Lenuxin
Lenuxin: instructions for use and reviews
- 1. Release form and composition
- 2. Pharmacological properties
- 3. Indications for use
- 4. Contraindications
- 5. Method of application and dosage
- 6. Side effects
- 7. Overdose
- 8. Special instructions
- 9. Application during pregnancy and lactation
- 10. Use in childhood
- 11. In case of impaired renal function
- 12. In case of impaired liver function
- 13. Use in the elderly
- 14. Drug interactions
- 15. Analogs
- 16. Terms and conditions of storage
- 17. Terms of dispensing from pharmacies
- 18. Reviews
- 19. Price in pharmacies
Latin name: Lenuxin
ATX code: N06AB10
Active ingredient: escitalopram (escitalopram)
Manufacturer: Gedeon Richter (Poland)
Description and photo update: 2018-21-11
Prices in pharmacies: from 749 rubles.
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Lenuxin is an antidepressant.
Release form and composition
Lenuxin dosage form - film-coated tablets: round, biconvex, white or almost white, engraved "No. 53" (for 5 mg tablets), "No. 54" (for 10 mg tablets) or "No. 56" (for tablets 20 mg) on one side and a line (for tablets 10 and 20 mg) - on the other side (14 or 28 tablets in vials, in a cardboard box 1 vial).
Composition of 1 tablet:
- active substance: escitalopram oxylate - 6.3875 / 12.7750 / 25.55 mg (corresponds to the content of escitalopram - 5/10/20 mg);
- auxiliary components: microcrystalline cellulose, croscarmellose sodium, talc, siliconized microcrystalline cellulose 90, siliconized microcrystalline cellulose HD90, magnesium stearate;
- film shell: opadry II white (hypromellose 6cP, titanium dioxide, lactose monohydrate, macrogol, glycerol triacetate).
Pharmacological properties
Pharmacodynamics
Escitalopram is a selective serotonin reuptake inhibitor (SSRI). Lenuxin increases the concentration of a neurotransmitter in the synaptic chain, prolongs and enhances the effect of serotonin on postsynaptic receptors. Practically does not bind with serotonin, dopamine, histamine, alpha-adrenergic, m-cholinergic receptors and benzodiazepine and opioid receptors.
Lenuxin's effect usually develops within 14-28 days of administration. The maximum antidepressant effect is noted after 90 days.
Pharmacokinetics
The absorption of escitalopram is independent of food intake. Bioavailability is 80%. The maximum plasma concentration is reached in 4 hours. Equilibrium plasma concentration - after 1 week. The average volume of distribution is 12–26 l / kg. Communication with plasma proteins - 56%.
It is metabolized in the liver to active demethylated and didemethylated metabolites. The half-life of escitalopram with regular use is 30 hours. It is excreted mainly by the kidneys, and partly by the liver.
In patients with hepatic insufficiency, the clearance of escitalopram is reduced by 37%, and the half-life is doubled.
With renal failure of moderate severity, the clearance of escitalopram is reduced by 17%. There are no data on its use in severe hepatic impairment.
In patients over 65, excretion of the substance slows down. The area under the concentration-time curve is increased by 50%.
Indications for use
- depression (moderate or severe);
- panic disorder (including agoraphobia);
- social anxiety disorder (social phobia);
- generalized anxiety disorder.
Contraindications
Absolute contraindications:
- deficiency of sucrase / isomaltase, fructose intolerance, glucose-galactose malabsorption;
- co-administration with monoamine oxidase inhibitors (MAO);
- age up to 18 years;
- increased sensitivity to any component of Lenuxin.
Relative contraindications:
- mania, hypomania;
- cardiac ischemia;
- epilepsy (not pharmacologically controlled);
- depression with suicide attempts;
- renal failure with creatinine clearance (CC) ˂ 30 ml / min;
- diabetes;
- cirrhosis of the liver;
- elderly age;
- bleeding tendency.
Instructions for the use of Lenuxin: method and dosage
Lenuxin tablets are taken orally 1 time a day, regardless of food intake.
Recommended dosage:
- depression of moderate and severe severity: 10 mg / day, depending on the patient's individual response, up to 20 mg / day. After the disappearance of symptoms of depression, Lenuxin should be taken for at least another 6 months to consolidate the effect obtained;
- panic disorder (including with agoraphobia): the first week - 5 mg / day, then - 10 mg / day. The maximum dose is 20 mg / day. The duration of treatment is usually several months;
- social anxiety disorder (social phobia): the usual starting dose is 10 mg / day, and may subsequently be increased to 20 mg / day, or reduced to 5 mg / day. The minimum duration of therapy is 12 weeks. In order to prevent the recurrence of the disease, it is possible to carry out a repeated course of therapy for 6 months or longer. Lenuxin is prescribed for differentiated social phobia with ordinary shyness or timidity;
- generalized anxiety disorder: usually the initial dose is 10 mg / day, and can be increased to 20 mg / day, depending on the individual patient's response.
In patients with reduced activity of the isoenzyme CYP2C19, the initial dose of Lenuxin should be reduced to 5 mg / day, followed by an increase to 10 mg / day.
To avoid the onset of a withdrawal syndrome, the dose of the drug should be reduced gradually over 1–2 weeks.
Side effects
- central nervous system (CNS): headache, dizziness, insomnia, drowsiness, weakness, hyperemia, tremor, convulsions, movement disorders, serotonin syndrome (agitation, tremor, hyperemia, myoclonus), hallucinations, confusion, mania, anxiety, panic attacks, depersonalization, increased irritability, visual disturbances;
- cardiovascular system: orthostatic hypotension, changes in the electrocardiogram (ECG) (prolongation of the QT interval, expansion of the QRS complex, changes in the ST segment and the T wave);
- digestive system: nausea, vomiting, diarrhea, impaired taste, dry mouth, decreased or increased appetite, constipation;
- musculoskeletal system: myalgia, arthralgia;
- skin: increased sweating, itching, rash, ecchymosis, purpura, angioedema;
- reproductive system: ejaculation disorder, impotence, menstrual irregularities;
- urinary system: urinary retention;
- metabolic disorders: insufficient secretion of antidiuregic hormone;
- laboratory parameters: changes in laboratory parameters of liver function, hyponatremia;
- other: anaphylactic reactions.
Overdose
Lenuxin overdose symptoms: dizziness, agitation, tremor, drowsiness, clouding of consciousness, convulsions, tachycardia, lengthening of the QT interval, expansion of the QRS complex, changes in the ST segment and T wave on the ECG, arrhythmia, vomiting, respiratory depression, rhabdomyolysis, hypokalemic acidosis. Taking escitalopram at a dose of 400–800 mg did not cause severe symptoms. Cases of coma and deaths in case of its overdose, as a rule, are associated with a simultaneous overdose of other drugs.
Recommended treatment: gastric lavage, provision of adequate oxygenation, symptomatic supportive care. The functions of the cardiovascular and respiratory systems should be monitored. There is no specific antidote.
special instructions
When treating with antidepressants, especially at the initial stage, patients need to be monitored for the possibility of deterioration or the appearance of suicidal thoughts and behavior.
In patients under the age of 24, taking antidepressants increases the risk of suicidal thoughts and intentions. In this connection, before prescribing Lenuxin, the risk of suicide and the benefits of using the drug should be correlated. In the case of using the drug, this group of patients needs careful observation in order to detect early suicidal tendencies.
In patients with panic disorder, at the beginning of SSRIs, an increase in anxiety is possible, usually this effect disappears within 1–2 weeks of therapy. To reduce the risk of anxiogenic effect, it is recommended to use lower doses of Lenuxin at the beginning of treatment.
Patients with controlled seizures should be closely monitored when taking SSRIs. If the frequency of seizures increases, the drug should be discontinued.
During the first few weeks of taking escitalopram, there is a risk of developing akathisia (anxiety, hyperactivity, inability to sit or stand in one place); if these symptoms appear, the dose should not be increased.
If a manic state develops in patients with a history of mania or hypomania, it is recommended to cancel Lenuxin.
In diabetes mellitus, it may be necessary to adjust the dose of insulin or oral hypoglycemic drugs due to changes in blood glucose levels during therapy with Lenuxin.
Patients at risk of developing hyponatremia (elderly, patients with cirrhosis of the liver, taking drugs that can cause hyponatremia), escitalopram should be prescribed with caution.
Taking escitalopram can cause skin hemorrhages (ecchymosis, purpura).
The experience of taking Lenuxin in combination with electroconvulsive therapy is limited, and therefore caution is required in these cases.
Influence on the ability to drive vehicles and complex mechanisms
During the period of taking escitalopram, you should refrain from performing potentially hazardous activities that require the speed of psychomotor reactions, including from driving and other complex mechanisms.
Application during pregnancy and lactation
According to the instructions, Lenuxin is not prescribed during pregnancy and lactation due to the lack of data on the safety and effectiveness of its use.
Pediatric use
Due to the lack of data on the safety and efficacy of Lenuxin in children and adolescents under 18 years of age, the drug is not used in pediatrics.
With impaired renal function
In case of moderate renal failure, dose adjustment of the drug is not required. In severe renal failure (creatinine clearance ˂ 30 ml / min) Lenuxin is used with caution.
If liver function is impaired
With mild to moderate liver failure, treatment should be started with a dose of 5 mg / day, after 2 weeks it can be increased to 10 mg / day.
Patients with severe hepatic impairment should be careful when titrating the Lenuxin dose.
Use in the elderly
Elderly patients are advised to reduce the dose of the drug by half. The maximum daily dose of Lenuxin for them is 10 mg.
Drug interactions
Co-administration of escitalopram and MAO inhibitors is contraindicated in connection with the risk of developing serotonin syndrome. After taking irreversible MAO inhibitors, Lenuxin is prescribed no earlier than 14 days, reversible - no earlier than 1 day. After taking escitalopram, non-selective MAO inhibitors are allowed to be used no earlier than 7 days later.
Interaction with other substances / preparations:
- serotonergic drugs (tramadol, sumatriptan, other triptans): risk of developing serotonin syndrome;
- drugs that lower the seizure threshold: caution should be exercised due to the risk of an excessive decrease in the seizure threshold;
- lithium, tryptophan: it is possible to enhance the action of escitalopram;
- St. John's wort: risk of increased side effects;
- anticoagulants and other drugs that affect blood clotting: the risk of a blood clotting disorder, and therefore requires regular monitoring;
- omeprazole (30 mg): the plasma concentration of escitalopram increases by 50%, and therefore may require a decrease in its dose;
- cimetidine (400 mg 2 times a day): the plasma concentration of escitalopram increases by 70%, which may require a decrease in its dose;
- drugs metabolized by the CYP2D6 isoenzyme and having a low therapeutic index, for example, flecainide, propafenone, metoprolol (for heart failure) or acting on the central nervous system (desipramine, clomipramine, thioridazine, haloperidol, and others): care should be taken when taken together with escitalopram a correction of their dose will be required (escitalopram in combination with desipramine or metoprolol leads to an increase in their serum concentration by 2 times);
- drugs metabolized by the isoenzyme CYP2C19: care should be taken when they are taken together.
Analogs
Lenuxin's analogs are Miaser, Heptral, Heptor, Prodep, Citalopram, Paroxetine, Trittiko, Spitomin, Tsipralex.
Terms and conditions of storage
Store away from light, at a temperature not exceeding 30 ° C. Keep out of the reach of children.
Shelf life is 2 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Lenuksin
Reviews about Lenuksin are mostly positive. Patients using the drug as prescribed by a doctor note an improvement in their general condition, absence of seizures, and normalization of sleep. Also, subject to long-term therapy, it is reported about a fairly long-term effect of Lenuxin after the completion of the course.
Lenuxin price in pharmacies
Estimated price for Lenuxin, 10 mg tablets, 28 pcs. - 670 rubles.
Lenuxin: prices in online pharmacies
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Drug name Price Pharmacy |
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Lenuxin 10 mg film-coated tablets 28 pcs. 749 RUB Buy |
Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
