosis, hyperventilation of the lungs. The clinical picture is not characteristic.

Treatment: It is necessary to wash the stomach as soon as possible after taking the drug. Conduct symptomatic and supportive therapy. Monitoring of the patient’s condition is recommended. There is no specific antidote.

Drug interactions

With simultaneous use of Tsipramil and MAO inhibitors, the development of a hypertensive crisis (serotonin syndrome) is possible.

When combined, cimetidine causes a moderate increase in the average equilibrium concentration of citalopram in the blood (therefore, it is necessary to carefully prescribe Cipramil in maximum doses while taking high doses of cimetidine).

No clinically significant pharmacokinetic interaction of Tsipramil with phenothiazines and tricyclic antidepressants was detected.

In clinical studies, pharmacodynamic interactions of Tsipramil and at the same time used benzodiazepines, neuroleptics, analgesics, lithium preparations, antihypertensive drugs, antihistamine drugs, beta-blockers and other cardiotropic drugs were not detected.

No interaction of Tsipramil with ethanol was detected.

The effects of Sumatriptan and other serotonergic drugs may be enhanced by citalopram.

Storage conditions

List B. The drug should be stored at a temperature not exceeding 30 ° C.