Acipe
Acipey: 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. For violations of 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: ACP
ATX code: N06AB10
Active ingredient: escitalopram (escitalopram)
Manufacturer: Veropharm (Russia)
Description and photo update: 2018-21-11
Prices in pharmacies: from 546 rubles.
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Acipey is an antidepressant.
Release form and composition
The dosage form of Acipey is film-coated tablets: round, biconvex, white, at a dosage of 5 mg - without risks, at a dosage of 10 and 20 mg - with a risk (7 or 14 tablets in a blister strip, in a cardboard box 1 or 2 packs of 7 tablets, or 2 or 4 packs of 14 tablets; 14 or 28 tablets in a jar, in a cardboard box 1 jar).
Composition of 1 film-coated tablet:
- active substance: escitalopram oxalate - 6.39 / 12.77 / 25.54 mg, which corresponds to escitalopram - 5/10/20 mg;
- auxiliary components: croscarmellose sodium, salting SMCC 90 (microcrystalline cellulose, colloidal silicon dioxide), magnesium stearate, talc;
- film shell: opadray II white (hypromellose, lactose monohydrate, macrogol, titanium dioxide).
Pharmacological properties
Pharmacodynamics
Escitalopram is an antidepressant, selective serotonin reuptake inhibitor (SSRI). The substance increases the concentration of serotonin in the synaptic cleft, prolongs and enhances its effect on postsynaptic receptors. The relationship of escitalopram with 5-HT 1A -, 5-HT 2 -receptors, dopamine D 1 - and D 2 -receptors, α 1 -, α 2 -, β-adrenergic receptors, histamine H 1 -receptors, muscarinic cholinergic, benzodiazepine and opioid receptors are very weak or absent.
The effect of the drug is achieved within 2-4 weeks of its use. Within 3 months, the maximum therapeutic effect occurs in the treatment of panic disorders.
Pharmacokinetics
The absorption of escitalopram is independent of food intake. Bioavailability is 80%. The maximum plasma concentration is reached in 4 hours. Escitalopram has linear kinetics. The time to reach equilibrium concentration is 7 days. The connection with proteins is below 80%. The apparent volume of distribution is 12–26 l / kg.
Escitalopram metabolism occurs in the liver with the formation of active demethylated and didemethylated metabolites. In individuals with weak activity of the isoenzyme CYP2C19, the concentration of escitalopram can be 2 times higher than in individuals with high activity of this isoenzyme.
The half-life with regular use of Acipey is 30 hours. It is excreted mainly by the kidneys and liver.
In patients over 65 years of age, the half-life and the area under the concentration-time curve increase.
Indications for use
- depressive episodes;
- panic disorder (including agoraphobia);
- obsessive-compulsive disorder.
Contraindications
Absolute:
- lactase deficiency, lactose intolerance, glucose-galactose malabsorption;
- co-administration with monoamine oxidase inhibitors (MAO);
- unstable epilepsy;
- age up to 18 years;
- pregnancy, lactation period;
- increased sensitivity to the components of the drug.
Relative (Aysipe is used with caution):
- epilepsy with controlled seizures (if the frequency of seizures increases, the drug should be discontinued);
- mania / hypomania (history);
- a tendency to bleeding or joint administration of anticoagulants.
Instructions for use of Acipey: method and dosage
Acipey tablets are taken orally, once a day, regardless of food intake.
Recommended dosage:
- depressive episodes: 10 mg / day. The maximum dose is 20 mg / day. After the disappearance of the symptoms of the disease, therapy is continued for at least 6 months in order to prevent relapse;
- panic disorder (including agoraphobia): the initial dose is 5 mg / day, after a week the dose is increased to 10 mg / day. The maximum dose is 20 mg / day. The duration of therapy is several months;
- obsessive-compulsive disorder: 10 mg / day. It is possible to increase the dose to 20 mg / day. The duration of treatment should be at least 6 months, to prevent relapse of the disease - 12 months.
In patients with reduced activity of cytochrome P 450 2C19, the dose of Acipey during the first 2 weeks of therapy should be 5 mg / day and then can be increased to 10 mg / day.
For the abolition of Acipey, it is recommended to gradually reduce its dose over 7-14 days in order to avoid the onset of withdrawal syndrome (headaches, dizziness, nausea).
Side effects
- central nervous system: weakness, dizziness, drowsiness, insomnia, tremors, convulsions, movement disorders, serotonin syndrome (tremor, agitation, myoclonus, hyperthermia), visual disturbances;
- psyche: mania, confusion, anxiety, irritability, agitation, hallucinations, depersonalization, panic attacks;
- respiratory system: yawning, sinusitis;
- digestive system: nausea, vomiting, dry mouth, taste disturbances, loss of appetite, diarrhea, constipation;
- cardiovascular system: orthostatic hypotension;
- endocrine system: decreased secretion of antidiuretic hormone (ADH);
- genitourinary system: urinary retention;
- organs of vision: visual impairment;
- reproductive system: decreased libido, galactorrhea, impotence, anorgasmia (in women), ejaculation disorder;
- skin: skin rash, itching, purpura, ecchymosis, angioedema, increased sweating;
- laboratory parameters: hyponatremia (reversible), changes in liver function indicators.
In addition, hyperthermia and anaphylactic reactions are possible.
Overdose
Overdose symptoms of Acipey: dizziness, tremor, drowsiness, agitation, blurred consciousness, seizures, arrhythmia, tachycardia, changes in the electrocardiogram (ECG) (ST-T change, QRS complex expansion, QT interval prolongation), respiratory depression, vomiting, metabolic acid rhabdomyolysis, hypokalemia.
There is no specific antidote. Gastric lavage, provision of adequate oxygenation, symptomatic treatment aimed at maintaining the cardiovascular and respiratory systems are recommended.
special instructions
During therapy, it is recommended to refrain from drinking alcohol.
In patients with panic disorder, treatment with Acipey should be started with low initial doses to reduce the risk of increased anxiety, which usually subsides within 2 weeks of taking the drug.
With the development of a manic state in patients with a history of mania / hypomania, the drug should be discontinued.
Escitalopram is able to affect blood glucose levels in patients with diabetes mellitus, and therefore may require dose adjustment of hypoglycemic drugs.
When using antidepressants, especially at the beginning of therapy, patients need careful monitoring due to the risk of suicidal behavior.
Influence on the ability to drive vehicles and complex mechanisms
At the time of taking Acipey, you should refrain from driving vehicles and other complex mechanisms that require the speed of psychomotor reactions.
Application during pregnancy and lactation
Acipey is contraindicated during pregnancy and lactation.
In newborns whose mothers took SSRIs until childbirth, the following disorders were noted, indicating possible serotonergic effects or withdrawal syndrome: tremor, irritability, poor sleep, increased muscle tone, hypertension, constant crying, and difficulty sucking.
If Asipey has been used during pregnancy, it should not be stopped abruptly.
Pediatric use
According to the instructions, Acipey is not used in pediatrics due to the risk of suicidal behavior and hostility. If, nevertheless, a decision is made to start therapy, the patient should be closely monitored.
With impaired renal function
With mild to moderate renal impairment, dose adjustment is not required. In case of severe renal failure (creatinine clearance ˂ 30 ml / min), Acipe should be used with caution.
For violations of liver function
In patients with impaired liver function, the recommended initial dose of the drug for 14 days is 5 mg / day. If necessary, it can be increased to 10 mg / day. Titration of the Acipey dose in patients with severe hepatic impairment should be performed with caution.
Use in the elderly
Patients over 65 are advised to reduce the dose of Acipey by half.
Drug interactions
Due to the risk of developing serotonin syndrome, Acipey should not be taken within 2 weeks after discontinuation of therapy with irreversible monoamine oxidase (MAO) inhibitors and within 24 hours after discontinuation of reversible MAO inhibitors. After discontinuation of escitalopram, non-selective MAO inhibitors are prescribed no earlier than 7 days later.
Also, the risk of developing serotonin syndrome exists with the joint administration of escitalopram and serotonergic drugs (tramadol, sumatriptan and other triptans).
Possible interactions of escitalopram with other drugs:
- drugs that lower the seizure threshold: the risk of seizures increases;
- tryptophan, lithium preparations: their effect is enhanced;
- St. John's wort preparations: their toxicity increases;
- oral anticoagulants, drugs that affect blood clotting: risk of bleeding disorders;
- desipramine, metoprolol: their concentration in plasma increases 2 times;
- drugs metabolized with the participation of the CYP2C19 system (including omeprazole, esomeprazole, fluvoxamine, lansoprazole, ticlopidine), cimetidine, CYP3A4 and CYP2D6 inhibitors: increase the plasma concentration of escitalopram.
Analogs
The analogues of Eisipe are: Lenuxin, Miracitol, Sancipam, Selektra, Tsipralex, Elicea, Escitalopram.
Terms and conditions of storage
Store at a temperature not exceeding 25 ° C. Keep out of the reach of children.
Shelf life is 2 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Acipey
Reviews of Acipey on the network are extremely few and mostly positive, showing the effectiveness of the drug.
Price for Acipey in pharmacies
Estimated price for Acipey (10 mg tablets, 28 pcs.) - 380 rubles.
Acipey: prices in online pharmacies
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Drug name Price Pharmacy |
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Acipey 10 mg film-coated tablets 28 pcs. 546 r 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!
